Banca de QUALIFICAÇÃO: MARIA CLARA PEIXOTO MARINHEIRO

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : MARIA CLARA PEIXOTO MARINHEIRO
DATE: 11/11/2024
TIME: 09:00
LOCAL: Remoto
TITLE:

DISCRIMINATIVE VALIDITY AND DIAGNOSTIC ACCURACY OF HORUS POSTUROGRAPHIC PARAMETERS IN INDIVIDUALS WITH AND WITHOUT VESTIBULOPATHY

KEY WORDS:

Vestibular Diseases; Postural Balance; Dizziness; Psychometrics.

PAGES: 97
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Efficient postural balance results from the joint participation of somatosensory, visual, vestibular, neuromotor, and cognitive systems. Changes in the vestibular system can cause dizziness, vertigo and postural instability. Posturography is applied to assess postural oscillations in individuals with and without vestibular dysfunction (VD). However, there is a lack of studies investigating the discriminatory validity and diagnostic accuracy of Horus® posturographic parameters in differentiating between individuals with and without VD under different sensory conditions. Objective: To evaluate the discriminative validity and diagnostic accuracy of Horus® posturographic parameters across seven sensory conditions in individuals with and without VD. Methodology: A methodological study of discriminative validity was conducted through cross-sectional clinical research and based on COSMIN and STARD consensus. The sample constituted of individuals aged 40 to 79 years, of both sexes, divided into two groups: Group 1 (with VD) and Group 2 (without VD). Clinical characterization questionnaires, cognition (Leganes Cognitive Test); daily activities (Vestibular Disorders Activities of Daily Living Scale); physical activity level (International Physical Activity Questionnaire); Activities-specific Balance Confidence Scale, Mini-Balance Evaluation Systems Test, and posturography Horus® by the parameters confidence ellipse/ stability limit (ratio CE/SL), anteroposterior mean velocity and mediolateral (AP/MV and ML/MV), and Sensory Analysis (SA). To assess discriminative validity, non-parametric multivariate analyses (MANOVA) and Mann-Whitney tests were performed, controlled with Holm's adjustment, and rank-biserial correlation was used as an effect size estimate. Additionally, the sensitivity and specificity of the variables CE/SL, ML/MV, AP/MV from C4, Vestibular Function, and Composite Equilibrium Index (CEI) were determined using ROC curves, Youden Index, as well as calculating the area under the curve (AUC) and the 95% CI. For all statistical analyses, was used a significance level of 5% (p<0.05). Results: The final sample comprised 153 individuals, 78 from the group with VD (G1=78) and 75 without VD (G2=75), with average ages of 59.36 and 56.48 years, respectively. Regarding the discriminative validity of the posturographic parameters from Horus®, significant differences were found between individuals with and without VD for all dependent variables of CE/SL and ML/MV (p<0.001), with moderate to large differences (ES: 0.28) and in the majority of dependent variables of AP/MV and SA (p<0.005), with slight to moderate differences (ES: > 0.11 and < 0.43). However, in condition 5, "optokinetic to the right on an unstable surface," "left visual dependence," and "tunnel visual dependence" did not show significant differences. The results of the ROC curve analyses demonstrated that the CE/LS variable showed an AUC of 0.726 (p< 0.0001), with a sensitivity of 52.6% and a specificity of 84%; the ML/MV showed an AUC of 0.711 (p<0.0001), with a sensitivity of 53.85% and a specificity of 80.00%, in contrast, the AP/MV presented a lower AUC of 0.5942 (p =0.04), with a sensitivity of 67.9% and a specificity of 46.67%. The Vestibular Function obtained an AUC of 0.676 (p=0.0003), with a sensitivity of 70% and a specificity of 60.8%, while the CEI stood out with an AUC of 0.773 (p< 0.0001), sensitivity of 79.49%, and specificity of 64%. Conclusions: The parameters CE/SL, ML/MV, and AP/MV across the seven conditions and SA are moderately capable of discriminating between individuals with and without VD. However, the current composition of the Horus® posturography has not yet met COSMIN criteria for discriminative validity. Additionally, the ROC curve analyses for the variables CE/SL, ML/MV, AP/MV from C4, vestibular function and CEI showed that the test has a moderate to good discriminatory ability to identify individuals with and without VD, with high specificity for certain variables but moderate sensitivity, and the CEI appears to have a good combination of sensitivity and specificity

COMMITTEE MEMBERS:
Externa à Instituição - FABIANE DE CASTRO VAZ - UnB
Presidente - 2090691 - JULIANA MARIA GAZZOLA
Interna - 4374835 - KARYNA MYRELLY OLIVEIRA BEZERRA DE FIGUEIREDO RIBEIRO