Hareket hastalığında video baş savurma testi, supresyon baş savurma paradigması ve fonksiyonel baş savurma testi sonuçlarının değerlendirilmesi
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Tarih
2023
Yazarlar
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Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızın amacı, hareket hastalığına (HH) duyarlı olan ve duyarlı olmayan kişilerde VHIT, SHIMP ve FHIT testleriyle VOR kazancı, doğru cevap yüzdesi ve sakkad parametrelerini objektif olarak ve baş dönmesi engellilik envanteri (BDEE) ve durumluluk-sürekli kaygı envanteri (DSKE) ile baş dönmesi engellilik düzeyi ve durumluk-sürekli kaygı düzeylerini subjektif olarak değerlendirmek ve bu sonuçları iki grup arasında karşılaştırmaktır. Gereç ve Yöntem: Çalışmada 18-65 yaş aralığında, hareket hastalığı haricinde baş dönmesi, dengesizlik şikâyeti olmayan, saf ses işitme eşikleri, timpanometri test sonuçları normal elde edilen 30 kişi deney grubunda; gönüllü olmayı kabul eden, baş dönmesi, dengesizlik şikâyeti ve başka bir sağlık problemi olmayan 30 kişi kontrol grubunda yer almıştır. Katılımcılara VHIT, SHIMP ve FHIT testleri uygulanmıştır. Hareket hastalığı duyarlılık ölçeği'nde (HHDÖ) 0 puan alan sağlıklı kişilerden kontrol grubu oluşturulmuştur. Ayrıca baş dönmesi engellilik envanteri (BDEE) ve durumluk-sürekli kaygı envanteri (DSKE) doldurtulmuştur. Olgu rapor formu (ORF) ile katılımcıların kişisel bilgileri, taşıtta seyahat durumları, hastalık öyküsü ve genel sağlıkları değerlendirilmiştir. Cinsiyet, yaş, VOR kazancı, doğru cevap yüzdesi ve sakkadların amplitüd, tepe hızı, latans parametreleri; baş dönmesi engellilik ve kaygı düzeyleri istatistiksel olarak değerlendirilmiştir. Verilerin analizleri SPSS 25 programı ile gerçekleştirilmiştir. Değişkenlerde normal dağılım sağlanmadığı için parametrik olmayan test yöntemlerinden ki-kare (?2), Mann Whitney Testi ve Kruskal Wallis ile analiz yapılmıştır. Değişkenler arasındaki ilişkilerin kontrolünde Spearman Sıra Korelasyon Katsayısı kullanılmıştır. Anlamlılık düzeyi p<0.05 değerler kabul edilmiştir. Bulgular: Çalışmamızda HHDÖ yaş grupları arasında istatiksel olarak anlamlı farklılık elde edilmemiştir. Deney grubundaki HHDÖ puanlarında kadınların ortalama puanı erkeklerden fazladır ancak istatiksel olarak anlamlı farklılık bulunmamıştır. Hareket hastalığı bulunan kişilerin %50'sinde ailede taşıt tutma şikâyeti bulunmuştur. Durumluk ve sürekli kaygı envanterinde gruplar arasında istatiksel olarak anlamlı farklılık elde edilmiştir. BDEE toplam ve emosyonel, fonksiyonel ve fiziksel alt ölçek skorlarında gruplar arasında istatiksel olarak anlamlı fark bulunmuştur. VHIT ve SHIMP VOR kazanç değerlerinde deney ve kontrol grubu arasında istatistiksel olarak anlamlı farklılık saptanmamıştır. İki grup arasındaki VHIT VOR kazanç değerleri ortalamasında istatistiksel olarak anlamlı bir fark elde edilmemiştir. VHIT lateral ve SHIMP 1. sakkad parametrelerinde gruplar arasında anlamlı bir farklılık bulunmamıştır. Deney grubunda kontrol grubuna göre daha çok sakkad oluştuğu gözlenmiştir. Hareket hastalığına olan duyarlılık arttıkça VHIT sakkad latanslarında kısalma, SHIMP sakkad latanslarında uzama olduğu gözlenmiştir. FHIT sol anterior (LA) ve RA toplam DCY, RP toplam DCY değerleri deney grubunda kontrol grubuna göre anlamlı derecede daha düşük saptanmıştır. Optokinetik uyaranlı fHIT (fHIT-opk) lateral sağ ortalama DCY değerlerinde deney ve kontrol grubu arasında istatistiksel olarak anlamlı farklılık bulunmuştur. Sonuç: Çalışmamızda elde edilen sonuçlarda, hareket hastalığı tanısında VHIT ve SHIMP testlerine göre fHIT'in daha çok anormallik saptadığı ve klinik uygulamalarda kullanılmasının avantajlı olacağı düşünülmektedir. VOR kazançlarının yanı sıra sakkad parametrelerinin incelenmesi subjektif testlerle beraber kullanılarak tanıda önemli olabilir. Bu çalışma ile, hareket hastalığı olan kişilerde vestibüler sistem ve kaygı bozukluklarına ilişkin çeşitli vestibüler hastalıklarda yapılacak çalışmalarda karşılaştırma yapılması açısından önemli bilgiler sağlayacağına inanıyoruz. İleride yapılacak çalışmalarda uyaranların türü ve şiddeti, ulaşım türleri, uyarıya maruz kalma sıklığı ve alışılma derecesi gibi faktörlerin gruplandırılıp hasta sayısının arttırılarak katılımcıların daha küçük yaş aralıklarında karşılaştırmasının hareket hastalığı için önemli olacağını düşünüyoruz.
Objective: The aim of our study was to objectively evaluate VOR gain, correct answer percentage and saccade parameters with VHIT, SHIMP and FHIT tests in motion sickness (HH) susceptible and non susceptible individuals, and to evaluate the disability level and state-trait anxiety levels subjectively with dizziness handicap inventory (BDEE) and state-trait anxiety inventory (STAI) and to compare these results between the two groups. Materials and Methods: In the study, 30 people between the ages of 18-65, who did not have dizziness or imbalance except for motion sickness, and whose pure tone hearing thresholds and tympanometry test results were normal, were in the experimental group; Thirty people who agreed to volunteer and had no complaints of dizziness, imbalance or any other health problem were included in the control group. VHIT, SHIMP and FHIT tests were applied to the participants. In addition, motion sickness sensitivity scale, dizziness disability inventory (DHI) and state-trait anxiety inventory (STAI) were completed. The case report form was used to assess the participants' personal information, travelling status, disease history and general health. Gender, age, VOR gain, percentage of correct responses, amplitude, peak velocity, latency parameters of saccades, dizziness disability and anxiety levels were statistically evaluated. Data analyses were performed with SPSS 25 software. Since the variables were not normally distributed, nonparametric test methods such as chi-square (?2), Mann Whitney Test and Kruskal Wallis were used for analyses. Spearman's Rank Correlation Coefficient was used to control the relationships between variables. Significance level p<0.05 values were accepted. Results: In our study, no statistically significant difference was found between the age groups of the MSSQ. In the patient group, the mean score of women was higher than that of men, but no statistically significant difference was found. In 50% of the patients with motion sickness, there was a family history of motion sickness. Statistically significant differences were found between the groups in state and trait anxiety inventory. Statistically significant differences were found between the groups in DHI total and emotional, functional and physical subscale scores. There was no statistically significant difference between the patient and control groups in VHIT and SHIMP VOR gain values. There was no statistically significant difference in the mean of VHIT VOR gain values between the two groups. VHIT lateral and SHIMP 1st saccade parameters showed no significant difference between the groups. It was observed that more saccades occurred in the patient group compared to the control group. As the sensitivity to motion sickness increased, shortening in VHIT saccade latencies and prolongation in SHIMP saccade latencies were observed. fHIT left anterior (LA) and RA total CA% and RP total CA% values were found to be significantly lower in the experimental group than in the control group. A statistically significant difference was found between the experimental and control groups in optokinetic stimulus fHIT (fHIT-opk) right lateral semisircular canal total CA% values. Conclusion: The results obtained in our study suggest that FHIT detects more abnormalities than VHIT and SHIMP tests in the diagnosis of movement disorders and its use in clinical applications would be advantageous. Examination of saccade parameters as well as VOR gains may be important in the diagnosis by using it together with subjective tests. We believe that this study will provide important information about the vestibular system and anxiety disorders in people with movement disorders for comparison in studies to be conducted in various vestibular diseases. We think that it will be important for motion sickness to compare the participants in younger age ranges by increasing the number of patients by considering parameters such as the type and severity of stimuli, the type of transportation, the frequency of exposure to stimuli and the degree of habituation in future studies.
Objective: The aim of our study was to objectively evaluate VOR gain, correct answer percentage and saccade parameters with VHIT, SHIMP and FHIT tests in motion sickness (HH) susceptible and non susceptible individuals, and to evaluate the disability level and state-trait anxiety levels subjectively with dizziness handicap inventory (BDEE) and state-trait anxiety inventory (STAI) and to compare these results between the two groups. Materials and Methods: In the study, 30 people between the ages of 18-65, who did not have dizziness or imbalance except for motion sickness, and whose pure tone hearing thresholds and tympanometry test results were normal, were in the experimental group; Thirty people who agreed to volunteer and had no complaints of dizziness, imbalance or any other health problem were included in the control group. VHIT, SHIMP and FHIT tests were applied to the participants. In addition, motion sickness sensitivity scale, dizziness disability inventory (DHI) and state-trait anxiety inventory (STAI) were completed. The case report form was used to assess the participants' personal information, travelling status, disease history and general health. Gender, age, VOR gain, percentage of correct responses, amplitude, peak velocity, latency parameters of saccades, dizziness disability and anxiety levels were statistically evaluated. Data analyses were performed with SPSS 25 software. Since the variables were not normally distributed, nonparametric test methods such as chi-square (?2), Mann Whitney Test and Kruskal Wallis were used for analyses. Spearman's Rank Correlation Coefficient was used to control the relationships between variables. Significance level p<0.05 values were accepted. Results: In our study, no statistically significant difference was found between the age groups of the MSSQ. In the patient group, the mean score of women was higher than that of men, but no statistically significant difference was found. In 50% of the patients with motion sickness, there was a family history of motion sickness. Statistically significant differences were found between the groups in state and trait anxiety inventory. Statistically significant differences were found between the groups in DHI total and emotional, functional and physical subscale scores. There was no statistically significant difference between the patient and control groups in VHIT and SHIMP VOR gain values. There was no statistically significant difference in the mean of VHIT VOR gain values between the two groups. VHIT lateral and SHIMP 1st saccade parameters showed no significant difference between the groups. It was observed that more saccades occurred in the patient group compared to the control group. As the sensitivity to motion sickness increased, shortening in VHIT saccade latencies and prolongation in SHIMP saccade latencies were observed. fHIT left anterior (LA) and RA total CA% and RP total CA% values were found to be significantly lower in the experimental group than in the control group. A statistically significant difference was found between the experimental and control groups in optokinetic stimulus fHIT (fHIT-opk) right lateral semisircular canal total CA% values. Conclusion: The results obtained in our study suggest that FHIT detects more abnormalities than VHIT and SHIMP tests in the diagnosis of movement disorders and its use in clinical applications would be advantageous. Examination of saccade parameters as well as VOR gains may be important in the diagnosis by using it together with subjective tests. We believe that this study will provide important information about the vestibular system and anxiety disorders in people with movement disorders for comparison in studies to be conducted in various vestibular diseases. We think that it will be important for motion sickness to compare the participants in younger age ranges by increasing the number of patients by considering parameters such as the type and severity of stimuli, the type of transportation, the frequency of exposure to stimuli and the degree of habituation in future studies.
Açıklama
Anahtar Kelimeler
Kulak Burun ve Boğaz, Otorhinolaryngology (Ear-Nose-Throat), Hareket Hastalığı, VHIT, SHIMP, FHIT, Sakkad, Kaygı, Motion sickness, VHIT, SHIMP, FHIT, Saccade, Anxiety
