title: Vestibulopathy induced by high impact aerobics. A new syndrome: discussion of 30 cases.
abstract: OBJECTIVE
  To examine the hypothesis that repetitive jarring traumas from the performance of high impact aerobic (HIA) exercises injuries the delicate otoliths and cochlea producing a syndrome of vertigo, tinnitus, balance dysfunction and hearing loss.
  
  
  METHODS
  Cohort study with descriptive analysis of 30 symptomatic subjects who only perform HIA. Age, sex and exercise/duration matched asymptomatic HIA control population was also surveyed.
  
  
  METHODS
  Community study over a 5-month period.
  
  
  METHODS
  Subjects receive detailed history, neurological and audiological testing. MRI/CAT and BSAER were utilized to rule out structural lesions and ENG assessed vestibular functions. Stratification of subjects into instructors and enthusiasts subgroup was based upon their exercise status.
  
  
  RESULTS
  Thirty females were identified with a mean age 35 years (+/- 9) (range 20-54 years). There were 12 instructors and 18 enthusiasts. The instructors significantly exercised greater number of hours (p < 0.01) and greater number of years (p < 0.051) than enthusiasts. The symptoms of vertigo, dizziness and imbalance were present 24/30 (80%), whereas tinnitus and/or ear fullness was present in 20/30 (67%). The instructor group displayed a statistically significant higher proportion of examination abnormality with Barany than enthusiasts (p < 0.05). ENG data was obtained in 19 subjects and was statistically abnormal in the enthusiast subgroup (p < 0.05). Sensitivity to barometric pressure (flying/Scuba/swimming) and car travel was statistically present in 18/30 individuals (60%), whereas, it was seen only in 4.3% of HIA controls (p < 0.0001). A characteristic 6000 Hz hearing loss with "notching" was seen in 22/30 (73%) of cases, suggesting that repetitive jarring and loud music produced damage to Organ of Corti. Instructors displayed this to a greater extent but this was not statistical.
  
  
  CONCLUSIONS
  There appears to be selective vulnerability to the otolith and Organ of Corti in individuals performing HIA. This previously unknown vestibulopathy produces characteristic auditory loss, as well as sensitivity to barometric pressure and car travel. Strategies for prevention include elimination or reduction of loud noise exposure during the dance routines, utilization of better insulated shoes and substitution to a less traumatic exercise.
authors.affiliation: New York Medical College, Valhalla.
authors.forename: M I
authors.initials: MI
authors.lastname: Weintraub
mesh_terms: D000328:Adult; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D015837:Vestibular Diseases / Q000209:etiology*