Presenter: Elle Gaudette
Authors: Elle Gaudette, Ryan Pelo, Leah Millsap, Cecilia Martindale, Leland Dibble, Melissa Cortez, Peter Fino
Faculty Advisor: Peter Fino
Institution: University of Utah
Dizziness is a common symptom that has been an ongoing problem in individuals with mild Traumatic Brain Injury (mTBI). While often associated with balance-oriented problems, dizziness can stem from multiple sources, including physiological and vestibular-ocular dysfunction after mTBI, and the origin of dizziness remains unclear in the mTBI population. To further assess the origin of dizziness, this study analyzed individual and combinational associations of physiological measures including blood pressure (BP), and heart rate (HR), balance measurements often associated with vestibular dysfunction, including turning velocity, gait speed, and postural sway, and vestibular-ocular measurements with reported levels of dizziness on the Dizziness Handicap Inventory (DHI). Twenty-two participants, ages 22-50 diagnosed with mTBI, were tested 25-484 days post mTBI. Participants completed a tilt table test to assess changes in BP and HR from supine to head up tilt (HUT) position for autonomic measures. A one-minute walk, and quiet standing (30 seconds, eyes closed) task were completed using wearable sensors (APDM Opals, Portland, OR) to compute balance and mobility measures. Vestibular-Ocular Motor Screening (VOMS) was completed to measure symptomatic changes before and after vestibular-ocular tasks, scored out of 7 task categories. Finally, participants completed the DHI, a 25-item self-assessment to evaluate the self-perceived handicapping effects imposed by dizziness. Pearson correlation coefficients assessed the relationship between individual measurements and DHI total scores. Additionally, a backwards-stepwise regression model was used to determine the combination of variables that associated with the DHI score. Results indicated small-to-moderate correlations between some individual measurements and DHI (R^2 ranged from 0.02 to 0.36). Turning velocity, mean BP during the HUT, and total VOMS scores were retained in the final regression model, which had an R^2=0.68. These results support the idea that dizziness can have varied etiologies in people with mTBI, including physical movement, autonomic dysfunction, and vestibular-ocular dysfunction.