J Sports Med Phys Fitness. 1994 Mar;34(1):56-63. Related Articles,
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Vestibulopathy induced by high impact aerobics. A new syndrome: discussion
of 30 cases.

Weintraub MI.

New York Medical College, Valhalla.

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. DESIGN. 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. SETTING. Community study over a 5-month period. MATERIALS AND
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.
CONCLUSION. 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.