Long-term effects of vestibular rehabilitation and head-mounted gaming task procedure in unilateral vestibular hypofunction: a 12-month follow-up of a randomized controlled trial

2018 ◽  
Vol 33 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Andrea Viziano ◽  
Alessandro Micarelli ◽  
Ivan Augimeri ◽  
Domenico Micarelli ◽  
Marco Alessandrini
Keyword(s):  
Power Spectra ◽  
Vestibular Rehabilitation ◽  
Performance Measure ◽  
Self Report ◽  
Long Term Effects ◽  
Ocular Reflex ◽  
Vestibular Hypofunction ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Objective: To investigate the long-term effects of adding virtual reality–based home exercises to vestibular rehabilitation in people with unilateral vestibular hypofunction. Design: Follow-up otoneurological examination in two randomized groups following a previous one-month trial. Setting: Tertiary rehabilitation center. Subjects: A total of 47 patients with unilateral vestibular hypofunction, one group ( n = 24) undergoing conventional vestibular rehabilitation and the other one ( n = 23) implementing, in addition, head-mounted gaming home exercises, 20 minutes per day for one month. Interventions: One year after completing rehabilitation, patients underwent testing with static posturography, video head impulse test, self-report questionnaires, and a performance measure. Main measures: Vestibulo-ocular reflex gain, posturographic parameters such as length, surface, and fast Fourier transform power spectra, self-report, and gait performance measure scores. Results: Vestibulo-ocular reflex gain was significantly better with respect to pretreatment in both groups. The mixed-method group showed significantly higher gain scores: mean (standard deviation (SD)) at 12 months was 0.71 (0.04), versus 0.64 (0.03) for the vestibular rehabilitation–only group ( P < 0.001). Accordingly, some classical posturography scores such as surface with eyes open and length with eyes closed and low-frequency power spectra were significantly different between groups, with the virtual reality group showing improvement ( P < 0.001). Self-report measures were significantly better in both groups compared to pretreatment, with significant improvement in the mixed-method group as compared to conventional rehabilitation alone: Dizziness Handicap Inventory mean total score was 24.34 (2.8) versus 35.73 (5.88) with a P-value <0.001. Conclusion: Results suggest that head-mounted gaming home exercises are a viable, effective, additional measure to improve long-term vestibular rehabilitation outcomes.

scholarly journals Relationship between vestibulo-ocular reflex gain and dizziness handicap inventory score to predict effectiveness of vestibular rehabilitation

2021 ◽  
Author(s):  
Morteza Hamidi Nahrani ◽  
Mehdi Akbari ◽  
Mohammad Maarefvand
Keyword(s):  
Vestibular Rehabilitation ◽  
Head Impulse Test ◽  
Dizziness Handicap Inventory ◽  
Strong Negative Correlation ◽  
Ocular Reflex ◽  
Vestibular Hypofunction ◽  
Before And After ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Background and Aim: Evaluating the effective­ness of vestibular rehabilitation (VR) in patients with vestibular lesions has always been a challe­nge. The questionnaires that are used for this pur­pose mostly show the degree of vestibular dis­ability rather than providing information about improvement of vestibular dysfunction. This study aimed to evaluate whether video head imp­ulse test (vHIT) that is used for the examination of vestibulo-ocular reflex (VOR), is a useful method for predicting the effectiveness of VR and has a correlation with dizziness handicap inventory (DHI) score. Methods: Participants were 42 patients with unilateral peripheral vestibular hypofunction (UPVH) undergoing VR. Patients were assessed before and after rehabilitation by the vHIT in all ipsilesional and contralesional semicircular can­als (SCCs) and the DHI. The changes in DHI score and VOR gain before and after rehabili­tation, were shown as ΔDHI and ΔVOR and their correlation was evaluated. Results: VOR gain from ipsilesional and contra­lesional SCCs was improved significantly after VR. There was a significant strong negative correlation between ΔVOR gain from ipsile­sional SCCs and ΔDHI score but no significant correlation was found between the ΔDHI score and ΔVOR gain from contralesional SCCs. Conclusion: vHIT test is a useful tool to evaluate the effectiveness of VR. VOR gain is correlated with the DHI score. Therefore, the improvement in vHIT results in all three SCCs after VR may be a good predictor of the degree of improvement in dizziness-related disability. Keywords: Vestibular rehabilitation; follow-up; unilateral vestibular hypofunction; video head impulse test; dizziness handicap inventory

Assessment of Vestibulo-ocular Reflex Gain and Catch-up Saccades During Vestibular Rehabilitation

2018 ◽  
Vol 39 (10) ◽  
pp. e1111-e1117 ◽  
Author(s):  
Elena Navari ◽  
Niccolò Cerchiai ◽  
Augusto Pietro Casani
Keyword(s):  
Vestibular Rehabilitation ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain ◽  
Catch Up

Viewing Target Distance Influences the Vestibulo-Ocular Reflex Gain when Assessed Using the Video Head Impulse Test

2018 ◽  
Vol 23 (5) ◽  
pp. 285-289 ◽  
Author(s):  
Patricia Castro ◽  
Sara Sena Esteves ◽  
Florencia Lerchundi ◽  
David Buckwell ◽  
Michael A. Gresty ◽  
...  
Keyword(s):  
Head Movements ◽  
Target Distance ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Gaze Stabilization ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Significant Difference ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Gaze stabilization during head movements is provided by the vestibulo-ocular reflex (VOR). Clinical assessment of this reflex is performed using the video Head Impulse Test (vHIT). To date, the influence of different fixation distances on VOR gain using the vHIT has not been explored. We assessed the effect of target proximity on the horizontal VOR using the vHIT. Firstly, we assessed the VOR gain in 18 healthy subjects with 5 viewing target distances (150, 40, 30, 20, and 10 cm). The gain increased significantly as the viewing target distance decreased. A second experiment on 10 subjects was performed in darkness whilst the subjects were imagining targets at different distances. There were significant inverse relationships between gain and distance for both the real and the imaginary targets. There was a statistically significant difference between light and dark gains for the 20- and 40-cm distances, but not for the 150-cm distance. Theoretical VOR gains for different target distances were calculated and compared with those found in light and darkness. The increase in gain observed for near targets was lower than predicted by geometrical calculations, implying a physiological ceiling effect on the VOR. The VOR gain in the dark, as assessed with the vHIT, demonstrates an enhancement associated with a reduced target distance.

scholarly journals Importance of Vestibulo-ocular Reflex Gain and Refixation Saccade Analysis in Individuals with Auditory Neuropathy Spectrum Disorder

2019 ◽  
Vol 24 (02) ◽  
pp. e140-e148
Author(s):  
Sujeet Kumar Sinha ◽  
Anuj Kumar Neupane ◽  
Krithika Gururaj
Keyword(s):  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Semicircular Canals ◽  
Normal Hearing ◽  
Auditory Neuropathy ◽  
Spectrum Disorder ◽  
Auditory Neuropathy Spectrum Disorder ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Abstract Introduction Auditory neuropathy spectrum disorder (ANSD) features the presence of otoacoustic emissions, poor speech identification score and absent auditory brainstem response. Objective The present study was designed to evaluate the functioning of all six semicircular canals in individuals with ANSD and to compare it with those of normal-hearing individuals. Methods A total of 50 individuals participated in the present study, in which Group I comprised 25 normal-hearing individuals, and Group II comprised 25 individuals with ANSD. All of the participants underwent case history, pure tone audiometry, immittance, otoacoustic emissions, auditory evoked response and video head impulse test (vHIT). Results The independent sample t-test revealed significantly lower vestibulo-ocular reflex gain values in individuals with ANSD. A presence of 100% corrective refixation saccades was observed in the same group. The Pearson correlation test revealed no significant correlation between vestibulo-ocular reflex (VOR) gain with duration of hearing loss and pure tone thresholds for any of the three orthogonal planes. The chi-squared test revealed no association between the VOR gain values and the presence or absence of saccades in any of the semicircular canals (p > 0.05). Conclusion Huge percentages of individuals with ANSD have been found to have associated vestibular dysfunction as well. Therefore, the vHIT can be used as one of the important tests of the vestibular test battery to evaluate all six semicircular canals in individuals with ANSD.

Plasticity in the adult vestibulo-ocular reflex arc

1977 ◽  
Vol 278 (961) ◽  
pp. 319-334 ◽  
Keyword(s):  
Human Subjects ◽  
Neural Model ◽  
Reflex Response ◽  
Normal Vision ◽  
Ocular Reflex ◽  
Field Of Vision ◽  
Reflex Arc ◽  
Vestibulo Ocular Reflex ◽  
Plastic Changes

Human subjects with maintained reversal of their horizontal field of vision exhibit very substantial adaptive changes in their ‘horizontal’ vestibulo-ocular reflex (v.o.r.). Short durations (8 min) of vision reversal during natural head movement led to 20 % v.o.r. attenuation while long periods (4 weeks) eventually led to approximate reversal of the reflex. The reversed condition is approached by a complex, but highly systematic, series of changes in gain and phase of the reflex response relative to normal. Recovery after return to normal vision exhibits a similar duration, but different pattern, to that of the original adaptation. A chronic cat preparation with long-term optical reversal of vision has now been developed and shows similar adaptive and recovery changes at low test stimulus amplitudes, but different patterns of adaptive response at high amplitudes. An adaptive neural model employing mown vestibulo-ocular pathways is proposed to account for these experimentally observed plastic changes. The model is used to predict the adapted response to patterns of stimulation extending beyond the range of experimental investigation.

The Horizontal Vestibulo-Ocular Reflex Gain During Active and Passive High-Frequency Head Movements

1994 ◽  
Vol 101 (2) ◽  
pp. 140???145 ◽  
Author(s):  
Borys Hoshowsky ◽  
David Tomlinson ◽  
Julian Nedzelski
Keyword(s):  
High Frequency ◽  
Head Movements ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain
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