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Concussion and Athletes: A New Test Evaluates Recovery

Concussion is a significant public health concern for individuals of any age. Dizziness is a common problem after concussion and can take a long time to improve. For athletes, this is especially important. Athletes with dizziness often cannot perform at their best. This can lead to another concussion or other injuries.

Dunlap and colleagues describe a test that can help identify those who may take longer to recover. This test evaluates how quickly an athlete can move his or her head and still see clearly. When an athlete has trouble with this test, he or she is more likely to have dizziness and balance problems. The authors of this research also report that understanding this test result can help better manage athletes who have had a concussion. 

Dunlap PM, Mucha A, Smithnosky D, Whitney SL, Furman JM, Collins MW, Kontos AP, Sparto PJ. The gaze stability test following concussion. J Am Acad Audiol 2018 Nov 29. doi: 10.3766/jaaa.18015. [epub ahead of print]

Managing Dizziness and Gulf War Illness

Many veterans experience a chronic condition called Gulf War Illness. This illness involves several symptoms such as headache and dizziness. Dizziness due to Gulf War Illness is thought to occur because of the veteran’s exposure to chemicals that damage the ears as well as traumatic experiences.

Fox and colleagues describe the reported symptoms of Gulf War veterans. They wanted to know how common and how severe dizziness is in this population. The authors of this research reported that nearly all interviewed veterans experienced severe dizziness which greatly impacted their quality of life. They suggested that formal dizziness and balance testing could help to determine better management strategies for veterans with Gulf War Illness.

Fox A, Riska K, Tseng CL, McCarron K, Satcher S, Osinubi O, Helmer D. Dizziness, vertigo, and mental health comorbidity in Gulf War veterans. J Am Acad Audiol 2018 Nov 4. doi: 10.3766/jaaa.17122 [epub ahead of print]

Hearing Loss and a Higher Risk of Falls

Falls are the leading cause of injury and death in older adults. There are many reasons why older adults are at risk for falling. These risks include certain medications; medical conditions such as vision loss, diabetes, and heart disease; and confusion. Hearing loss is also associated with higher risk for falling.

Agmon and colleagues reviewed available research to describe the relationship between hearing loss and falling. They found that individuals with hearing loss were at more risk for falling than those without hearing loss. Also, those with more severe hearing loss were more likely to have a fall. The authors of this research suggest that treating the hearing loss and addressing balance problems may reduce the risk for falling.

Agmon M, Lavie L, Doumas M. The association between hearing loss, postural control, and mobility in older adults: a systemic review. J Am Acad Audiol 2017 Jun; 28(6): 575-588. doi: 10.3766/jaaa.16044.

Ear Infections and Balance Concerns

Children often experience ear infections. An overlooked problem with ear infections is the impact on a child’s ability to maintain balance. Children usually can’t tell you when they have balance problems and most children aren’t screened for balance disturbances. 

Dr. Rehagen and colleagues presented a pilot study to show the results of a balance screening test for children. They found that children with hearing loss due to middle-ear infection are more likely to demonstrate difficulty with tracking objects with their eyes than their counterparts with normal hearing or permanent (sensorineural) hearing loss. The authors suggest that children with ear infections are screened for balance problems.  

Rehagen, Sonia Kim, et al. “Vestibular Screening in Pediatric Patients with Otitis Media.” Journal of the American Academy of Audiology, 2019, doi:10.3766/jaaa18101.

Balance Management Is a Team Approach

Balance problems can be from many different causes. We maintain our balance through the integration of multiple organs and systems. Since balance problems can be complicated, diagnosis and management should involve different professions that specialized in each of those organs and systems. These specialists include otologists, audiologists, ophthalmologists, neurologists, physical therapists, and pharmacists. Unfortunately, most patients don’t receive this thorough evaluation.

Dr. Rodriguez and colleagues found that patients with balance problems who received care from a team of professionals report improved symptoms as compared to those who didn’t. This study suggests that since those who received care by an interprofessional team reported improved symptoms, patients should expect to see multiple professionals to better manage balance problems. 

Rodriguez, Amanda I., et al. “Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient.” Journal of the American Academy of Audiology, vol. 28, no. 3, Jan. 2017, pp. 177–186., doi:10.3766/jaaa.15054.

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