OBJECTIVE: This study compared the results of the caloric test with those of the video head impulse test obtained during the same session and evaluated whether the former can be used to screen for non-acute vestibular dysfunction. METHODS: A total of 157 participants complaining of dizziness with vestibular characteristics of varying durations and clinical courses completed the caloric test and video head impulse test. RESULTS: Significantly more caloric test results than video head impulse test results were abnormal. CONCLUSIONS: The results of the caloric test and video head impulse test are distinct but complement each other. Within our sample, the caloric test was more sensitive for vestibular dysfunction. Therefore, the video head impulse test is not a suitable screening tool of the vestibular system in patients with chronic complaints.

Abstract Introduction Cervical pain contributes to postural deviations and imbalance. Nanotechnology may be used for the treatment of neck pain by fixing to the skin small rounds silicone patches containing double spiral carbon nanotubes arranged in the form of a coil (Helical), which would then relieve dizziness caused by muscular contraction. Objective The objective of this study is to Evaluate pain and dizziness scores before and after Helical patches effect on cervicogenic dizziness treatment. Methods The selected patients should have neck pain arising from muscle contraction with loss of balance or instability lasting more than 90 days and normal electrooculography. Treatment consisted of placing 10 Helical patches distributed as follows: two in the upper cervical area, two in the lower cervical area (near the 5th and 6th vertebrae), two in the upper trapezius muscle area (between neck and shoulder), and four in the tender point area (as reported by the patient). Using a Visual Analogue Scale (VAS), we matched pain and dizziness scores from Day 1 to those from Day 15 and Day 30 using Mann-Whitney test. Results There was a significant difference between pain score reported on Day 1 and Day 15 (Z = 2.43, U = 5, p = 0.01). We also found significant differences between dizziness scores reportedondays1 and15 (Z = 2.62, U = 3.5, p = 0.01) and days 1 and 30 (Z = 2.36, U = 5.5, p = 0.01). Conclusion The Helical patches seem to be an effective treatment for cervicogenic dizziness.

RESUMO INTRODUÇÃO: Alguns pacientes com déficit severo do equilíbrio corporal submetidos à reabilitação vestibular (RV) podem não apresentar resultados satisfatórios. OBJETIVO: Verificar a eficácia do equipamento de biofeedback Vertiguard(tm) como substituto sensorial do sistema vestibular em pacientes sem bons resultados à RV. MÉTODO: Estudo prospectivo clínico randomizado. Treze pacientes sem resposta satisfatória à RV convencional foram randomizados entre grupo de estudo (GE), que utilizou o estímulo vibratório do Vertiguard(tm) por dez dias e grupo controle (GC) que usou o equipamento desligado. Para avaliação pré e pós-tratamento foi utilizado o protocolo Teste de Integração Sensorial (TIS) da Posturografia Dinâmica Computadorizada (PDC) e duas escalas de autopercepção do equilíbrio: ABC (Activities-specific Balance Confidence) e DHI (Dizziness Handicap Inventory). RESULTADOS: Apenas o GE apresentou melhora estatisticamente significante em C5 (p = 0,007) e C6 (p = 0,01) da PDC após treinamento. Na escala ABC houve diferença significante no GE (p = 0,04). No DHI ocorreu diferença significante no aspecto físico em ambos os grupos e no aspecto funcional (p= 0,04) apenas no GE. CONCLUSÃO: O estímulo de substituição sensorial do Vertiguard(tm) auxiliou a integração das redes neurais e na manutenção da postura, melhorando as estratégias utilizadas na recuperação do equilíbrio corporal.

ABSTRACT INTRODUCTION: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR). OBJECTIVE: To evaluate the effectiveness of Vertiguard(tm) biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR. METHODS: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard(tm) for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used. RESULTS: After treatment, only the SG showed statistically significant improvement in C5 (p = 0.007) and C6 (p = 0.01). On the ABC scale, there was a significant difference in the SG (p= 0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p = 0.04). CONCLUSION: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard(tm) system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.