Background: Meniere disease (MD) is an inner ear disorder associated with comorbidities such as autoimmune diseases or migraine. This study describes clinical and cytokine profiles in MD according to the age of onset of the condition. Methods: A cross-sectional study including 83 MD patients: 44 with early-onset MD (EOMD, 50 years old), 64 patients with migraine and 55 controls was carried out. Clinical variables and cytokines levels of CCL3, CCL4, CCL18, CCL22, CXCL,1 and IL-1β were compared among the different groups. Results: CCL18 levels were higher in patients with migraine or MD than in controls. Elevated levels of IL-1β were observed in 11.4% EOMD and in 10.3% LOMD patients and these levels were not dependent on the age of individuals. EOMD had a longer duration of the disease (p = 0.004) and a higher prevalence of migraine than LOMD (p = 0.045). Conclusions: Patients with EOMD have a higher prevalence of migraine than LOMD, but migraine is not associated with any cytokine profile in patients with MD. The levels of CCL18, CCL3, and CXCL4 were different between patients with MD or migraine and controls.

Physical exercises are crucial for enhancing postural balance and muscle strength in children and adolescents with Down syndrome (DS). Virtual reality-based therapy (VRBT), which utilizes exergames, can favor performing physical activity. The aim of this review was to assess the effectiveness of VRBT in improving balance and muscular endurance in children and adolescents with DS. Since inception up to August 2024, we screened in PubMed Medline, SCOPUS, WOS, CINAHL, and PEDro studies that assessed the effectiveness of VRBT, compared to conventional therapy (CT) or usual care (UC), in improving balance and muscular endurance in DS. Methodological quality was assessed using the PEDro scale. Effect size in meta-analyses was calculated with the Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI). Nine studies providing data from 424 participants with good methodological quality (PEDro: 6.3 ± 1.2 points) were included. Our meta-analysis showed that VRBT is more effective than controls in increasing function (SMD = 1.22; 95% CI 0.64 to 1.81; p < 0.001), dynamic balance (SMD = −2.2; 95% CI −3.1 to −1.25; p < 0.001), and muscular endurance (SMD = 1.37; 95% CI 0.58 to 2.2; p < 0.001). This is the first meta-analysis to exclusively focus on children and adolescents with DS, demonstrating the effectiveness of VRBT in enhancing balance and muscular endurance.

(1) Objective: To determine the effect of a directed vestibular rehabilitation therapy (VRT) program with manual therapy (MT) on dizziness-related disability and imbalance symptoms among patients with peripheral unilateral vestibular dysfunction. (2) Methods: Eighty patients (54.75 ± 1.34 years) were allocated either to a control group (n = 40), who underwent a directed VRT program, or to an experimental group (n = 40), who received the same program plus MT once a week/4 weeks. We assessed their level of disability (Dizziness Handicap Inventory, DHI), balance confidence (the Activities-specific Balance Confidence scale—16 items), postural balance (resistive multisensor platform), and the frequency and intensity of dizziness symptoms (visual analog scale). (3) Results: Post-intervention between-group improvements were observed regarding DHI total score and intensity in the experimental group (p < 0.001), as well as four weeks later. Six months after, the experimental group exhibited improvements in the center of pressure velocity with eyes open (p = 0.019), DHI total score (p = 0.001) and subscales (all p < 0.05), and intensity (p = 0.003) and frequency (p = 0.010) of dizziness. Balance confidence improvements were observed 1 month (p = 0.035) and 6 months (p = 0.038) post-intervention. (4) Conclusions: Directed VRT plus MT is a safe and beneficial intervention that speeds up recovery for patients suffering from dizziness and instability derived from unilateral vestibular dysfunction.

Background: Patient-reported outcome (PRO) questionnaires are essential tools for evaluating symptom burden and quality of life in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Instruments such as NOSE, SNOT-22, CRS-PRO, and NPQ are commonly used; however, the capability to translate scores between these instruments remains largely unexplored, limiting cross-study comparisons and continuity in patient care. Objective: To develop and validate predictive models quantifying relationships between widely utilized PRO questionnaires in CRSwNP and to assess their practical implications for clinical management and integration into research. Methods: In this observational cross-sectional study, 200 patients with CRSwNP completed the NOSE, SNOT-22, CRS-PRO, and NPQ questionnaires. Pairwise predictive models were constructed using linear and Random Forest regression methods. Model performance was evaluated through metrics such as R² and mean squared error (MSE). Model validity was ensured using the Durbin-Watson, Breusch-Pagan, Shapiro-Wilk, and variance inflation factor (VIF) tests. Clinical subgroup analyses based on variables such as asthma and prior nasal surgery were also conducted. Results: Strong correlations among questionnaires were observed (r=0.61–0.87). Linear regression models demonstrated high predictive accuracy, notably for SNOT-22 predicting NPQ (R²=0.76), NPQ predicting CRS-PRO (R²=0.76), and CRS-PRO predicting SNOT-22 (R²=0.74). Random Forest models showed minor performance enhancements (ΔR²≤0.03). Subgroup analyses indicated increased predictive precision in patients with asthma or previous nasal surgery. These predictive models enable clinicians to interpret scores across different instruments confidently, optimizing patient management decisions, particularly in monitoring treatment responses and longitudinal follow-ups. Results: Predictive modeling among PRO questionnaires in CRSwNP is both feasible and clinically impactful. These models facilitate the translation of scores between instruments, thus enhancing clinical decision-making, streamlining patient assessments, and supporting data harmonization in multicentric and longitudinal studies. Future research should pursue external and longitudinal validations to ensure broader applicability and reliability of these predictive tools.

Objectives: This work aims to evaluate the psychometric properties of the Vertigo Handicap Questionnaire (VHQ) in a Spanish-speaking population. Methods: A total of 150 patients were included. Exploratory Factorial Analysis (EFA), Cronbach’s alpha, weighted kappa, Spearman correlation with respect to the Dizziness Handicap Inventory (DHI) and Activities Balance Confidence Scale (ABC), Kruskal-Wallis test and receiver operating characteristics (ROC) curve analysis were performed. Results: Internal consistency analysis found eight items uncorrelated with the total score, after whose elimination a 17-item VHQ version was generated. The EFA did not find clear factorization but did find a 7-item VHQ subscale that correlated strongly with VHQ_17 and VHQ_25. The Kappa was 0.993, 0.979 and 0.996 for VHQ_25, VHQ_17 and VHQ_7, respectively. Standard Error of Measurement (SEM) was 1.57, 2.11 and 0.60 points, and Minimum Detectable Change (MDC) was 3.08, 4.13 and 1.17 points for the three scales. VHQ_25, VHQ_17 and VHQ_7 strongly correlated with ABC-16 (Rho = −0.716, −0.787 −0.603, respectively) and DHI (Rho = 0.708, 0.696 0.721, respectively). VHQ_7 score was statistically different for different health conditions. The cut-off point >57 in VHQ_25 and >14 in VHQ_7 had 100% sensitivity, while a cut-off point >41 in VHQ_17 had 100% specificity in predicting severe disability due to vertigo. Conclusions: The Spanish version of the VHQ_25 is a valid and reliable instrument for measuring disability, handicap and psychological distress related to vertigo. However, the VHQ_17 and VHQ_7 versions may be viable options, especially the last, which has excellent psychometric properties and may be easier to implement.

Objective: To evaluate the psychometric properties of the Spanish version of the Chronic Rhinosinusitis Patient-Reported Outcome (CRS-PRO) measure in patients with chronic rhinosinusitis (CRS), including those with and without nasal polyps. Methods: A cross-sectional validation study was conducted with 124 CRS patients recruited from a tertiary otolaryngology center. Internal consistency (Cronbach’s α), test–retest reliability (ICC), construct validity (exploratory factor analysis), concurrent validity (Pearson correlation with NPQ, NOSE-E, and SNOT-22), and discriminative capacity (ROC curve analysis) were assessed. A subsample of 35 patients completed the CRS-PRO twice to evaluate reproducibility. Results: Factor analysis confirmed a three-factor structure (rhinologic symptoms, psychosocial impact, and facial discomfort), explaining 69.4% of the variance. Internal consistency was excellent (α = 0.874), and test–retest reliability was very high (ICC = 0.986; SEM = 2; MDC95 = 3). All items demonstrated moderate to high item-total correlations. The CRS-PRO strongly correlated with NPQ ( r = 0.848), NOSE-E ( r = 0.849), and SNOT-22 ( r = 0.803). ROC analysis yielded an AUC of 0.929, with an optimal cut-off point of > 22 points (sensitivity 86.67%, specificity 86.08%) to identify severe symptom burden. Conclusions: The Spanish CRS-PRO is a valid, reliable, and efficient instrument for assessing disease-specific quality of life in CRS. Its strong psychometric performance, brevity, and diagnostic accuracy support its use in routine clinical practice, research, and digital health applications. These findings establish the CRS-PRO as a core PROM for Spanish-speaking patients with CRS. Clinical trial registration: Not applicable.