Additional Information
Book Details
Abstract
Get a quick, expert overview of dizziness and vertigo from childhood through old age with this concise, practical resource. Drs. Bradley W. Kesser and Tucker Gleason have assembled a leading team of experts to address timely clinical topics of interest to otolarynologists and other health care providers who see patients with these common problems.
- Covers key topics such as the clinical exam and diagnostic techniques, assessment and differential diagnosis in the pediatric population, dizziness and vertigo in the adolescent and the elderly, evaluation of dizziness in the litigating patient, vHIT, positional vertigo in all age groups, vestibular neuritis, migraine-associated vertigo, Meniere’s disease, medication-related dizziness in the older adult, and more.
- Includes information on dizziness demographics and population health, as well as development of the vestibular system and balance function.
- Consolidates today’s available information and experience in this important area into one convenient resource.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Dizziness and Vertigo Across the Lifespan | i | ||
| Dizziness and Vertigo Across the Lifespan | iii | ||
| Copyright | iv | ||
| List of Contributors | v | ||
| Preface | ix | ||
| Contents | xi | ||
| I - INTRODUCTION TO DIZZINESS | 1 | ||
| 1 - Dizziness Demographics and Population Health | 1 | ||
| DEFINITIONS OF DIZZINESS, IMBALANCE, AND PRESBYVESTIBULOPATHY | 1 | ||
| EPIDEMIOLOGY OF DIZZINESS, IMBALANCE, AND PRESBYVESTIBULOPATHY | 2 | ||
| Prevalence | 2 | ||
| Risk Factors | 3 | ||
| IMPACTS OF DIZZINESS, IMBALANCE, AND PRESBYVESTIBULOPATHY | 3 | ||
| Falls | 4 | ||
| Quality of Life | 4 | ||
| Activities of Daily Living | 4 | ||
| Healthcare Utilization | 4 | ||
| Presbyvestibulopathy and Cognitive Decline | 5 | ||
| CONCLUSION | 5 | ||
| REFERENCES | 6 | ||
| 2 - Technological Advances in Testing the Dizzy Patient: The Bedside Examination Is Still the Key to Successful Diagnosis | 9 | ||
| INTRODUCTION | 9 | ||
| PHYSIOLOGIC PRINCIPLES FOR VESTIBULAR EXAMINATION | 9 | ||
| VESTIBULAR EXAMINATION IN ACUTE-ONSET DIZZINESS, VERTIGO, AND IMBALANCE | 11 | ||
| Vestibulo-ocular Examination | 11 | ||
| rHead impulse test, evaluation of nystagmus, and test of skew deviation | 11 | ||
| Peripheral versus central nystagmus (Table 2.2) | 12 | ||
| Head impulse test | 14 | ||
| Test of skew deviation | 14 | ||
| HINTS plus hearing loss | 14 | ||
| Vestibulo-ocular Examination and Video-oculography | 14 | ||
| Balance and Gait Evaluation | 16 | ||
| VESTIBULAR EXAMINATIONS IN CHRONIC DIZZINESS | 16 | ||
| Static Vestibular Evaluation | 16 | ||
| Provoking Maneuvers | 16 | ||
| Skull vibration | 17 | ||
| Hyperventilation | 17 | ||
| Dynamic Vestibular Evaluation | 17 | ||
| Dynamic visual acuity | 17 | ||
| Slow and fast head rotations | 17 | ||
| Skew deviation | 19 | ||
| Subjective visual vertical | 20 | ||
| Ocular Motor Examination | 21 | ||
| Saccades | 21 | ||
| Smooth pursuit and VOR cancellation | 22 | ||
| Optokinetic reflex | 22 | ||
| Balance and Gait Examination | 22 | ||
| Romberg test | 22 | ||
| Modified clinical test of sensory interaction and balance | 23 | ||
| Gait | 23 | ||
| Stepping tests | 23 | ||
| Positional Vertigo | 23 | ||
| Dix-Hallpike test | 23 | ||
| Epley maneuver | 24 | ||
| CONCLUSIONS | 25 | ||
| ACKNOWLEDGMENTS | 26 | ||
| REFERENCES | 26 | ||
| II - PEDIATRIC | 31 | ||
| 3 - Development of the Vestibular System and of Balance Function: Differential Diagnosis in the Pediatric Population | 31 | ||
| OVERVIEW OF THE VESTIBULAR SYSTEM | 31 | ||
| EMBRYOLOGY | 31 | ||
| Inner Ear | 31 | ||
| Maturation of Vestibular Receptors | 32 | ||
| Development of vestibular pathways | 32 | ||
| DEVELOPMENTAL REFLEXES | 32 | ||
| Development of Vestibular-Induced Reflexes | 33 | ||
| Vestibulo-ocular reflex | 33 | ||
| Vestibulospinal reflex | 34 | ||
| Vestibulocollic reflex | 34 | ||
| BALANCE AND MOTOR DEVELOPMENT | 35 | ||
| INCIDENCE OF VESTIBULAR DISORDERS IN THE PEDIATRIC POPULATION | 35 | ||
| The Differential Diagnosis | 36 | ||
| Patient History | 36 | ||
| “What Does It Feel like?” | 36 | ||
| “What Other Symptoms Are Associated With It?” | 36 | ||
| “How Long Do the Symptoms Typically Last and How Many Have Occurred?” | 36 | ||
| “What Makes It Worse or Better?” | 36 | ||
| “What is the Background History?” | 37 | ||
| Physical Examination | 37 | ||
| Static Imbalance | 37 | ||
| Dynamic Imbalance | 38 | ||
| Vestibulospinal Testing | 38 | ||
| Gait and Gross Motor Assessment | 39 | ||
| CHARACTERISTICS OF VESTIBULAR DISORDERS IN THE PEDIATRIC POPULATION | 39 | ||
| SUMMARY | 43 | ||
| REFERENCES | 43 | ||
| 4 - Assessment Techniques for Vestibular Evaluation in Pediatric Patients | 47 | ||
| INTRODUCTION | 47 | ||
| TAKING THE HISTORY | 47 | ||
| THE INFORMAL EVALUATION (MEDICAL-PHYSICAL EXAMINATION) | 47 | ||
| FORMAL VESTIBULAR EVALUATION MEASURES | 50 | ||
| Videonystagmography and Video-oculography | 50 | ||
| Rotary Chair | 52 | ||
| Video Head Impulse Testing and Gaze Stabilization Test | 54 | ||
| Computerized Dynamic Posturography | 54 | ||
| Vestibular Evoked Myogenic Potentials | 56 | ||
| CONCLUSIONS | 58 | ||
| REFERENCES | 59 | ||
| 5 - An Update on the Predominant Forms of Vertigo in Children and Their Associated Findings on Balance Function Testing | 63 | ||
| INTRODUCTION | 63 | ||
| BACKGROUND | 63 | ||
| ASSESSING DIZZINESS HANDICAP IN PEDIATRIC PATIENTS | 64 | ||
| DIFFERENTIAL DIAGNOSIS | 64 | ||
| THE MOST COMMON DISORDERS | 66 | ||
| MIGRAINE-ASSOCIATED VERTIGO IN CHILDREN | 67 | ||
| Etiology and Pathophysiology of Migraine | 69 | ||
| Balance Function Findings in Children With Migraine | 69 | ||
| BENIGN PAROXYSMAL VERTIGO OF CHILDHOOD | 70 | ||
| Etiology and Pathophysiology of Benign Paroxysmal Vertigo of Childhood | 70 | ||
| Balance Function Findings in Children With Benign Paroxysmal Vertigo of Childhood | 70 | ||
| TRAUMA | 70 | ||
| Etiology and Pathophysiology of Trauma | 71 | ||
| Balance Function Findings in Children With Trauma | 71 | ||
| COCHLEAR IMPLANTATION | 73 | ||
| Etiology and Pathophysiology of Cochlear Implant–Related Dizziness | 73 | ||
| Balance Function Findings in Children Post–Cochlear Implantation | 73 | ||
| VESTIBULAR NEURITIS | 74 | ||
| Etiology and Pathophysiology of Vestibular Neuritis | 74 | ||
| Balance Function Findings in Children With Vestibular Neuritis | 74 | ||
| OTITIS MEDIA | 76 | ||
| Etiology and Pathophysiology of Otitis Media | 76 | ||
| Balance Function Findings in Children With Otitis Media | 76 | ||
| SUMMARY | 76 | ||
| ON THE HORIZON | 77 | ||
| REFERENCES | 77 | ||
| III - ADOLESCENT AND ADULT | 83 | ||
| 6 - Dizziness and Vertigo in the Adolescent | 83 | ||
| THE ADOLESCENT BRAIN | 83 | ||
| VERTIGO AND DIZZINESS IN THE ADOLESCENT | 83 | ||
| DIAGNOSIS AND TREATMENT OF SPECIFIC CAUSES OF VERTIGO IN THE ADOLESCENT | 85 | ||
| Migraine | 85 | ||
| Chronic Daily Headaches | 87 | ||
| Postural Orthostatic Tachycardia Syndrome | 87 | ||
| LESS COMMON CAUSES OF VERTIGO OR DIZZINESS IN THE ADOLESCENT | 89 | ||
| CAUSES OF VERTIGO OR DIZZINESS IN THE ADOLESCENT REQUIRING HEAD IMAGING | 89 | ||
| SUMMARY | 90 | ||
| REFERENCES | 91 | ||
| 7 - Evaluation of Dizziness in the Litigating Patient | 95 | ||
| INTRODUCTION | 95 | ||
| BASIC PRINCIPLES | 95 | ||
| Physician Role: Patient Advocate Versus Advocate/Agent of Court | 95 | ||
| Payment | 95 | ||
| Extensive Documentation of History and Physical Examination | 97 | ||
| Extensive Objective Testing to Verify Complaints | 97 | ||
| Corroboration of Objective and Subjective Findings | 97 | ||
| Make Sure All Pieces Fit: Do Symptoms and Severity Correlate With Objective Findings? | 97 | ||
| Assessment of Causation | 98 | ||
| Prognosis | 98 | ||
| Interacting With Lawyers | 98 | ||
| HISTORY AND PHYSICAL EXAMINATION | 99 | ||
| TESTING | 99 | ||
| Audiologic Testing | 99 | ||
| Vestibular Testing | 100 | ||
| Imaging | 100 | ||
| REVIEW OF MEDICAL RECORDS | 100 | ||
| MALINGERING | 100 | ||
| DSM IV Criteria for Malingering6 | 101 | ||
| Malingering by Imputation | 101 | ||
| Red Flags | 101 | ||
| THE “NORMAL EVALUATION” PATIENT | 101 | ||
| ASSUMPTIONS/PEARLS | 102 | ||
| Your Work and Your Credentials Will Be Scrutinized | 102 | ||
| Never Assume Any Prior Diagnosis Is Correct | 102 | ||
| Cannot Assume a Normal Premorbid State | 102 | ||
| Appropriate Referrals | 102 | ||
| Financial Incentives Obscure the Picture | 102 | ||
| Litigation May Become Protracted | 103 | ||
| Be Prepared to Change Your Opinion as New Evidence Arises | 103 | ||
| CONCLUSIONS | 103 | ||
| REFERENCES | 103 | ||
| 8 - The Video Head Impulse Test | 105 | ||
| INTRODUCTION | 105 | ||
| BACKGROUND OF THE HEAD IMPULSE TEST | 105 | ||
| BEDSIDE HEAD IMPULSE TEST | 106 | ||
| MAGNETIC FIELD SCLERAL SEARCH COIL HEAD IMPULSE TEST | 107 | ||
| VIDEO HEAD IMPULSE TEST | 107 | ||
| VIDEO HEAD IMPULSE TEST TECHNIQUE | 107 | ||
| VIDEO HEAD IMPULSE TEST AND VESTIBULO-OCULAR REFLEX GAIN | 108 | ||
| VIDEO HEAD IMPULSE TEST ARTIFACTS | 108 | ||
| VIDEO HEAD IMPULSE TEST RESULTS FROM HEALTHY SUBJECTS AND THE EFFECTS OF AGE | 109 | ||
| ABNORMAL VIDEO HEAD IMPULSE TEST | 110 | ||
| Vestibular Neuritis | 110 | ||
| Meniere’s Disease | 110 | ||
| Vestibular Schwannoma | 111 | ||
| Acute Vestibular Syndrome | 113 | ||
| VIDEO HEAD IMPULSE TEST AND CALORICS | 113 | ||
| VIDEO HEAD IMPULSE TEST IN CHILDREN | 113 | ||
| SUPPRESSION HEAD IMPULSE PROTOCOL | 114 | ||
| CONCLUSION | 115 | ||
| ACKNOWLEDGEMENT | 115 | ||
| REFERENCES | 115 | ||
| 9 - Positional Vertigo: As Occurs Across All Age Groups | 119 | ||
| INTRODUCTION | 119 | ||
| BENIGN PAROXYSMAL POSITIONAL VERTIGO ACROSS THE LIFESPAN | 119 | ||
| PATHOPHYSIOLOGY OF BENIGN PAROXYSMAL POSITIONAL VERTIGO | 120 | ||
| DIAGNOSIS AND TREATMENT | 121 | ||
| EFFICACY OF TREATMENT | 123 | ||
| SURGICAL TREATMENT | 126 | ||
| CONCLUSIONS | 126 | ||
| REFERENCES | 126 | ||
| 10 - Vestibular Neuritis | 129 | ||
| INTRODUCTION | 129 | ||
| CLINICAL CHARACTERISTICS | 129 | ||
| DIAGNOSIS AND DIFFERENTIATION FROM CENTRAL INSULT/STROKE | 130 | ||
| MANAGEMENT: ACUTE PHASE | 131 | ||
| MANAGEMENT: CHRONIC PHASE | 131 | ||
| CONCLUSION | 132 | ||
| REFERENCES | 132 | ||
| 11 - Migraine-Associated Vertigo | 135 | ||
| INTRODUCTION | 135 | ||
| PATHOPHYSIOLOGY OF MIGRAINE-ASSOCIATED VERTIGO | 135 | ||
| COMMON HISTORICAL FEATURES OF MIGRAINE-ASSOCIATED VERTIGO | 136 | ||
| DEMOGRAPHICS AND RISK FACTORS OF MIGRAINE-ASSOCIATED VERTIGO | 136 | ||
| PHYSICAL EXAMINATION IN MIGRAINE-ASSOCIATED VERTIGO | 136 | ||
| PARACLINICAL TESTING FOR MIGRAINE-ASSOCIATED VERTIGO | 137 | ||
| DIFFERENTIAL DIAGNOSIS OF MIGRAINE-ASSOCIATED VERTIGO | 137 | ||
| TREATMENT OF MIGRAINE-ASSOCIATED VERTIGO | 137 | ||
| PROGNOSIS OF MIGRAINE-ASSOCIATED VERTIGO | 140 | ||
| REFERENCES | 140 | ||
| 12 - Superior Semicircular Canal Dehiscence | 143 | ||
| INTRODUCTION | 143 | ||
| INCIDENCE AND ETIOLOGY | 143 | ||
| CLINICAL PRESENTATION | 144 | ||
| PHYSICAL EXAMINATION | 145 | ||
| TESTING | 145 | ||
| PATHOPHYSIOLOGY | 147 | ||
| OTHER DEHISCENCES | 147 | ||
| Near Dehiscence | 147 | ||
| TEGMEN DEHISCENCE AND OSSICULAR HEAD IMPINGEMENT | 148 | ||
| TREATMENT: NONSURGICAL | 148 | ||
| WINDOW REINFORCEMENT | 148 | ||
| RESURFACING | 148 | ||
| OCCLUSION/PLUGGING | 148 | ||
| TRANSMASTOID VERSUS MIDDLE FOSSA VERSUS COMBINED APPROACH | 149 | ||
| OUTCOMES | 149 | ||
| COMPLICATIONS | 149 | ||
| CONCLUSIONS | 150 | ||
| REFERENCES | 150 | ||
| 13 - Meniere’s Disease: A Challenging and Relentless Disorder | 153 | ||
| INTRODUCTION | 153 | ||
| What Are the Diagnostic Criteria for Meniere’s Disease? | 156 | ||
| Differential Diagnosis of Meniere’s Disease—Migraine and Meniere’s Disease | 156 | ||
| What Is the Role of Adjunctive Tests in the Diagnosis of Meniere’s Disease? | 156 | ||
| Electrophysiologic studies | 156 | ||
| Caloric testing and head thrust testing | 157 | ||
| Retrocochlear studies | 157 | ||
| What Is Cochlear Hydrops? What Is Its Significance? | 157 | ||
| What Is the Pathophysiology of Cochlear Hydrops and Meniere’s Disease? | 157 | ||
| What Is the Role of Medical Management? | 158 | ||
| What Is the Role of Vestibular Rehabilitation in the Acute Phase? | 158 | ||
| What Is the Initial Treatment if Medical Therapy Fails? | 158 | ||
| Controversies with endolymphatic sac surgery | 159 | ||
| Is endolymphatic sac surgery better than natural history? | 159 | ||
| Is endolymphatic sac decompression without shunt placement effective? | 159 | ||
| What is the best next step in management if nondestructive procedures fail to control vertigo? | 160 | ||
| Chemical labyrinthectomy. The use of chemical labyrinthectomy in the treatment of MD was introduced in the 1970s and popularized... | 161 | ||
| Vestibular nerve section versus labyrinthectomy | 163 | ||
| Vestibular nerve section versus intratympanic perfusion of gentamicin | 163 | ||
| Role of diagnostic tests | 164 | ||
| Vertigo control in patients with bilateral Meniere’s disease and failed medical therapy | 164 | ||
| Hearing Rehabilitation in Meniere’s Disease | 164 | ||
| Management of Meniere’s Disease in an Only Hearing Ear | 165 | ||
| CONCLUSION | 165 | ||
| REFERENCES | 165 | ||
| 14 - Uncommon Causes of Disequilibrium in the Adult | 169 | ||
| UNCOMMON CAUSES OF CHRONIC DISEQUILIBRIUM IN THE ADULT | 169 | ||
| Bilateral Vestibular Loss | 169 | ||
| Progressive Supranuclear Palsy and Other Atypical Parkinsonisms | 169 | ||
| Spinocerebellar Ataxias | 170 | ||
| Mal de Debarquement | 170 | ||
| UNCOMMON CAUSES OF EPISODIC DISEQUILIBRIUM IN THE ADULT | 171 | ||
| Psychogenic Disequilibrium | 171 | ||
| Vestibular Paroxysmia | 171 | ||
| Episodic Ataxia, Type 1 | 172 | ||
| Episodic Ataxia, Type 2 | 172 | ||
| Vestibular Seizures | 172 | ||
| Cervicogenic Vertigo | 173 | ||
| REFERENCES | 173 | ||
| IV - ELDERLY | 175 | ||
| 15 - The Cardiovascular Dizziness Connection: Role of Vestibular Autonomic Interactions in Aging and Dizziness | 175 | ||
| INTRODUCTION | 175 | ||
| REGULATION OF BLOOD PRESSURE | 175 | ||
| BAROREFLEX REGULATION OF BLOOD PRESSURE | 176 | ||
| REGULATION OF BRAIN BLOOD FLOW | 178 | ||
| AUTOREGULATION OF CEREBRAL BLOOD FLOW | 178 | ||
| EFFECTS OF AGE ON CEREBRAL BLOOD FLOW | 180 | ||
| UNIQUE CHARACTERISTICS OF THE UPRIGHT POSTURE IN HUMANS | 182 | ||
| VESTIBULAR EFFECTS ON BLOOD PRESSURE AND CEREBRAL BLOOD FLOW | 183 | ||
| SUMMARY | 185 | ||
| REFERENCES | 186 | ||
| 16 - Vertebrobasilar Infarcts and Ischemia | 191 | ||
| INTRODUCTION | 191 | ||
| EXCITING NEW HORIZONS IN STROKE TREATMENT | 191 | ||
| Vertebrobasilar Ischemia and Infarcts | 191 | ||
| Acute Ischemic Stroke | 192 | ||
| Endovascular Therapy in the Posterior Circulation | 192 | ||
| Imaging in identification and management of posterior circulation stroke | 193 | ||
| BRIEF SUMMARY OF THE ANATOMY OF THE POSTERIOR CIRCULATION | 193 | ||
| The Posterior Circulation: Mechanisms of Stroke and Transient Ischemic Attacks | 195 | ||
| DIZZINESS, VERTIGO, AND VERTEBROBASILAR ISCHEMIA | 195 | ||
| BEDSIDE EVALUATION OF THE PATIENT WITH ACUTE VESTIBULAR SYNDROME | 197 | ||
| Acute Vertebrobasilar Occlusion: Intervention Is Possible | 198 | ||
| Advances in Intervention in Vertebrobasilar Ischemia and Infarcts | 198 | ||
| Peripheral Versus Central Causes of Vertigo in Vertebrobasilar Insufficiency | 198 | ||
| Vertigo as a Presentation of Vertebrobasilar Insufficiency | 199 | ||
| Patients with vertebrobasilar ischemia have a very high prevalence of stroke risk factors | 200 | ||
| Benign paroxysmal positional vertigo is associated with vertebrobasilar insufficiency | 200 | ||
| The natural course of vertebral or basilar artery stenosis: a high risk of early recurrent stroke | 200 | ||
| Anterior Inferior Cerebellar Artery Territory Infarcts and Audiovestibular Symptoms | 201 | ||
| Posterior inferior cerebellar artery syndrome or lateral medullary infarction | 202 | ||
| Superior cerebellar artery infarcts are mainly embolic | 203 | ||
| Basilar migraine and migraine-associated vertebrobasilar strokes | 204 | ||
| Modifiable risk factors and noninvasive medical interventions aimed at preventing vertebrobasilar stroke progression and recurre... | 204 | ||
| REFERENCES | 205 | ||
| 17 - Dizziness in the Elderly | 209 | ||
| INTRODUCTION | 209 | ||
| CAUSES OF DIZZINESS AND DISEQUILIBRIUM IN OLDER INDIVIDUALS | 209 | ||
| Age-Related Deterioration of Sensory and Motor Mechanisms | 210 | ||
| Vestibular system | 210 | ||
| Proprioceptive system | 211 | ||
| Visual system | 211 | ||
| Motor system | 211 | ||
| Central integration mechanisms | 212 | ||
| Pathologic Causes of Dizziness | 213 | ||
| Environmental and Lifestyle Causes of Dizziness | 214 | ||
| DIAGNOSIS OF DIZZINESS IN OLDER INDIVIDUALS | 214 | ||
| History | 214 | ||
| Physical Examination | 214 | ||
| Laboratory Tests | 216 | ||
| Vestibular function tests | 217 | ||
| Other tests | 218 | ||
| MANAGEMENT OF DIZZINESS IN OLDER INDIVIDUALS | 218 | ||
| SUMMARY | 219 | ||
| REFERENCES | 219 | ||
| 18 - Medication-Related Dizziness in the Older Adult | 223 | ||
| MEDICATION-RELATED DIZZINESS | 223 | ||
| LITERATURE SEARCH STRATEGY | 225 | ||
| ANTIHYPERTENSIVE DRUGS | 226 | ||
| BENZODIAZEPINES AND RELATED DRUGS | 228 | ||
| SEDATIVE HYPNOTICS AND OTHER DRUGS | 228 | ||
| ANXIOLYTIC DRUGS | 229 | ||
| ANTIEPILEPTIC DRUGS | 229 | ||
| CONCLUSIONS AND RECOMMENDATIONS | 230 | ||
| REFERENCES | 233 | ||
| 19 - Older Adults With Dizziness: Rehabilitation Strategies and Novel Interventions | 237 | ||
| INTRODUCTION | 237 | ||
| THE ROLE OF THE REHABILITATION PROVIDER IN EVALUATING PATIENTS WITH DIZZINESS | 237 | ||
| Screening | 237 | ||
| Assessment of Falling Risk and Quality of Life in Older Adults | 239 | ||
| THE ROLE OF THE REHABILITATION PROVIDER IN TREATING PATIENTS WITH DIZZINESS | 240 | ||
| THE EFFECT OF VESTIBULAR REHABILITATION ON VARIOUS CONDITIONS | 240 | ||
| Chronic unilateral vestibular dysfunction | 242 | ||
| Bilateral vestibular dysfunction | 244 | ||
| Vestibular neuritis | 244 | ||
| Meniere’s disease | 244 | ||
| Functional dizziness (functional movement disorder) | 244 | ||
| Postsurgical conditions | 244 | ||
| Central Vestibular Disorders | 244 | ||
| Parkinson’s disease | 245 | ||
| Multiple sclerosis | 245 | ||
| Head injuries | 245 | ||
| IMPORTANT CONSIDERATIONS WITH VESTIBULAR REHABILITATION | 245 | ||
| NOVEL INTERVENTIONS IN TREATING OLDER ADULTS WITH VESTIBULAR DISORDERS | 246 | ||
| Virtual Reality | 246 | ||
| Balance-Enhancing Insoles | 247 | ||
| Tai Chi | 247 | ||
| Vibrotactile Feedback Devices | 247 | ||
| Optokinetic Stimulation | 248 | ||
| The Nintendo Wii | 248 | ||
| SUMMARY | 248 | ||
| REFERENCES | 248 | ||
| Index | 255 | ||
| A | 255 | ||
| B | 256 | ||
| C | 256 | ||
| D | 257 | ||
| E | 258 | ||
| F | 258 | ||
| G | 259 | ||
| H | 259 | ||
| I | 259 | ||
| K | 259 | ||
| L | 259 | ||
| M | 260 | ||
| N | 260 | ||
| O | 261 | ||
| P | 261 | ||
| Q | 262 | ||
| R | 262 | ||
| S | 262 | ||
| T | 263 | ||
| U | 264 | ||
| V | 264 | ||
| W | 265 | ||
| Y | 265 | ||
| Z | 265 |