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Biomedical subjects

H Aalto

Publications and source records attributed to H Aalto.

At least 19 recordsLinked to original sources

Relevance of the Tullio phenomenon in assessing perilymphatic leak in vertiginous patients.

The Tullio phenomenon was studied in 57 control subjects, in 7 patients with confirmed PLF and in 149 patients with different types of inner ear pathology. The subjects were exposed to low-frequency sound (LFS) with sound pressure levels ranging from 130 to 132 dB and at frequencies of 25, 50, and 63 Hz. The duration of each stimulation was 30 seconds. The postural responses were measured using a force platform and analyzed with a computer. In control subjects the LFS stimulation somewhat improved the postural stability. All patients with PLF showed significantly altered postural stability during LFS exposure. Also about 20 percent of patients with labyrinthine vertigo, patients with Menièré's disease, patients with chronic middle ear disease (with vertigo) had pathologic response to LFS. None of the patients with pure sensorineural hearing loss without vertigo responded to LFS. Post-urography with LFS loading is a new, promising tool in detection of PLF, but the specificity of the test is still unsatisfactory.

Adolescent

Tullio phenomenon and postural stability: experimental study in normal subjects and patients with vertigo.

The effect of low-frequency sound (LFS) on postural stability was studied in 55 healthy volunteers and in 152 patients with vertigo due to different types of inner ear disease. The sound pressure levels ranged from 130 to 132 dB and were given at frequencies of 25, 50, and 63 Hz. The duration of each stimulation lasted 30 seconds. The postural responses were measured with a force platform. The LFS stimulation improved the postural stability of the healthy subjects through the alerting response. We did not observe any difference in the body sway according to whether the LFS was delivered with monaural or binaural stimulation. Twenty-six percent of the patients with Meniere's disease, 40% with chronic otitis media with vertigo, and 26% with vertigo of peripheral origin experienced significant postural instability at least at two of the three test frequencies during stimulation with LFS. The results demonstrate that in subjects with different types of inner ear disease the vestibular system starts to respond to LFS. The activation of vestibulospinal responses by LFS seems to be an expression of the Tullio phenomenon.

Acoustic Stimulation

Postural stability on moving platform oscillating at high frequencies. Effect of vestibular lesion.

The effect of linear perturbation at a frequency range of 8 to 24 Hz on postural stability was studied in 7 patients with unilateral vestibular function loss. Force platform technique was used with automatic analysis resulting in the sway velocity of the center point of force. In all patients the support surface movement produced increased sway velocity which was significantly greater than in the controls. Tests at lower frequencies (8 and 10 Hz) produced higher sway velocities than tests at higher frequencies (12, 14, 16 and 24 Hz). The results indicate that the vestibular system controls postural reflexes at a substantially higher frequency range than hitherto suggested.

Adult

Repeatability and effect of instruction of body sway.

The effect of instruction and repeatability of posturography measurement was studied in 24 healthy volunteers. In an instruction, "stable" (inverted pendular model) and "relaxed" (segmental oscillating model) positions were studied. In addition, the effect of habituation adaptation, and day-to-day variation were investigated. Sway velocity and average and maximum displacement during vibration perturbated stance were analysed. In individual responses, no statistically significant day-to-day variation could be observed and the individual variation was small. In the "relaxed" condition, the instability was greater when maximum displacement was analysed. No significant changes in sway velocity and average displacement were observed. The results demonstrated remarkable stability of normal postural control mechanism.

Adult

The Tullio phenomenon in patients with Menière's disease as revealed with posturography.

The effect of low frequency sound (LFS) on postural stability was studied in 55 healthy volunteers and in 50 patients with Menière's disease. The sound levels ranged from 130 to 132 dB and were given at frequencies of 25, 50 and 63 Hz. The patients with Menière's disease displayed increased body sway during stimulation. In the individual response, 26% of the patients with Menière's disease experienced significant body sway. The results demonstrate that subjects with Menière's disease are sensitive to low frequency sound. The activation of vestibulo-spinal responses by low frequency sound seems to be a result of the Tullio phenomenon, in which sound energy activates the vestibular end-organ.

Acoustic Stimulation

A microcomputer system for assessment of peripheral blood flow. An example of nasal blood flow.

We have designed and implemented a microcomputer system for studying the effect of various mediator substances on the nasal blood flow. The system uses an IBM PC/AT microcomputer, which is connected with a Laser Doppler Flowmeter (LDF) and an iontophoretic drug application system. The LDF measures flux from the tissue that in the example is the inferior nasal turbinate. The flux is converted to digital form by an analog-digital converter of 12 bits. The program is implemented in the Pascal language. In the analysis, a flux level, amplitude, rise time and decay time of the pulse wave are determined. The effect of drugs on the flux can be studied by applying them iontophoretically. In the program the length and number of the drug application periods as well as the recording period are user-driven. In the nasal blood flow iontophoretically administered adrenaline reduced significantly the flux parameters and histamine canceled this effect. Tachyphylalaxis was a frequent observation in repeated measurements. The system can be used to evaluate the role of different transmitters in the etiology of chronic rhinitis.

Adult

Postural control in elderly subjects.

The postural stability of 23 subjects aged 85 years or over was studied with a force platform. The sensory function of the lower limbs was disturbed with small vibrators placed on both calf muscles and/or by placing the subjects on a platform covered with foam plastic. When compared with a group (n = 100) of 50-60-year-old subjects, the elderly subjects had significantly higher sway velocities even during nonperturbed conditions. The perturbation of muscle spindles with vibration and/or pressoreceptor function with foam plastic did not increase the postural instability of the elderly subjects. Visual deprivation had a significant effect on postural stability, and the visual influx contributed about 50% of the postural stability. Postural control is reduced as a result of loss of sensory cues of pressoreceptors and also deterioration in function of stretch reflexes initiated from muscle spindles. The very elderly seem to rely on visual control of posture; this is slow, which can be one reason for susceptibility to falls.

Age Factors

Postural stability in shooters.

Ten competition shooters were tested during simulated race using the force platform technique to investigate the effect of training on postural stability. The shooters were tested at 30-min intervals during a race simulating actual race conditions. Sway velocity was calculated during 27-second periods. The postural stability was evaluated with and without competition clothing. The shooters had significantly better stability than untrained control subjects, when tested without supportive clothing. The competition clothing reduced the sway velocity further both in visual and nonvisual conditions. The Romberg quotient was higher in shooters than in normal controls, indicating that the shooters used to an increased amount proprioceptive and vestibular cues to stabilize their posture. The good postural stability of the shooters apparently results from assiduous training aimed to improve postural stability.

Adolescent

A microcomputer system for clinical signal analysis of vestibular laboratory.

A vestibular laboratory system was implemented for clinical testing and medical examination of patients with balance disorders. Programs for analysis of postural control and eye movements were made for a microcomputer. The microcomputer system can be used by a nurse without technical education. The system has now been used for two years at the laboratory.

Eye Movements

Hierarchy of different muscles in postural control.

The effects of muscle spindle activation on different postural muscles were examined in eight volunteers, using a force platform technique. Small electrical vibrators were placed symmetrically over the muscles concerned and the effects of vibration frequencies of 20, 40, 60, 80 and 100 Hz were studied at a constant amplitude of 0.4 mm (peak-to-peak). Significant responses were observed in most muscles. The responses were observed (in maximum response order) from: the neck, triceps surae, gluteus, abdominal, hamstring, quadriceps, lumbar and tibialis anterior muscles. The response direction did not follow anatomical gonistic vis-à-vis antagonistic distribution of the muscles studied, indicating that it is the functional properties of the muscles that determine posture stabilization. The large inter-individual variability in responses, but the consistency in intra-individual muscle responses indicates that the subjects used afferent muscles to a varying extent in postural control. The vibration-induced activation of the muscles was presumably derived by activation of stretch-sensitive secondary endings of muscle spindles that control postural stability.

Adult

Does impulse noise induce vestibular disturbances?

The effect of impulse noise on postural stability was evaluated in 54 subjects from the Finnish army, who were suffering from acute hearing loss caused by exposure to firearms noise. For referents we used 20 non-exposed army recruits and 39 civilian volunteers. The effects of vision, pressoreceptor function and proprioception were stepwise excluded or altered, leaving mainly the vestibular guidance of postural control intact. Since the postural perturbation was fairly smooth during these instances we assume that the condition evaluates mainly the function of the otolith organs in guiding stance. We found no difference in any of the test conditions used, between normal controls, army controls and impulse noise exposed subjects. Furthermore, there was no dose response with body sway and severity of hearing loss. The results indicate that impulse noise may not be the cause of significant functional changes in the vestibular system that can account for noise-induced postural instability.

Adult

Vestibulo-ocular and vestibulo-spinal reflexes in evaluation of vestibular lesions.

In order to evaluate to what extent different diseases causing vertigo can be detected by studying vestibulo-spinal and vestibulo-ocular reflexes, 146 patients were examined. The diagnosis classes were: periodical attacks, position induced attacks, vestibular neuronitis, brain concussion, cerebrovascular disorders and acoustic neurinoma. Dynamic posturography was performed on all the patients, standard bithermal caloric test on 129 and voluntary saccades on 127 patients. The proportion of pathological test results in posturography exceeded that in the caloric test in all but one diagnosis class. In vestibular neuronitis the amount of abnormal test results was low in posturography, probably due to vestibular compensation. Posturography tested with eyes open and with 80 Hz vibration revealed disturbances in equilibrium the most sensitively.

Caloric Tests

Computerized posturography, a development of the measuring system.

A computerized posturography system is composed of a custom made strain gauge force platform and it utilizes commercially available amplifiers. The body sway response signals are digitized for the calculation of the following parameters by a computer: average velocity of body sway, mean value for fore-aft and lateral body sway, and maximal amplitude of body sway. Calf muscles were exposed to vibration to disturb the postural control. The program contains appropriate filters to remove transient and quantification noise.

Humans

Vasomotor oscillation in vibration-induced white finger.

Vasomotor oscillation at different ambient temperatures, with and without anesthesia of the finger nerves, was studied in six persons with vibration-induced white finger (VWF) and in 10 referents. The power spectral density (PSD) of the Fourier transform of the laser-Doppler flowmeter signal from the finger pad vessels was analyzed. In both groups, the PSD of the vasomotor oscillation in the frequency range of 0.05-0.25 Hz was more pronounced in a cold than in a hot environment. Without finger nerve anesthesia, the oscillations of the referents were significantly greater (p less than 0.01) than those of the VWF subjects (PSD -34.4 dB and -41.6 dB, respectively). With anesthesia of the finger vasomotor nerves, the PSD was reduced in both groups. In the anesthetized finger there was no statistically significant group difference. Thus the myogenic component of the vasomotor activity was the same in the referents as in the VWF subjects. The results show that the autonomic neural influence on vasomotor oscillation in skin of the finger pad is weaker in persons with VWF. This weakness may be a sign of peripheral neuropathy, which may lead to a denervation syndrome causing hypersensitivity of the adrenoceptors to cold.

Adult