Banca de QUALIFICAÇÃO: LUANA DANTAS DA SILVA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : LUANA DANTAS DA SILVA
DATE: 06/10/2025
TIME: 09:00
LOCAL: Remoto
TITLE:

Postural Control and Functionality in Middle-Aged and Older Adults With and Without Chronic Vestibulopathy

KEY WORDS:

Vestibular Disorders; Postural Balance; Dizziness; Vertigo; Reference Values; Assessment; Activities of Daily Living

PAGES: 110
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Individuals with vestibular deficits may experience symptoms that compromise their performance in activities of daily living (ADLs). Balance assessment instruments can be applied not only to measure balance confidence but also to evaluate functional performance across a variety of activities in individuals with and without vestibular dysfunction (VD). However, to date, no studies have investigated the discriminative validity and diagnostic accuracy of the Activities-Specific Balance Confidence Scale (ABC Scale) and the Balance Evaluation Systems Test (MiniBESTest) in distinguishing individuals with and without VD. Objectives:1 - To evaluate the impact of daily activities, assessed using the Vestibular Disorders Activities of Daily Living Scale (VADL), in individuals with chronic vestibulopathy in relation to sociodemographic, clinical, and functional variables. 2 - To examine the discriminative validity and diagnostic accuracy of the Activities-Specific Balance Confidence Scale (ABC Scale) and the Balance Evaluation Systems Test (MiniBESTest), including their respective domains, in distinguishing individuals with and without vestibular dysfunction (VD). Methods: This was an analytical, quantitative study with a cross-sectional clinical design. Participants of both sexes, aged 40 to 79 years, were included and allocated into two groups: Group 1 (G1) consisted of individuals without a diagnosis of vestibulopathy, falls, or complaints of imbalance and/or dizziness; Group 2 (G2) included individuals with vestibulopathy, a history of falls, and complaints of imbalance and/or dizziness/vertigo. Both groups were assessed using the following instruments: clinical characterization; cognition (PCL); activities of daily living (VADL); physical activity level (IPAQ); balance confidence (ABC Scale); and balance performance (MiniBESTest), with scores expressed as percentages. Manuscript 1 presents comparative analyses, with the sample drawn from Group 2 (G2), whereas Manuscript 2 refers to a methodological study on discriminative validity and diagnostic accuracy, based on the COSMIN and STARD consensus, using samples from both Group 1 (G1) and Group 2 (G2). 1 - Descriptive analyses were performed, and either the Mann–Whitney or Kruskal–Wallis test was applied. 2 - Descriptive data were presented, the Mann–Whitney test was employed, and effect size was calculated using the rank-biserial correlation coefficient (r). The diagnostic accuracy of the ABC Scale, the MiniBESTest, and their respective domains for detecting the presence or absence of vestibulopathy was assessed using receiver operating characteristic (ROC) curve analysis, with determination of cutoff points (CP), sensitivity, accuracy, positive and negative predictive values, true positives (TP), false positives (FP), false negatives (FN), and true negatives (TN). Statistical significance was set at p < 0.05. Results: 1 - A total of 72 individuals with chronic vestibulopathy were evaluated, the majority of whom were female (80.8%), aged 40–59 years (52.8%), with a mean age of 59.03 years (± SD 11.20), and a predominant syndromic diagnosis of peripheral vestibulopathy (77.8%). Significant associations (p < 0.05) were observed between total VADL scores and the following variables: female sex, education up to nine years, symptom frequency (daily/weekly), self-reported memory/concentration problems, insomnia, and fear of falling. Similarly, the functional subscale was associated with education, symptom frequency, insomnia, and fear of falling; the locomotion subscale showed associations with the same variables, in addition to cognitive complaints and fear; and the instrumental subscale was associated with type of dizziness, memory/concentration problems, insomnia, falls within the last six months, and fear of falling. 2 - A total of 129 participants were evaluated, of whom 76 (58.91%) had a clinical diagnosis of vestibulopathy. When compared between groups, statistically significant differences were observed in the total ABC Scale score (U = 600; p < 0.001), the total MiniBESTest score (U = 543; p < 0.001), and in its domains: “anticipatory adjustments” (U = 854.50; p < 0.001), “postural responses” (U = 975.50; p < 0.001), “sensory orientation” (U = 846.50; p < 0.001), and “gait” (U = 679.50; p < 0.001). The area under the curve (AUC, 95% CI) and cutoff points (CP) for detecting the presence of vestibulopathy were as follows: ABC Scale [AUC = 0.851 (0.778–0.908); CP ≤ 72.50], with 76% sensitivity and 81% specificity; and MiniBESTest total percentage score [AUC = 0.875 (0.803–0.928); CP ≤ 82.14], with 75% sensitivity and 86% specificity. Conclusions: 1- Knowledge of the variables that trigger dizziness and postural imbalance is essential for the prevention and appropriate management of vestibular rehabilitation in these individuals, in order to optimize the performance of activities of daily living (ADL). 2- The Activities-specific Balance Confidence (ABC) scale and the Mini-BESTest demonstrate good discriminative validity to differentiate individuals with and without vestibular dysfunction (VD) in the 40–79-year age range, with moderate to strong effect sizes (r ≥ 0.39). Among the Mini-BESTest domains, the “gait” component is the most suitable as a rapid screening measure.

COMMITTEE MEMBERS:
Externa à Instituição - FABIANE DE CASTRO VAZ - UnB
Externa à Instituição - SABRINA GABRIELLE GOMES FERNANDES MACEDO - UFRN
Presidente - 5566309 - VANESSA REGIANE RESQUETI FREGONEZI