Head and shoulder alignment among patients with Hypofuncation

• Published in: Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Vol. 14; no. 4; pp. 330 - 336
• Main Authors: Coelho, AN Jr, Gazzola, J M, Gabilan, YPL, Mazzetti, K R, Perracini, M R, Gananca, F F
• Format: Journal Article
• Language: Portuguese
• Published: 01.08.2010
• ISSN: 1413-3555

Objectives: To investigate head and shoulder alignment among patients with unilateral vestibular hypofunction (UVH), using computerized biophotogrammetry (CB) and to correlate these measurements with gender, age, duration of clinical evolution, self-perception of intensity of dizziness and occurrences of falls. Methods: This was a cross-sectional study. Thirty individuals with UVH and 30 with normal vestibular function and without complaints of dizziness underwent CB in the anterior, right and left and posterior views, in an upright standing position. Alcimage 2.0 was used to evaluate three angles in order to verify the anterior deviation and inclination of the head, and the alignment of the shoulders. The groups were paired according to age, gender and height. The statistical analysis consisted of the Mann-Whitney test, Kruskal-Wallis test followed by the Dunn test, and the Spearman Correlation Coefficient. Results: The patients with UVH had greater forward (55.44 plus or minus 16.33) and lateral (2.03 plus or minus 1.37) head deviation angles than did the normal individuals (34.34 plus or minus 4.60 and 1.34 plus or minus 1.05 respectively), with a statistically significant difference (p<0.001). The increment of forward and lateral deviation in the UVH group was 38.05% and 33.78% respectively. Forward head was associated with the duration of clinical symptoms of the vestibular disease (p=0.003), age (p=0.006), intensity of dizziness (p<0.001) and occurrence of falls (p=0.002). Conclusions: Patients with UVH had greater forward and lateral head deviations. Forward head deviation increased with age, duration of clinical symptoms and greater self-perception of the intensity of dizziness. Forward head deviation was also greater among patients who reported having had falls.Original Abstract: Objetivos: Avaliar o alinhamento de cabeca e ombros de pacientes com hipofuncao vestibular unilateral (HVU) por meio da biofotogrametria computadorizada e associar esses dados com genera, idade, tempo de evolucao clinica, autopercepcao da intensidade de tontura e ocorrencia de quedas. Metodos: Trata-se de estudo transversal em que 30 individuos com HVU e 30 individuos com funcao vestibular normal e sem queixa de tontura foram submetidos a biofotogrametria computadorizada. Foram registradas imagens em vistas anterior, posterior, laterais direita e esquerda em ortostatismo. O programa Alcimage registered 2.0 foi usado para avaliar tres angulos que permitem verificar anteriorizacao e inclinacao da cabeca e alinhamento dos ombros. Os grupos foram pareados por idade, genero e estatura. Para a analise estatistica, realizaram-se os testes de Mann-Whitney, Kruskal-Wallis, seguidos do teste de Dunn e Coeficiente de Correlacao de Spearman. Resultados: Pacientes com HVU apresentam maiores valores para os angulos de anteriorizacao (55,44 plus or minus 16,33) e de inclinacao lateral da cabeca (2,03 plus or minus 1,37) quando comparados aos individuos normais (34,34 plus or minus 4,60 e 1,34 plus or minus 1,05, respectivamente), com diferenca estatisticamente significante (p<0,001). O aumento da anteriorizacao e da inclinacao lateral da cabeca do grupo de individuos com HVU foi de 38,05% e 33,78% respectivamente. A anteriorizacao da cabeca foi associada com o tempo de evolucao clinica da doenca vestibular (p=0,003) com a idade (p=0,006), com a intensidade da tontura (p<0,001) e com a ocorrencia de quedas (p=0,002). Conclusao: Pacientes com HVU apresentam maior anteriorizacao e inclinacao lateral da cabeca. A anteriorizacao da cabeca aumenta com a idade, com o tempo de evolucao clinica, maior auto-percepcao da intensidade da tontura e nos pacientes que relataram quedas.