Jendrassik Maneuver Facilitates cVEMP Amplitude: Some Preliminary Observations

2014 ◽  
Vol 25 (03) ◽  
pp. 237-243
Author(s):  
Lauren Roberts ◽  
Anthony T. Cacace
Keyword(s):  
Head Trauma ◽  
Repeated Measures ◽  
Neurological Disease ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Experimental Conditions ◽  
Hearing Sensitivity ◽  
History Of ◽  
Post Hoc ◽  
Jendrassik Maneuver

Background: The cervical vestibular evoked myogenic potential (cVEMP) is an acoustically driven electrophysiological measure of saccular and inferior nerve function that requires tonic sternocleidomastoid muscle (SCM) activity in order to be elicited. The cVEMP is gaining increased interest in the clinical and research communities based on the anatomical specificity it adds to vestibular test batteries, because it is noninvasive, and since it can be performed with instrumentation commonly found in audiology clinics worldwide. Purpose: Because maintaining a constant level of tonic background electromyography (EMG) over the entire course of the recording epoch is a requirement for response elicitation, active participation for some individuals including the elderly and those with cervical problems can be difficult. As a way to facilitate the response for some clinical populations, this study addressed whether cVEMPs could be modulated by remote or local changes in EMG related neural activity by applying various maneuvers during the course of the recording epoch. Research Design: Keeping acoustic stimulation and recording parameters constant, three separate experimental conditions, Jendrassik maneuver, jaw (teeth) clenching, and forced-eye closure, were used to determine whether cVEMP amplitudes could be enhanced from the control condition. Study Sample: Nine adults (2 males; 7 females) ranging in age from 24 to 42 yr with normal pure-tone hearing sensitivity and a negative history of otological disease, neurological disease, and head trauma. Data Collection and Analysis: Cervical vestibular evoked myogenic potentials were recorded from the SCM using surface electrodes in response to suprathreshold 500 Hz Blackman windowed tone bursts under a control and three experimental conditions. Three separate one-way repeated measures analyses of variance (ANOVAs) were used to evaluate the effects of these maneuvers on P1/N1 peak-to-peak amplitudes and P1 and N1 peak latencies. Results: A significant main effect of experimental condition was shown to increase P1/N1 peak-to-peak cVEMP amplitude. Post hoc analysis found that Jendrassik maneuver versus control was the only the condition that produced significantly increased response amplitudes in comparison to all other post hoc contrasts. P1 and N1 peak latencies were unchanged across the various experimental conditions. Conclusions: In adults with normal hearing sensitivity and a negative history of otological disease, neurological disease, and head trauma, Jendrassik maneuver increased cVEMP amplitude by over 39% in comparison to the control condition. Such a simple modulation effect warrants further investigation for application in clinical studies.

The Effects of Click and Tone-Burst Stimulus Parameters on the Vestibular Evoked Myogenic Potential (VEMP)

2003 ◽  
Vol 14 (09) ◽  
pp. 500-509 ◽  
Author(s):  
Faith Wurm Akin ◽  
Owen D. Murnane ◽  
Tina M. Proffitt
Keyword(s):  
Stimulus Frequency ◽  
Tone Burst ◽  
Stimulus Level ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Hearing Sensitivity ◽  
Surface Electrodes ◽  
Acoustic Stimuli ◽  
History Of ◽  
High Level

Vestibular evoked myogenic potentials (VEMP) are short latency electromyograms (EMG) evoked by high-level acoustic stimuli and recorded from surface electrodes over the tonically contracted sternocleidomastoid (SCM) muscle and are presumed to originate in the saccule. The present experiments examined the effects of click and tone-burst level and stimulus frequency on the latency, amplitude, and threshold of the VEMP in subjects with normal hearing sensitivity and no history of vestibular disease. VEMPs were recorded in all subjects using 100 dB nHL click stimuli. Most subjects had VEMPs present at 500, 750, and 1000 Hz, and few subjects had VEMPs present at 2000 Hz. The response amplitude of the VEMP increased with click and tone-burst level, whereas VEMP latency was not influenced by the stimulus level. The largest tone-burst-evoked VEMPs and lowest thresholds were obtained at 500 and 750 Hz. VEMP latency was independent of stimulus frequency when tone-burst duration was held constant.

Does Electrode Impedance Affect the Recording of Ocular Vestibular-Evoked Myogenic Potentials?

2014 ◽  
Vol 25 (10) ◽  
pp. 969-974 ◽  
Author(s):  
Rachael L. Taylor ◽  
Mikael Schulin ◽  
Samanthi Goonetilleke ◽  
Miriam S. Welgampola
Keyword(s):  
Repeated Measures ◽  
Isopropyl Alcohol ◽  
Skin Surface ◽  
Estimating Equation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Electrode Impedance ◽  
Vestibular Evoked Myogenic Potential ◽  
Skin Preparation ◽  
Skin Abrasion ◽  
Stimulus Artifact

Background: In evoked potential testing, it is common practice to abrade the skin surface as a means of reducing and balancing electrode impedance. The effects of skin preparation and electrode impedance on ocular vestibular-evoked myogenic potential (oVEMP) prevalence and amplitudes are not known. Purpose: We sought to determine whether comparable oVEMP waveforms could be recorded without excessive skin preparation. Research Design: This was a prospective study with a repeated-measures (within-subjects) design. Study Sample: The study group comprised 20 healthy participants (12 females and 8 males) ages 21–57 yr. Data Collection and Analysis: oVEMP reflexes were recorded in response to air-conducted and bone-conducted (AC and BC) stimuli in three conditions. In the first condition (no skin preparation), electrodes were simply placed over the skin surface. For the second condition (moderate skin preparation), oVEMP testing was repeated after the skin had been prepared with 70% isopropyl alcohol swabs. oVEMPs recorded in these two conditions were then compared with those recorded using a third conventional protocol whereby the skin was abraded with skin preparation gel until electrode impedances were low and balanced. For BC stimuli, reflex amplitudes and latencies were compared using a repeated-measures general linear model. For AC stimuli, rates of reflex detection were analyzed using a generalized estimating equation. Nonparametric Friedman tests were used to compare AC oVEMP amplitudes across the three conditions. Results: There was no significant effect of electrode impedance on reflex amplitudes, latencies, or rates of detection (p > 0.05). The results indicated significant stimulus-related artifact (≥3 μV) in 25 of 40 recordings under the high-impedance condition in response to BC stimulation. The stimulus artifact was detectable in 12 of 40 recordings after moderate skin preparation and in 5 recordings after skin abrasion. Conclusions: Comparable rates of reflex detection and oVEMP amplitudes were recorded in the three conditions, implying that rigorous rubbing of the facial skin is largely unnecessary in clinical oVEMP testing. However, for oVEMPs recorded in response to a single-polarity stimulus, reducing and balancing electrode impedances with either isopropyl alcohol wipes or skin abrasion may help reduce unwanted stimulus artifact.

scholarly journals Tasks of Attention Augment Rigidity in Mild Parkinson Disease

2008 ◽  
Vol 35 (4) ◽  
pp. 501-505 ◽  
Author(s):  
Dan A. Mendon¸a ◽  
Mandar S. Jog
Keyword(s):  
Parkinson Disease ◽  
Repeated Measures ◽  
Ordinal Scale ◽  
Experimental Conditions ◽  
Contralateral Hand ◽  
Foot Tapping ◽  
Anatomic Basis ◽  
Attentional Tasks ◽  
Post Hoc ◽  
Hand Opening

Objective:The purpose of this study was to determine whether tasks involving effortful attention would cause augmentation of rigidity in patients with mild Parkinson disease.Methods:In 17 subjects with mild Parkinson disease, rigidity in a single arm was assessed during various experimental conditions by a blinded movement disorders neurologist. Rigidity was scored separately at the wrist and the elbow using an ordinal scale. In three of the conditions, sustained attention was directed toward visual, auditory or movement-related stimuli. Two varieties of Froment maneuver served as positive controls: contralateral hand opening-closing or ipsilateral foot tapping. In addition, rigidity was assessed twice with subjects resting. The examiner was unaware of the sequence of experimental conditions and this was changed for each subject. Mean rigidity scores for the various experimental conditions were compared against the baseline state (an average of both trials with the patient resting) using a repeated measures ANOVA and post-hoc Tukey-Kramer multiple comparisons test.Results:Rigidity was significantly increased from baseline with each of the attentional tasks (p <0.01 to p <0.001) and also with the two Froment maneuvers (p <0.001). Rigidity augmentation with contralateral hand opening-closing was significantly greater than with any of the attentional tasks (p <0.05 to p <0.001).Conclusion:Tasks of effortful attention did appear to augment rigidity in patients with mild Parkinson disease. We speculate that the greater augmentation seen with the Froment maneuver could have an anatomic basis.

The Evaluation of Joint Mobilization Dosage on Ankle Range of Motion in Individuals With Decreased Dorsiflexion and a History of Ankle Sprain

2020 ◽  
pp. 1-6
Author(s):  
Jennifer E. Meyer ◽  
Matthew J. Rivera ◽  
Cameron J. Powden
Keyword(s):  
Range Of Motion ◽  
Ankle Sprain ◽  
Repeated Measures ◽  
Weight Bearing ◽  
Lower Extremity Injury ◽  
Future Research ◽  
Post Hoc Analysis ◽  
History Of ◽  
Single Data ◽  
Post Hoc

Context: Mulligan’s Mobilization with Movement (MWM) is a common intervention used to address dorsiflexion range of motion (DFROM) impairments. However, the treatment dosage of MWMs varies within the literature. Objective: The aim of this study was to examine the effect of serial MWM application on DFROM. Design: Repeated-measures cohort. Setting: A Midwestern University and the surrounding community. Participants: A total of 18 adults (13 females; age = 29 [12.87] y; DFROM = 30.26° [4.60°]) with decrease dorsiflexion (<40°) participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥18 years old, no lower-extremity injury in the last 6 months, and no history of foot/ankle surgery. Intervention: Participants completed a single data collection session consisting of 10 individual sets of MWMs. Main Outcome Measures: DFROM was taken at baseline and immediately after each intervention set (post 1, post 2, … post 10). DFROM was measured with a digital inclinometer on the anterior aspect of the tibia during the weight-bearing lunge test with the knee straight and knee bent. Analysis of variances examined DFROM changes over time. Post hoc analysis evaluated sequential pairwise comparisons and changes from baseline at each time point. Results: Analysis of variance results indicated a significant time main effect for weight-bearing lunge test with knee bent (P < .001) and a nonsignificant effect for weight-bearing lunge test with knee straight (P < .924). Post hoc analysis indicated improvements in the weight-bearing lunge test with knee bent at each timepoint compared with baseline (P < .005). Post 2 improved compared with post 1 (P = .027). No other pairwise sequential comparisons were significant (P > .417). Conclusions: MWMs significantly improved acute knee bent DFROM and indicated that after 2 sets of MWMs, no further DFROM improvements were identified. Future research should investigate the lasting effects of DFROM improvements with variable MWM dosages.

Tone-induced cervical and ocular vestibular-evoked myogenic potentials: comparing abnormalities in traumatic and non-traumatic vestibular disease

2018 ◽  
Vol 132 (10) ◽  
pp. 906-910 ◽  
Author(s):  
N S Longridge ◽  
A I Mallinson
Keyword(s):  
Companion Paper ◽  
High Rate ◽  
Vestibular Evoked Myogenic Potentials ◽  
Tertiary Referral ◽  
Vestibular Evoked Myogenic Potential ◽  
Vestibular Disease ◽  
Myogenic Potential ◽  
Number Of Patients ◽  
History Of ◽  
Vestibular Assessment

AbstractBackgroundOtolithic function is poorly understood, but vestibular-evoked myogenic potential testing has allowed the documentation of pathology in patients who complain of imbalance.MethodsSeventy-four patients with traumatic and non-traumatic vestibular disease were sequentially assessed at a tertiary referral neuro-otology unit in a teaching hospital. A detailed history of all patients was taken and standard vestibular assessment was conducted using the technique described in the companion paper. The results of both groups of patients were analysed and the rate of abnormalities was assessed.ResultsThere was a high rate of abnormalities, including bilateral pathology, in a significant number of patients. Many patients in both groups inexplicably failed to recover.ConclusionVestibular-evoked myogenic potentials are helpful in documenting pathology, including bilateral pathology, which is outlined in the literature as being exceedingly difficult to compensate for.

Effects of Depression and Headache Type on Biofeedback for Muscle-contraction Headaches

1984 ◽  
Vol 12 (4) ◽  
pp. 300-307 ◽  
Author(s):  
Bruce A. Levine
Keyword(s):  
Muscle Contraction ◽  
Head Trauma ◽  
Treatment Center ◽  
Biofeedback Therapy ◽  
Need For Treatment ◽  
Headache Treatment ◽  
Headache Type ◽  
History Of ◽  
Posterior Neck ◽  
Post Hoc

The present study was designed to investigate further the possible interactive role of both depression and headache type on the outcome of a standard E.M.G. biofeedback therapy for muscle-contraction headache. Forty-eight patients applying for treatment at a headache treatment center were given forehead/posterior neck E.M.G. biofeedback therapy for 20 weeks. Twelve subjects in each of four groups had either depression with or without a history of head trauma, or were not depressed, with or without a history of head trauma. Results showed that headache activity was lowered more for non-depressed subjects and more for non-trauma subjects, although there was no interaction. However, post-hoc examination also showed that the possibility of monetary gain from legal action might have confounded the data for some of the trauma subjects. The study supports the need for separation of depressed and non-depressed patients in headache treatment and the probable need for treatment for the depression itself, aside from the headache.

scholarly journals Efectos agudos de distintas estrategias de calentamiento sobre el rendimiento físico y las habilidades motrices en escolares (Acute effects of different warm-up strategies on physical performance and motor skills in schoolchildren)

Retos ◽  
2021 ◽  
Vol 42 ◽  
pp. 18-26
Author(s):  
Nicolás Gómez-Álvarez ◽  
Alexander Schweppe-Villa ◽  
Aarón Parra-Gatica ◽  
Falú Cid-Rojas ◽  
Gustavo Pavez-Adasme ◽  
...  
Keyword(s):  
Motor Skills ◽  
Repeated Measures ◽  
Vertical Jump ◽  
Acute Effect ◽  
Experimental Conditions ◽  
Warm Up ◽  
Different Types ◽  
Quality Of Movement ◽  
Post Hoc ◽  
And Control

  El objetivo de esta investigación fue valorar los efectos de distintos tipos de calentamientos aplicados en escolares sobre la calidad de movimiento de las habilidades motrices y el rendimiento de salto y carrera. La metodología utilizada fue a partir de un diseño estudio cruzado aleatorizado (n=27 escolares), que incluyó tres condiciones experimentales para valorar el efecto agudo de distintos tipos de calentamiento (tradicional, basado en juegos adaptados reducidos y FIFA 11+) sobre el salto vertical, sprint en 20 metros y habilidades motoras de locomoción y control de objetos en niños y niñas. Se utilizó estadística descriptiva y comparativa a través de ANOVA de medidas repetidas y Friedman con sus pruebas post-hoc según corresponda. Los resultados muestran que todos los tipos de calentamiento mostraron diferencias significativas en sprint, salto vertical y habilidades motoras, respecto al a la condición control sin calentamiento. El calentamiento basado en juegos adaptados reducidos presentó efectos superiores que las otras modalidades en las habilidades motoras de locomoción (p< .05). Las comparaciones entre calentamientos mostraron que la intervención basada en FIFA 11+ mostró ser más eficaz en reducir el tiempo de sprint en 20 metros y aumentar la altura del salto vertical (p< .05). En conclusión, este estudio sugiere que, la selección de una estrategia adecuada basada en una diversidad de experiencias motrices como las ofrecidas por los protocolos de calentamiento FIFA11+ y de juegos adaptados reducidos podría ser clave para mejorar el rendimiento motor y la magnitud de los beneficios asociados al calentamiento.  Abstract: The objective of this research is to assess the effects of different types of warm-ups applied in schoolchildren on the quality of movement of motor skills and jumping and sprint performance. The methodology used was based on a randomized crossover study design (n = 27 schoolchildren), which included three experimental conditions to assess the acute effect of different types of warm-up (traditional, based on reduced adapted games and FIFA 11+) on the vertical jump, sprint in 20 meters and motor skills of locomotion and control of objects in children. Descriptive and comparative statistics were used through repeated measures ANOVA and Friedman with its post-hoc tests as appropriate. The results show that all types of warm-up showed significant differences in sprint, vertical jump and motor skills, compared to the control condition without warm-up. The warm-up based on reduced adapted games presented greater effects than the other modalities on the motor skills of locomotion (p <.05). Comparisons between warm-ups showed that the intervention based on FIFA 11+ was shown to be more effective in reducing sprint time by 20 meters and increasing vertical jump height (p <.05).  In conclusion, this study suggests that the selection of an appropriate strategy based on a diversity of motor experiences such as those offered by the FIFA11 + warm-up protocols and reduced adapted games could be key to improving motor performance and the magnitude of the benefits associated with warm-up.

scholarly journals Experimental Analysis of a Novel, Magnetic-Driven Tactile Feedback Device

Prosthesis ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 25-38
Author(s):  
Fahad Alshaibani ◽  
Mark S Thompson ◽  
Jeroen HM Bergmann
Keyword(s):  
Repeated Measures ◽  
Experimental Testing ◽  
Area Under The Curve ◽  
Comparative Trial ◽  
Tactile Feedback ◽  
Experimental Conditions ◽  
Human Volunteers ◽  
Specific Frequency ◽  
Post Hoc ◽  
Future Work

The study presented in this paper details the development and experimental testing of a novel, magnetic, tactile feedback device that is able to deliver a stimulus to a patch of skin on the lower arm of a user. The device utilizes magnets to deliver a sensation that is not dependent on controlling specific frequency bands to stimulate the mechanoreceptors, as is the case with vibro-tactile methods. The device was tested on human volunteers to evaluate its ability to induce a response from the user through the magnetic interface. The study aims to quantify the ability of the user to sense the stimulus by analysis of the receiver operating characteristic (ROC) and delay in response under different experimental conditions. Three different speeds and two different distances were explored for the magnetic interface. A two-way, repeated-measures ANOVA with post-hoc analysis was performed for the percentage of correct responses, delay in response time, and area under the curve (AUC) of the obtained ROCs. The results showed that the different conditions had a significant effect on the number of correct responses and the AUC, but not on the delay. The magnetic interface thus needs to be optimized across different parameters to deliver the best detectable stimulus to the user. Future work includes further development of the device and working towards a comparative trial with other tactile feedback approaches.

The Influence of Caffeine on Calorics and Cervical Vestibular Evoked Myogenic Potentials (cVEMPs)

2014 ◽  
Vol 25 (03) ◽  
pp. 261-267 ◽  
Author(s):  
Kathleen McNerney ◽  
Mary Lou Coad ◽  
Robert Burkard
Keyword(s):  
Data Collection ◽  
Vestibular Function ◽  
Stimulus Presentation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Future Research ◽  
Vestibular Evoked Myogenic Potential ◽  
Moderate Amount ◽  
Potential System ◽  
History Of ◽  
Clinically Significant

Background: Prior to undergoing vestibular function testing, it is not uncommon for clinicians to request that patients abstain from caffeine 24 hr prior to the administration of the tests. However, there is little evidence that caffeine affects vestibular function. Purpose: To evaluate whether the results from two tests commonly used in a clinical setting to assess vestibular function (i.e., calorics and the cervical vestibular evoked myogenic potential [cVEMP]) are affected by caffeine. Research Design: Subjects were tested with and without consuming a moderate amount of caffeine prior to undergoing calorics and cVEMPs. Study Sample: Thirty young healthy controls (mean = 23.28 yr; females = 21). Subjects were excluded if they reported any history of vestibular/balance impairment. Data Collection and Analysis: The Variotherm Plus Caloric Irrigator was used to administer the water, while the I-Portal VNG software was used to collect and analyze subjects’ eye movements. The TECA Evoked Potential System was used for the cVEMP stimulus presentation as well as for the data collection. During cVEMP collection, subjects were asked to monitor their sternocleidomastoid muscle contraction with a Delsys EMG monitor. IBM SPSS Statistics 20 was used to statistically analyze the results via paired t-tests. Results: Analysis of the data revealed that ingestion of caffeine did not significantly influence the results of either test of vestibular function. Conclusions: The results revealed that a moderate amount of caffeine does not have a clinically significant effect on the results from caloric and cVEMP tests in young healthy adults. Future research is necessary to determine whether similar results would be obtained from individuals with a vestibular impairment, as well as older adults.

Plantar Pressures During Level Walking Compared with Other Ambulatory Activities

1994 ◽  
Vol 15 (6) ◽  
pp. 324-328 ◽  
Author(s):  
Steve Lundeen ◽  
Kurt Lundquist ◽  
Mark W. Cornwall ◽  
Thomas G. McPoil
Keyword(s):  
Repeated Measures ◽  
Experimental Conditions ◽  
Plantar Pressures ◽  
Time Integral ◽  
Level Walking ◽  
Pressure Time ◽  
Normal Individuals ◽  
Sensor Platform ◽  
Ambulatory Activities ◽  
Post Hoc

This study was designed to determine the magnitude of plantar pressures during level walking in comparison to other activities. These activities included climbing up stairs, going down stairs, a simple pivot while walking, and a crossover pivot while walking in normal individuals. Twelve volunteers, six men and six women, mean age 28 years, served as subjects. Data were collected on the dominant foot with an EMED-SF pressure sensor platform as each subject walked barefoot and did each of the five activities. Maximum plantar pressure (MPP) and pressure-time integral (PTI) was found in the metatarsal and heel regions. The results of repeated-measures analysis of variance tests showed that the five experimental conditions were statistically different for both MPP and PTI in the metatarsal and heel regions. Post hoc analysis indicated that MPP and PTI were decreased during the going down stairs condition in the heel and increased during the crossover pivot while walking and pivot while walking conditions for the metatarsal region.

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