Evaluation of balance and executive function relationships in older individuals.

BACKGROUND: Executive function is an important cognitive factor in gait and balance control. Weakening of balance system components and executive functions due to aging may affect walking and balance and increase the risk of falling. AIMS: The present study aimed to investigate the relationship between balance and executive function in older individuals and the contributions of physical activity and depression to this relationship. METHODS: A total of 84 healthy individuals aged 60 and over were included in the study. In the study, the Timed Up and Go Test (TUG), Mini Balance Evaluation Systems Test (Mini-BESTest), Digit Symbol Substitution Test (DSST), Trail Making Test A and B (TMT A and TMT B), Physical Activity Scale for the Elderly (PASE), and Geriatric Depression Scale (GDS) were applied. RESULTS: The Mini-BESTest and TUG correlated with DSST, TMT A, and TMT B. GDS was correlated with TUG. PASE was correlated with Mini-BESTest and TUG. Executive functions differed according to education level; DSST, TMT B, and GDS were effective in fall history. DISCUSSION: There was a significant relationship between balance and executive function. It was found that balance and walking speed increased as executive function skills increased. Depression and physical activity are associated with balance and gait speed. CONCLUSIONS: Balance and executive functions are related to each other, and physical activity and depression contribute to this relationship. In order to protect against the negative effects of aging, cognitive and physical training can be performed to prevent balance and executive function declines.

Validity and reliability study of the Khalfa's hyperacusis questionnaire with using ULL in tinnitus patients.

PURPOSE: This study aims to investigate the validity and reliability of the Khalfa's hyperacusis questionnaire (HQ) in Turkish tinnitus patients with hyperacusis using uncomfortable loudness levels (ULLs) and to determine a cutoff score for tinnitus patients specifically. MATERIALS AND METHODS: One hundred and forty subjects with a mean age ± SD of 45.27 ± 14.43 years ranging from 18 to 75 participated in the study. HQ and ULLs were used as measures of hyperacusis. The participants were divided into two groups due to ULLs ≤ 90 dB in one or both ears (Group 1) and 56 participants have ULLs > 90 dB (Group 2). RESULTS: The mean HQ score of the participants was 19.55 ± 7.18 points, Group 1 (n = 84) HQ mean score was 21.97 ± 7.08, and Group 2 (n = 56) 15.91 ± 5.56 points, and the cutoff point was found 16.50. Statistically significant differences were found between the groups in total HQ (p < 0.001), attention, social, and emotional subscales of HQ. CONCLUSIONS: Hyperacusis questionnaire using with ULLs is a precise tool for the steps of identifying, categorizing, and managing the hyperacusis in patients with tinnitus. However, the effect of the tinnitus on hyperacusis should be considered, because it causes additional problems.

Effects of Virtual Reality for Postural Control in Chronic Neck Pain: A Single-Blind, Randomized Controlled Study.

OBJECTIVE: The purpose of this study was to investigate the effects of virtual reality (VR) on postural control, posture, and kinesiophobia in patients with chronic neck pain (CNP). METHODS: Forty-one participants with CNP were randomly allocated to the VR and control groups. The VR group experienced VR with glasses for 20 minutes and then performed motor control (MC) exercises for 20 minutes. The control group received only MC exercises for 40 minutes. Both groups received 18 sessions over 6 weeks. Computerized dynamic posturography outcomes, including sensory organization test (SOT), limits of stability, and unilateral stance tests, gait speed, forward head posture (FHP), shoulder protraction (SP), cervical lordosis angle, kinesiophobia, and exercise compliance were recorded. RESULTS: The VR group had more effects regarding composite equilibrium (Cohen's d = 1.20) of SOT and kinesiophobia (Cohen's d = -0.96), P < .05). Also, the VR group was more effective in exercise compliance (P < .05). Contrary to these results, the control group was more effective in correcting FHP and SP (Cohen's d > 0.7, P < .05). CONCLUSION: Virtual reality seemed to have an effect on postural control, posture, and kinesiophobia in patients with chronic neck pain.

Balance performance measured by posturography in mild-moderate Alzheimer's Disease: An undervalued assessment.

PURPOSE: The aim of the study was to compare balance performance in mild-moderate stage Alzheimer's disease (AD) patients and healthy peers using clinical balance tests and computerized posturography. METHODS: We recruited 95 patients and divided them into two groups; 51 patients (62 % (n=32) female) in AD group and 44 patients in healthy controls group (50 % (n=22) female). Berg Balance Scale (BBS) and Timed Up & Go (TUG) test were performed. Computerized posturography was performed. RESULTS: The mean age was 77.2±5.5 years in the AD group and 73.8±4.4 years in the control group (p<0.001). Sensory organization test composite equilibrium score (60[30-81], p<0.001), step quick turn-sway velocity (69.2 [38.2-95.8], p<0.001) and step quick turn-time (3.8 [1.6-8.4], p<0.001) were significantly impaired in mild-moderate stage AD patients. Berg Balance Scale (50 [32-56], p<0.001) and TUG test (13.0 [7.0-25.7], p<0.001) results were worse in AD. CONCLUSIONS: Computerized posturography measures were impaired in mild-moderate AD patients. The results highlight importance of early screening for balance and fall risk in AD patients. The study provides multi-dimensional and holistic assessment of balance performance in early-stage AD patients. Alzheimer's disease patients at earlier stages are prone to fall risk and should be evaluated accordingly.

Transcutaneous Electric Nerve Stimulation in Chronic Subjective Tinnitus.

OBJECTIVE: It is aimed to determine the therapeutic role of transcutaneous electrical nerve stimulation (TENS) on chronic subjective tinnitus with a randomized and comparative analysis. METHOD: 46 individuals with normal hearing, chronic subjective tinnitus, aged 20-65; randomly divided into the study (TENS therapy) and tje control groups. The control group (n = 23) was informed only about tinnitus, while the study group (n = 23) received TENS therapy (20 sessions in 4 weeks). Before TENS therapy, tinnitus-related evaluations of all participants [tinnitus frequency, loudness, minimum masking level (MMS), residual inhibition (RI)] were made and Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), Short Form 36 (SF-36), and The Quality of Life Scale were applied to the participants. These evaluations and questionnaires were repeated after 4 weeks of the therapy. RESULTS: There was a significant decrease in the tinnitus severity after TENS therapy in the study group (p = 0.003). Moreover, it was found that VAS (loudness and annoyance), THI (functional, emotional and total score), SF-36 (physical function, physical role, pain, general health, vitality, emotional role and social function) values improved compared to before TENS therapy and the difference was significant (p < 0.05). There was no significant difference between the first and last evaluations of the control group (p > 0.05). CONCLUSION: TENS is an effective, practical and reliable therapy method in reducing severity, loudness, and annoyance of tinnitus, and increasing the quality of life in individuals with chronic subjective tinnitus.

Concordance of vestibular test batteries in patients with vestibular neuritis.

BACKGROUND: A growing number of vestibular function tests are utilized to differentiate and verify the diagnosis of vestibular neuritis. The aim of this study is to retrospectively investigate the consistency of the results of the objective vestibular test batteries in patients with a preliminary diagnosis of vestibular neuritis. METHODS: We reviewed a total of 37 adult patients (mean age: 39.03 ± 11.67, 19 females, 18 males) who met the inclusion criteria with a prediagnosis of vestibular neuritis from 379 patients suffering vestibular symptoms. Caloric test (CVT), video head impulse test (vHIT), and ocular and cervical VEMP tests were compared with Cohen's kappa (Κ) analysis according to the likely affected part of the vestibular nerve. RESULTS: The highest statistically significant K value was found between horizontal vHIT and ocular VEMP (K = 0.707; good grade, p < 0.05). All the tests compared with CVT were poorly in agreement (K = 0.288; 0.262; 0.256 for HvHIT, oVEMP, AvHIT, respectively, p < 0.05). DISCUSSION: VEMP and vHIT tests have prominent diagnostic value and agree with each other for detecting and differentiating the types of vestibular neuritis. Further studies should aim to include cutting-edge technologies such as functional HIT and ocular counter roll test.

Comparison of Activity-Based Home Program and Cawthorne-Cooksey Exercises in Patients With Chronic Unilateral Peripheral Vestibular Disorders.

OBJECTIVE: This study aimed to investigate the effects of an activity-based home program and an exercise-based home program on dizziness severity, balance, and independent level of daily life activities in patients with dizziness due to chronic unilateral peripheral vestibular disorders. DESIGN: A single-blind randomized controlled trial. SETTING: University dizziness management clinics. PARTICIPANTS: Individuals (N=75) between 18 and 65 years of age who had chronic unilateral peripheric vestibular disorders and vestibular rehabilitation indication. INTERVENTION: Participants were randomly divided into 3 groups: an activity-based home program (group 1/activity group), an exercise-based home program (group 2/exercise group), and a control group (group 3). After an initial assessment, all groups participated in the patient education program. In addition, the activity-based home program was administered to the first group, while the Cawthorne-Cooksey home exercise program was administered to the second group. MAIN OUTCOME MEASURES: Visual analog scale (VAS), Vestibular Disorders Activities of Daily Living Scale (VADL), and computerized dynamic posturography before and immediately after the treatment program. RESULTS: A statistically significant improvement was found in the activity and exercise groups in terms of VAS, VADL, Sensory Organization Test (SOT) 5, SOT 6, and SOT (composite) scores compared with the control group (P<.05). A statistically significant improvement was found in the activity group in terms of the instrumental subscale of VADL, SOT 5, SOT 6, and SOT (composite) scores compared with the exercise group. CONCLUSIONS: The activity-based home program was more effective in improving the home management task, the occupational task, and balance than the exercise-based home treatment program in patients with chronic peripheral vestibular disorders.

Clinical significance of head shake movement in three planes in individuals with dizziness.

PURPOSE: This study aims to evaluate the efficacy of head shake movement on three head movement planes (yaw, pitch and, roll) in patients with dizziness despite normal vestibular test results. MATERIALS AND METHODS: Twenty individuals aged between 20 and 51 years with complaints of dizziness were included in the study, and their results were compared with the results from twenty age- and gender-matched controls. Participants were assessed using the Sensory Organization Test, Head Shake-Sensory Organization Test which is based on the modification of the Sensory Organization Test on the yaw, pitch, and roll planes, videonystagmography, caloric test, and Dizziness Handicap Inventory. RESULTS: Significant differences were found in the yaw (p = 0.007), pitch (p < 0.001), and roll (p = 0.002) planes between the study and control groups of the Head Shake-Sensory Organization Test-5 scores. There were no statistically significant differences between the two groups of the Head Shake-Sensory Organization Test-2 scores in the yaw (p = 0.448), pitch (p = 0.213), and roll (p = 0.531) planes. When the sensitivity and specificity of Head Shake-Sensory Organization Test-5 conditions were examined, the highest specificity was observed in the pitch plane (100%), followed by the yaw (95%) and roll plane (95%). CONCLUSION: Dynamic head movements are an important parameter for the evaluation of balance performance. The head shake modification could be used effectively in three-movement planes in individuals with dizziness.

Investigation of the effects of cognitive tasks on balance performance in young adults.

INTRODUCTION: Individuals routinely perform cognitive tasks concurrent to balance functions. The attention is one of the most important cognitive functions and it has effects on vestibular system. This study aims to investigate the connection between balance and cognitive tasks under different conditions. METHODS: Visual attention tasks (VAT) and auditory attention tasks (AAT) were given to 30 healthy adults (40.42 ±â€¯11.22 years) during functional balance tasks. Sensory Organization Test (SOT) and Adaptation Test (ADT) were used for the evaluation of postural stability and adaptation. The sounds were presented from the computer speakers in AATs, and VATs were presented in the virtual reality (VR) environment. RESULTS: The first SOT condition had a statistically significant difference between all dual VAT (DT-VAT) and single task (ST) (p < 0.001), but there was no statistically significant difference between ST and DT-AAT (p = 1.00). In the fourth SOT condition, there was a statistically significant difference between all DT-VATs versus ST and DT-VA (p < 0.001); there was no statistically significant difference between ST and DT-AA scores (p = 0.80). While there was a significant difference between DT-VA and ST and DT-AA (p < 0.001), no statistically significant difference was observed between ST and DT-AA in the ADT (p = 0.321). CONCLUSIONS: Balance performance gets worse with VAT in a VR environment. VR technology can be used to effectively evaluate balance and cognitive performance. The use of experimental environments in standard postural evaluations increases the efficiency of the postural stability tests.

The use of Goal Attainment Scaling (GAS) in the rehabilitation of ataxic patients.

The aim of this study was to formulate an exercise program according to GAS, an approach that reflects the patients' point of view and expectations and investigate the effects of this program in ataxia rehabilitation. This study was designed as an assessor-blinded, single-group trial, and 24 patients with cerebellar ataxia were included. Treatment goals, postural control, disease severity, and daily living activities were assessed pre- and post-treatment using the Goal Attainment Scaling (GAS), the Sensory Organization Test (SOT), the International Cooperative Ataxia Rating Scale (ICARS), and the Barthel Index (BI), respectively. An exercise program was applied by taking patients' individual expectations and treatment goals into account. The participants enrolled in the physiotherapy program for 8 weeks, 3 days a week for 1 hour per day. The mean age of the patients was 34.00 ± 9.15 years. While the GAS, kinetic functions ICARS subscores, ICARS total scores, SOT-composite, and BI scores improved significantly after treatment (p < 0.05), other ICARS subscores did not change after treatment (p > 0.05). The results showed that putting the patient at the center of the evaluation and treatment process while formulating a treatment plan had a positive effect on treatment outcome. If the functions that patients consider important are known and the treatment process concentrates on these functions, a patient's participation in his/her individual treatment is supported by increasing his/her motivation and contribution to more successful rehabilitation practices.

Sensorimotor integration training in Parkinson`s disease.

OBJECTIVE: To determine the effects of sensorimotor integration training on postural control in Parkinson`s disease. METHODS: This prospective, randomized controlled trial was conducted at Hacettepe University (Ankara, Turkey). The study was carried out from August 2012 until March 2015 and included 24 Parkinson`s patients with stage 2-3 according to the Modified Hoehn&Yahr Rating Scale. The patients were divided into 2 groups (control and study). The control group received conventional physiotherapy; the study group received sensorimotor integration training combined with conventional physiotherapy, 2 times per week for 6 weeks. We assessed the patients with clinical balance tests and computerized dynamic posturography. Assessments were performed at baseline, 7- and 12-weeks follow-up. RESULTS: Computerized dynamic posturography posturography values (5th and 6th positions, composite balance, and vestibular system scores) were higher in the study group than in the control group. The improvements were maintained at the 12-week follow up except 6th positions scores (p<0.05). CONCLUSION: Sensorimotor integration training combined with conventional physiotherapy approach ameliorated postural control by improving vestibular system in patients with Parkinson`s disease by improving sensory processes.

Electrophysiologic vestibular evaluation in type 2 diabetic and prediabetic patients: Air conduction ocular and cervical vestibular evoked myogenic potentials.

OBJECTIVE: Chronically increased blood glucose levels may affect the vestibular system by damaging cells and neural structures in diabetes mellitus (DM). We aimed to search the effects of neurovascular degeneration on the vestibular system in type 2 DM and prediabetic patients by using air-conducted ocular (oVEMP) and cervical (cVEMP) vestibular evoked myogenic potentials. DESIGN: Prospective study. STUDY SAMPLE: Thirty diabetic, 30 prediabetic patients, and 31 age- and sex-matched controls having no peripheral or central vestibular disease, were enrolled. All participants were evaluated by audiovestibular tests, oVEMP, and cVEMP. RESULTS: In the diabetic group, mean values of both oVEMP and cVEMP p1, n1 latencies were significantly longer compared to the prediabetic group and the control group, whereas latencies were similar in prediabetic and the control groups. Bilateral neural dysfunction was recognized in both tests and lateralization was not seen in VEMP asymmetric ratios. In the diabetic group, prevalence of pathological p1 and n1 latencies in oVEMP were 30.4% and 37.5%, whereas they were 53.7%, 59.3% in cVEMP, respectively. p1 latencies of cVEMP and oVEMP were positively correlated with HbA1c and fasting plasma glucose level in the diabetic group. CONCLUSION: Subclinical vestibular neuropathy can be a newly defined diabetes-related complication.

The Relationship Between Vertigo/Dizziness and Somatoform Complaints: A Systematic Review.

To systematically synthesize published literature on somatoform complaints as psychological factors in vertigo/dizziness to determine the characteristics of comorbidities, relationships and causality. Following PRISMA guidelines, systematic searches of PubMed, WOS, and Cochrane Library databases and manual follow-up reference searches were performed for articles published in English up to 2021. All original research studies and retrospective or prospective studies focusing on the relationship between vertigo/dizziness and somatoform complaints/somatization were systematically retrieved. Studies that did not include data on the association between somatoform complaints/somatization and vertigo/dizziness were excluded, as were reviews, comments, case reports, editorials, letters, and practice guidelines. Extracted data included research type, number of participants, assessment tools for vertigo/dizziness and somatoform complaints/somatization, statistical methods, and the main results. The quality of included studies was evaluated. Records identified through database searching n = 1238. After removing duplicates and unrelated articles based on abstract and title search, 155 articles recorded as relevant. Except for the 5 articles, title and abstract of all records screened and 88 of them excluded. Critically evaluating those full texts, 28 studies included. The present study highlights the relationship between the vertigo/dizziness and somatoform complaints/somatization. It is determined that somatoform complaints of the individuals suffering from vertigo/dizziness is highly prevelant and some other factor such as personality characteristics or accompanying psychopathology have affect on the prevelance. The main results of all reviewed studies emphasize the requirement for assessment and intervention of vertigo/dizziness, in collaboration with the department of psychiatry. PROSPERO REGISTRATION: PROSPERO: CRD42020222273.

Evaluation of Balance with Computerized Dynamic Posturography in Children with Otitis Media.

BACKGROUND: Otitis media with effusion (OME) frequently leads to vestibular symptoms in children. However, young children face difficulty expressing their symptoms due to their limited language abilities. METHODS: The balance of study and patient group evaluated with computer dynamic posturography, single-leg stance test with eyes closed and regular Head Impulse Test. The study group was assessed once again after the insertion of a ventilation tube two months later. RESULTS: In the Sensory Organization Test, the scores for conditions 5, 6, and composite equilibrium of the preoperative patient group were notably lower compared with both the control and postoperative patient groups (p < 0.05). Additionally, a significant correlation was found between single-leg stance test with eyes closed results and conditions 5, 6, and composite equilibrium scores. CONCLUSION: The impact of OME on the vestibular system is negative. This effect can be objectively assessed using Computer Dynamic Posturography and following tube insertion, there is a notable improvement in vestibular function. Furthermore, the single-leg stance (SLS) test with eyes closed has shown its reliability in assessing balance disorders, notably in children with OME. LEVEL OF EVIDENCE: Level 2 Laryngoscope, 2024.

Investigation of the applicability of internet-based approach to subjective tinnitus.

BACKGROUND: To ensure that subjective tinnitus patients develop positive attitudes toward tele-audiology. AIMS/OBJECTIVES: This study investigates the appropriateness of the internet-based software in patients with subjective tinnitus. MATERIAL AND METHODS: Patients between the ages of 19 and 59 applying to the clinic with the subjective tinnitus filled in Tinnitus Handicap Index (THI) and Coronavirus Anxiety Scale (CAS). Visual Numeric Scale (VNS) was applied to the patients to complaint of tinnitus. Parameter measurements related to hearing and tinnitus were performed clinically. After the evaluations, 54 participants were divided into two groups to receive the 'Basic Information Material Service' (BIMS) face-to-face and online. Afterwards, THI and VNS were used to determine the current status. RESULTS: There was no significant difference between the groups that received BIMS with 2 different methods (p > .05). A significant difference was found in the scores before and after BIMS in terms of THI and VNS (p < .05). A strong negative correlation was found between the duration of tinnitus and the change in THI. In addition, there is a stronger-negative relationship between the number of centers consulted and the informational benefit revealed by the scales. CONCLUSIONS AND SIGNIFICANCE: Online intervention is as effective as face-to-face interaction in the management of tinnitus.

Adaptation and Validation of the Turkish Version of the International Tinnitus Inventory.

Objective: Tinnitus is a common auditory symptom that negatively affects the quality of life of individuals. This study aimed to determine the validity and reliability of a Turkish version of the International Tinnitus Inventory (Tr-ITI) for both clinical and research purposes. ITI is a short, easily applicable self-report inventory to measure perceived tinnitus. Methods: The Turkish translation of the ITI and the Tinnitus Handicap Inventory (THI) were administered to 125 participants aged 19 to 76 with tinnitus complaints for over three months. A routine audiological evaluation was performed, and the psychoacoustic properties of tinnitus were determined. Confirmatory factor analysis (CFA) was performed to construct validity, Cronbach's alpha coefficient was used for the reliability of internal consistency, and retests were administered to participants 15 days after the first measurement. Results: CFA and inter-item correlations confirmed the unifactorial model. Tr-ITI showed high internal consistency reliability (Cronbach's alpha =0.909). All fit index values showed a good fit. Correlations between the total scores of Tr-ITI and THI were moderate (r=-0.620) and between retest scores were very high (r=0.993). Conclusion: The Tr-ITI is a valid, reliable, and practical tool for determining tinnitus severity and tinnitus complaints.

Acute effects of lumbosacral mobilization on balance and functional activities in idiopathic Parkinson's disease:A randomised controlled trial.

BACKGROUND: Decreased axial rotation, impaired coordination between axial segments and axial tone contribute to gait, balance and postural disorders in Parkinson's Disease. AIMS: The aim of our study was to examine the acute effects of lumbosacral mobilization on balance and functional activities in patients with idiopathic Parkinson's Disease. METHODS: This study was a randomized controlled clinical trial conducted at Hacettepe University. The study included 28 patients with Parkinson's Disease who were between stage 2-3 according to the Modified Hoehn&Yahr Staging Scale. Participants were randomised to the study group, including 10 minutes of lumbosacral mobilization, or the control group, including no intervention. The Unified Parkinson's Disease Rating Scale (UPDRS), Modified Parkinson's Activity Scale (MPAS), Dynamic Gait Index (DGI), and static posturography test (Modified Clinical Test of Sensory Interaction and Balance - mCTSIB) were all examined twice. RESULTS: The UPDRS, MPAS, DGI values and the composite score with the soft ground eyes open condition in the mCTSIB were improved in the study group (p < 0.05). DGI and MPAS values reached the level of significance between the groups (p < 0.05). CONCLUSION: This study is the first to examine the effect of lumbosacral mobilization on balance and functional activities in patients with Parkinson's disease. Lumbosacral mobilization is an effective method in PwPD. Lumbosacral mobilization may be an alternative way for these patients to improve their balance and functional activities.

Do cervical stabilization exercises change the effects of conventional exercises in patients with Parkinson's disease?

OBJECTIVES: The aim of this study was to examine whether cervical stabilization exercises (CSEs) change the effects of conventional exercises (CEs) in patients with PD. METHODS: Twenty-five patients with PD were randomized into two groups. While the experimental group (EG) received CSEs in addition to CEs, the control group (CG) received only CEs. Both programs lasted 8 weeks. Eighteen participants were able to complete the study. The outcomes were the changes in posture, cervical joint position sense (JPS), balance assessment, 10-m walking tests (10MWT), and the Timed Up & Go (TUG) test. RESULTS: At the end of the study, significant improvement was observed in both groups in terms of trunk rotation angle and pelvic asymmetry, the time parameter of TUG, and the 10MWT (p < 0.05). In the EG, greater improvement was detected in the Berg Balance Scale, static posturography, postural alignment, JPS, and the cadence parameter of TUG (p < 0.05). DISCUSSION: CEs and CSEs could improve walking speed and posture in patients with PD, but if CSEs are added to CEs, greater improvements could be achieved in JPS and postural control.(Clinical Trials ID: NCT03854747).

The reliability and validity of decreased sound tolerance scale-screening.

OBJECTIVES: Decreased Sound Tolerance (DST) is a negative reaction to a sound that does not cause any reaction in an individual with normal hearing. DST's subclasses include hyperacusis, phonophobia, and misophonia, which are distinct and have therapy variations. There is no diagnostic method or scale that distinguishes them in the literature. This study's purpose was to develop a screening scale that distinguishes these three DSTs. METHODS: The study comprised 257 willing participants with normal hearing. Cronbach alpha coefficient, item-total correlation, and item differentiation of the Decreased Sound Tolerance Scale-Screening (DSTS-S) were evaluated. Structural validity of DSTS-S was performed by Varimax rotation with Kaiser normalization using Explanatory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) was performed to assess its structural compatibility. The scale's total scores from each section were compared using the Mann-Whitney U test in symptom (+) and symptom (-) participants. RESULTS: The Cronbach alpha value for hyperacusis, phonophobia, and misophonia sections of DSTS-S was calculated as 0.881, 0.775, and 0.938, respectively. The difference between the independent samplet-test and the variables was statistically significant (p < 0.01). The Mann-Whitney U test showed a significant difference between the median values of the total groups' scores with and without hyperacusis, phonophobia, and misophonia (HTS, PTS, and MTS, respectively) (p < 0.05). Evaluation by ROC analysis showed that hyperacusis was useful in predicting the presence of hyperacusis, phonophobia was useful in predicting the presence of phonophobia, and misophonia was useful in predicting the presence of misophonia (p < 0.001). Hyperacusis and misophonia sections showed high reliability, and phonophobia section showed a moderately reliable level. The Kappa test showed that the compatibility between test-retest for the total scores was statistically significant (p < 0.001). CONCLUSION: The study's results indicated that DSTS-S is a valid and reliable scale for identifying subtypes/problems/classes of decreased sound tolerance.

Is Inadequate Water Intake a Risk Factor for Vestibular Disorders?

BACKGROUND: Water is a vital nutrient for the human body system and failing to consume enough water could cause health problems. The purpose of this study is to investigate the relationship between water intake and vestibular system disorders. METHODS: Data from 93 patients (aged between 20 and 76 years) with vestibular disorders were analyzed in the study. The mean age of the patients was 46.96 ±13.94 years (female: 45.68 ±13.45, male: 49.96 ±14.85), and 69.9% (n=65) were female. Participants were sub-categorized into diagnostic groups as follows: benign paroxysmal positional vertigo, Meniere's disease, vestibular neuritis, vestibular migraine, and persistent postural perceptual dizziness. The water intake information was analyzed for total water, plain water, and caffeinated beverages separately and compared between groups. RESULTS: There was a significant difference between vestibular neuritis and benign paroxysmal positional vertigo (P < .001) and also between vestibular neuritis and Meniere's disease (P = .021) in terms of the intake values of plain water and total water. No significant difference was found between groups in caffeinated beverages intake (P = .151), and it was found that there is no statistically significant difference in plain water and total water intake in terms of gender (P > .05). CONCLUSION: The most significant result of this study is that inadequate water intake can be a risk factor for some forms of peripheral vestibular disorders. People should be informed about the importance of drinking water and be encouraged to increase their water intake.