Courtney D Hall

East Tennessee State University | ETSU · Department of Physical Therapy

Introduction Dizziness is a growing public health concern with as many as 95 million adults in Europe and the United States experiencing vestibular hypofunction, which is associated with reduced quality of life, poorer health, and falls. Vestibular rehabilitation therapy (VRT) is effective in reducing symptoms and improving balance; however, limite...

Many patients with cerebellar ataxia have dizziness caused by oculomotor or peripheral vestibular deficits; however, there is little evidence supporting the use of vestibular rehabilitation for this population. The purpose of this study was to determine whether patients with degenerative cerebellar diseases improve following rehabilitation includin...

Background Unilateral peripheral vestibular hypofunction can result in symptoms of dizziness, gaze and gait instability, and impaired navigation and spatial orientation. These impairments and activity limitations may negatively impact an individual’s quality of life, ability to perform activities of daily living, drive, and work. There is strong ev...

Purpose The primary aim of this study was to examine the factors associated with long-term outcomes of postconcussive disruptive dizziness in Veterans of the post-9/11 wars. Method For this observational cohort study, the Neurobehavioral Symptom Inventory–Vestibular subscale (NSI-V) score was used as an outcome measure for dizziness in 987 post-9/...

Objective: The aim of this study was to develop and validate an outcome measure for individuals with motion-provoked dizziness. Study design: Methodological. Setting: Academic outpatient vestibular and dizziness clinic. Patients/subjects: Adults with and without motion-provoked dizziness. Main outcome measures: Scores from the modified Mot...

The purpose of this study was to examine vestibular and balance function in individuals with chronic dizziness associated with mTBI/blast. A prospective case-control study design was used to examine ocular motor, vestibular function, and postural stability in veterans with symptoms of dizziness and/or imbalance following an mTBI or blast exposure (...

Background: Uncompensated vestibular hypofunction can result in symptoms of dizziness, imbalance, and/or oscillopsia, gaze and gait instability, and impaired navigation and spatial orientation; thus, may negatively impact an individual's quality of life, ability to perform activities of daily living, drive, and work. It is estimated that one-third...

Dizziness is very common, but it is never normal. Dizziness can make performing daily activities, work, and walking difficult. Inner ear balance problems can make people dizzy when they turn their head, which can cause problems during walking and make people more likely to fall. Most of the time dizziness is not from a life-threatening disease. Oft...

Objectives Given their professional education and participation within the healthcare system, pharmacists are ideal candidates to assess drug-associated fall risk for patients. The purpose of this investigation was to determine if pharmacists can quantitatively differentiate individuals who reported falling within the previous year (Fallers) from t...

Objective: To identify disruption due to dizziness symptoms following deployment-related traumatic brain injury (TBI) and factors associated with receiving diagnoses for these symptoms. Setting: Administrative medical record data from the Department of Veterans Affairs (VA). Participants: Post-9/11 veterans with at least 3 years of VA care who...

Clinical relevance: Mobility and fall risk may be important considerations in choosing between intraocular lenses. Background: Fall risk in older adults increases when wearing multifocal spectacles, but little is known about mobility among individuals with different types of intraocular lenses. This study compared visual function, fall risk and bal...

Despite our understanding of the impact of noise-induced damage to the auditory system, much less is known about the impact of noise exposure on the vestibular system. In this article, we review the anatomical, physiological, and functional evidence for noise-induced damage to peripheral and central vestibular structures. Morphological studies in s...

Objective The purpose of this study was to determine factors associated with rehabilitation outcomes following vestibular rehabilitation (VR). Methods In this prospective cohort study, 116 patients who completed at least 2 supervised sessions participated. Patient characteristics and comorbidities were recorded. Initial and discharge measures incl...

Objectives: Following the loss of vestibular function, some patients functionally improve and are minimally bothered by their loss of peripheral function while others remain more symptomatic and are unable to return to their activities of daily living. To date, the mechanisms for functional improvement remain poorly understood. The purpose of the...

Objective: To describe the prevalence and impact of vestibular dysfunction and nonspecific dizziness diagnoses and explore their associations with traumatic brain injury (TBI) severity, mechanism, and postconcussive comorbidities among post-9/11 veterans. Setting: Administrative medical record data from the US Departments of Defense and Veterans...

Methods: Forty-nine patients participated in 10-20 sessions of SMART training, with integrated use of a visual targeting system and physical therapy. Between sessions, patients were instructed to perform mindfulness breathing, relaxation and grounding techniques. Pre- and post-training Dizziness Handicap Inventory (DHI), 4-item Dynamic Gait Index (...

Background: Current vestibular rehabilitation for peripheral vestibular hypofunction is an exercise-based approach that improves symptoms and function in most, but not all patients, and includes gaze stabilization exercises focused on duration of head movement. One factor that may impact rehabilitation outcomes is the speed of head movement during...

The purpose of this article is to review relevant literature on the effect of mild traumatic brain injury (mTBI) and blast injury on the vestibular system. Dizziness and imbalance are common sequelae associated with mTBI, and in some individuals, these symptoms may last for six months or longer. In war-related injuries, mTBI is often associated wit...

Background: the development of an objective and comprehensive drug-based index of physical function for older adults has the potential to more accurately predict fall risk. Design: the index was developed using 862 adults (ages 57-85) from the National Social Life, Health, and Aging Project (NSHAP) Wave 1 study. The index was evaluated in 70 adu...

STUDY OBJECTIVES: Nocturnal awakenings may constitute a unique risk for falls among older adults. We describe differences in gait and balance between presleep and midsleep testing, and whether changes in the lighting environment during the midsleep testing further affect gait and balance. METHODS: Twenty-one healthy, late middle-aged and older (64...

Background: Case reports are presented on four Veterans, aged 29–46 years, who complained of chronic dizziness and/or postural instability following blast exposures. Two of the four individuals were diagnosed with mild traumatic brain injury and three of the four were exposed to multiple blasts. Comprehensive vestibular, balance, gait, audiometry a...

Hypothesis: The purpose of this study was to determine reliability of computerized dynamic visual acuity (DVA) testing and to determine reference values for younger and older adults. Background: A primary function of the vestibular system is to maintain gaze stability during head motion. The DVA test quantifies gaze stabilization with the head m...

Background: Uncompensated vestibular hypofunction results in postural instability, visual blurring with head movement, and subjective complaints of dizziness and/or imbalance. We sought to answer the question, "Is vestibular exercise effective at enhancing recovery of function in people with peripheral (unilateral or bilateral) vestibular hypofunc...

Intraocular lenses (IOLs) provide distance and near refraction and are becoming the standard for cataract surgery. Multifocal glasses increase the variability of toe clearance in older adults navigating stairs and increase fall risk; however, little is known about the biomechanics of stair navigation in individuals with multifocal IOLs. This study...

Background: Vestibular rehabilitation (VR) improves symptoms and function in some but not all patients with bilateral vestibular hypofunction (BVH). Objective: The purpose of this retrospective study was to examine change following vestibular rehabilitation and to identify factors associated with rehabilitation outcome in patients with BVH. Met...

The use of low-cost interactive game technology for balance rehabilitation has become more popular recently with generally good outcomes. Very little research has been undertaken to determine whether this technology is appropriate for balance assessment. The Wii balance board has good reliability and is comparable to a research-grade force plate; h...

Vestibular function (specifically, horizontal semicircular canal function) can be assessed across a broad frequency range using several different techniques. The head impulse test is a qualitative test of horizontal semicircular canal function that can be completed at bedside. Recently, a new instrument (video head impulse test [vHIT]) has been dev...

This work reports the use of a head-motion monitoring system to record patient head movements while completing in-home exercises for vestibular rehabilitation therapy. Based upon a dual-axis gyroscope (yaw and pitch, ± 500-degrees/sec maximum), angular head rotations were measured and stored via an on-board memory card. The system enabled the clini...

Evidence-based recommendations for interventions to reduce fall risk in older adults with visual impairment are lacking. Adapted tango dance (Tango) and a balance and mobility program (FallProof™) have improved mobility, balance and quality of life (QOL) in individuals with movement impairment. This study compared the efficacy of Tango and FallProo...

Dizziness is one of the most common reasons patients seek medical care, and because there are many causes of dizziness, management of these patients requires an interdisciplinary approach. Peripheral vestibular dysfunction is the most common cause of dizziness/vertigo diagnosed in specialty clinics. The purpose of this article is to present an inte...

Background: Fall risk increases with age and visual impairment, yet the oldest-old adults (>85 years) are rarely studied. Partnered dance improves mobility, balance, and quality of life in older individuals with movement impairment. Objective: The aim of the study was to determine the feasibility and participant satisfaction of an adapted tango...

: Dance has demonstrated beneficial effects on mobility in older individuals with movement disorders; yet, effects of partnered dance remain unexamined in individuals with chronic stroke. The purpose of this study was to describe the effects of adapted tango classes on balance, mobility, gait, endurance, dual-task ability, quality of life (QOL), an...

Not all individuals with unilateral vestibular hypofunction (UVH) have fewer subjective complaints and improved function after vestibular rehabilitation. To identify factors and/or combinations of factors that are strongly associated with rehabilitation outcome in patients with UVH and that ultimately can be used to develop models to predict outcom...

An impaired ability to allocate attention to gait during dual-task situations is a powerful predictor of falls. The primary purpose of this study was to examine the relative contributions of participant characteristics and motor and cognitive factors to the ability to walk while performing cognitive tasks. The impact of cognitive task complexity on...

Specific criteria have been developed based on computerized dynamic posturography (CDP) to assist clinicians in identifying patients with psychogenic balance problems (Cyr and Cevette, 1993; Cevette et al., 1995; Goebel et al., 1997; Gianoli et al., 2000). Patients with known spinocerebellar ataxia (SCA) meet several of the criteria for psychogenic...

Background/Purpose: Recent evidence suggests that an impaired ability to allocate attention to balance during dual-task situations is a powerful predictor of falls. Increased difficulty under dual-task conditions may result from cognitive or motor impairments or both. The extent to which interventions should be directed at cognitive or motor impair...

The purpose of this study was to determine whether the addition of gaze stability exercises to balance rehabilitation would lead to greater improvements of symptoms and postural stability in older adults with normal vestibular function who reported dizziness. Participants who were referred to outpatient physical therapy for dizziness were randomly...

Vestibular adaptation exercises have been shown to improve gaze stability during active head rotation in individuals with vestibular hypofunction. Little is known, however, of the types of eye movements used during passive head rotation and their effect on gaze stability in individuals with vestibular hypofunction. The primary purpose of this study...

To determine if a 12-week program of Tai Chi that has been shown to reduce falls incidence in older adults would improve the ability to allocate attention to balance under dual-task conditions. Pre-/posttest experimental research design. Movement studies research laboratory. Community dwelling older adults (N=15; range, 62-85y) participated in eith...

The focus of this article is on the role of vestibular rehabilitation in the remediation of postural and gaze instability in individuals with peripheral vestibular deficits. Although vestibular rehabilitation does not cure the organic disease that produces the balance disorder, it improves mobility, prevents falls, and overall has a positive impact...

To determine the effect of vestibular exercises on the recovery of visual acuity during head movement in patients with bilateral vestibular hypofunction (BVH). Prospective, randomized, double-blinded study. Outpatient clinic, academic setting. Thirteen patients with BVH, aged 47 to 73 years. One group (8 patients) performed vestibular exercises des...

The purposes of this research were to (1) determine test-retest reliability of clinical measures of self reported disability and subjective complaints, gait, and fall risk; and (2) establish normal variability for each of these measures based on test-retest variability in people with peripheral vestibular disorders. Sixteen patients with confirmed...

To determine the effect of vestibular rehabilitation on reduction of fall risk in individuals with unilateral vestibular hypofunction and to identify those factors that predict fall risk reduction. Retrospective chart review. Tertiary referral center. Forty-seven patients with unilateral vestibular hypofunction, aged 28 to 86 years, who were at ris...

The compensatory step is a critical component of the balance response and is impaired in older fallers. The purpose of this research was to examine whether utilization of a cane modified the compensatory step response following external posterior perturbations. Single subject withdrawal design was employed. Single subject statistical analysis--the...

The purpose of this study was to examine a comprehensive measure relating to the ability to generate, absorb, and transfer mechanical energy introduced by a perturbation. It was hypothesized that this measure would reveal age-related differences leading to different balance recovery responses (i.e., feet-in-place and compensatory step). Cross-secti...

Numerous reaction time studies have suggested that age-related declines in cognitive function might be ameliorated by lifestyles involving aerobic activity or by interventionist programmes of aerobic exercise. These studies are far from conclusive, however, reflecting a failure to factor out cognitive from sensory and motor processes. Following a c...

Objective. The compensatory step is a critical component of the balance response and is impaired in older fallers. The purpose of this research was to examine whether utilization of a cane modified the compensatory step response following external posterior perturbations. Design. Single subject withdrawal design was employed. Single subject statist...

One of the key components of postural control is the motor system's ability to produce appropriate torques to counteract perturbations that may lead to a loss of balance. Evidence exists to show that there is an age-related decline in absolute strength and in the ability to rapidly produce torque. The relationship between age-related decreases in t...

Thèse (M.S.)--University of Oregon, 1997. Microfiche (négatif) du manuscrit dactylographié.