OBJECTIVE: To determine why dynamic visual acuity (DVA) improves after vestibular rehabilitation in people with vestibular hypofunction. DESIGN: Combined descriptive and intervention study. SETTING: Outpatient department in an academic medical institution. PARTICIPANTS: Five patients (age, 42-66 y) and 4 age-matched controls (age, 39-67 y) were studied. Patients had vestibular hypofunction (mean duration, 177+/-188 d) identified by clinical (positive head thrust test, abnormal DVA), physiologic (reduced angular vestibulo-ocular reflex [aVOR] gain during passive head thrust testing), and imaging examinations (absence of tumor in the internal auditory canals or cerebellopontine angle). INTERVENTION: Vestibular rehabilitation focused on gaze and gait stabilization (mean, 5.0+/-1.4 visits; mean, 66+/-24 d). The control group did not receive any intervention. MAIN OUTCOME MEASURES: aVOR gain (eye velocity/head velocity) during DVA testing (active head rotation) and horizontal head thrust testing (passive head rotation) to control for spontaneous recovery. RESULTS: For all patients, DVA improved (mean, 51%+/-25%; range, 21%-81%). aVOR gain during the active DVA test increased in each of the patients (mean range, 0.7+/-0.2 to 0.9+/-0.2 [35%]). aVOR gain during passive head thrust did not improve in 3 patients and improved only partially in the other 2. For control subjects, aVOR gain during DVA was near 1. CONCLUSIONS: Our data suggest that vestibular rehabilitation increases aVOR gain during active head rotation independent of peripheral aVOR gain recovery.
OBJECTIVE: To determine why dynamic visual acuity (DVA) improves after vestibular rehabilitation in people with vestibular hypofunction. DESIGN: Combined descriptive and intervention study. SETTING:Outpatient department in an academic medical institution. PARTICIPANTS: Five patients (age, 42-66 y) and 4 age-matched controls (age, 39-67 y) were studied. Patients had vestibular hypofunction (mean duration, 177+/-188 d) identified by clinical (positive head thrust test, abnormal DVA), physiologic (reduced angular vestibulo-ocular reflex [aVOR] gain during passive head thrust testing), and imaging examinations (absence of tumor in the internal auditory canals or cerebellopontine angle). INTERVENTION: Vestibular rehabilitation focused on gaze and gait stabilization (mean, 5.0+/-1.4 visits; mean, 66+/-24 d). The control group did not receive any intervention. MAIN OUTCOME MEASURES: aVOR gain (eye velocity/head velocity) during DVA testing (active head rotation) and horizontal head thrust testing (passive head rotation) to control for spontaneous recovery. RESULTS: For all patients, DVA improved (mean, 51%+/-25%; range, 21%-81%). aVOR gain during the active DVA test increased in each of the patients (mean range, 0.7+/-0.2 to 0.9+/-0.2 [35%]). aVOR gain during passive head thrust did not improve in 3 patients and improved only partially in the other 2. For control subjects, aVOR gain during DVA was near 1. CONCLUSIONS: Our data suggest that vestibular rehabilitation increases aVOR gain during active head rotation independent of peripheral aVOR gain recovery.
Authors: Rose Marie Rine; Dale Roberts; Bree A Corbin; Roberta McKean-Cowdin; Rohit Varma; Jennifer Beaumont; Jerry Slotkin; Michael C Schubert Journal: J Rehabil Res Dev Date: 2012
Authors: Courtney D Hall; Susan J Herdman; Susan L Whitney; Stephen P Cass; Richard A Clendaniel; Terry D Fife; Joseph M Furman; Thomas S D Getchius; Joel A Goebel; Neil T Shepard; Sheelah N Woodhouse Journal: J Neurol Phys Ther Date: 2016-04 Impact factor: 3.649
Authors: M Muntaseer Mahfuz; Michael C Schubert; William V C Figtree; Christopher J Todd; Americo A Migliaccio Journal: J Assoc Res Otolaryngol Date: 2018-08-17