Banca de DEFESA: MARIA CLARA PEIXOTO MARINHEIRO

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : MARIA CLARA PEIXOTO MARINHEIRO
DATE: 26/02/2025
TIME: 15:00
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: 100
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 can be 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 (Leganés
Cognitive Test); physical activity level (International Physical Activity
Questionnaire); and Horus® posturography were applied using the
parameters ellipse confidence/stability limit (CE/SL ratio), mean
anteroposterior and mediolateral velocity (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. Six hypotheses were accepted, indicating they
discriminated against individuals with and without VD. 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
Interna - 2090691 - JULIANA MARIA GAZZOLA
Interna - 4374835 - KARYNA MYRELLY OLIVEIRA BEZERRA DE FIGUEIREDO RIBEIRO