scholarly journals Vestibular Rehabilitation after Vestibulopathy Focusing on the Application of Virtual Reality

2021 ◽  
Vol 2 (2) ◽  
pp. 5
Author(s):  
Masashi Matsumura ◽  
Toshihisa Murofushi
Keyword(s):  
Virtual Reality ◽  
Balance Training ◽  
Sensory Information ◽  
Vestibular Function ◽  
Vestibular Rehabilitation ◽  
The Body ◽  
Drop Out ◽  
Bilateral Vestibulopathy ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Human postural control is regulated by the vestibular, somatosensory, and visual systems. These types of sensory information are integrated in the central nervous system to ascertain the body’s position in space. Proper functioning of the vestibular, somatosensory, and visual senses is necessary for the body to maintain equilibrium. Bilateral vestibulopathy (BVP) is a condition in which bilateral peripheral vestibular function is reduced. Its treatment includes vestibular rehabilitation (VeR), balance training, counseling, treating the underlying cause, and avoiding further damage to the vestibular system. As VeR is often tedious for patients, patient motivation is required or patients may drop out of the program. To solve this problem, in recent years, there have been increasing reports of VeR using virtual reality, which increases vestibulo-ocular reflex gain and decreased dizziness by inducing adaptation. In this review, we discuss VeR, particularly for BVP, and VeR using virtual reality.

scholarly journals Importance of high-frequency vestibular function in the prognosis of bilateral vestibulopathy

2020 ◽  
Author(s):  
Seonghoon Bae ◽  
Gi Sung Nam ◽  
Sang Hyun Kwak ◽  
Sung Huhn Kim
Keyword(s):  
High Frequency ◽  
Vestibular Function ◽  
Vestibular Rehabilitation ◽  
Composite Score ◽  
Head Impulse Test ◽  
Caloric Test ◽  
Bilateral Vestibulopathy ◽  
Dynamic Posturography ◽  
Vestibulo Ocular Reflex

Objective: To investigate whether preserved vestibular function in the high-frequency range influences the prognosis after vestibular rehabilitation in patients with BVP.Methods: Twenty-four patients followed up with vestibular rehabilitation were recruited. Enrolled patients were divided into two groups according to the preservation of high-frequency vestibulo-ocular reflex (VOR) based on the video head impulse test (vHIT). The results on the computerized dynamic posturography (CDP) and dizziness handicap inventory (DHI) survey collected at baseline and at the 6-month follow-up with vestibular rehabilitation therapy were analysed. Results: Both groups showed significantly increased composite and DHI scores after follow up with vestibular rehabilitation. The high-frequency VOR preserved group showed a better composite score (p = 0.064) and vestibular score (p = 0.008) than the high-frequency VOR loss group at the 6-month follow up. The DHI score was significantly decreased only in the high-frequency VOR loss group (p = 0.047). Among the three vestibular function tests (caloric test, rotary chair test, vHIT) used to diagnose BVP, only vHIT showed a significant correlation (p = 0.015) with favourable prognosis (composite score

A Case Report: Balance Training with Virtual Reality in Patients with Bilateral Peripheral Vestibulopathy

2017 ◽  
pp. 24-28
Author(s):  
Esra Dogru Huzmeli
Keyword(s):  
Virtual Reality ◽  
Balance Training ◽  
Berg Balance Scale ◽  
Bilateral Vestibulopathy ◽  
Balance Confidence ◽  
Before And After ◽  
Peripheral Vestibulopathy ◽  
The Subject ◽  
Balance Rehabilitation ◽  
Confidence Scale

The use of computerised imaging technologies in vestibular rehabilitation is a new concept. We aimed to examine the effects of virtual reality in a bilateral vestibulopathy patient. The subject was a 22-year old male patient. The bilateral semi-circular channels of patient were ossified, which showed advanced stage sensorineural hearing loss. Balance was analysed with Berg balance Scale (BBS), state of balanced feeling with visual analogue scale (VAS), and daily living activities with the activitiesspecific balance confidence scale (ABC). The scales were applied before and after treatment. The patient’s balance was treated with virtual reality for 18 sessions, after which the patient was feeling his balance better. The patient’s VAS score before rehabilitation was 5 and later it was 7. The ABC scores changed from 60 to 90. The BBS score was 51 before rehabilitation and later it was 56. Balance rehabilitation was successful in bilateral vestibulopathy. Keywords: Bilateral vestibulopathy, virtual reality, balance, vertigo.

scholarly journals Multimodality in VR: A survey

2022 ◽  
Author(s):  
Daniel Martin ◽  
Sandra Malpica ◽  
Diego Gutierrez ◽  
Belen Masia ◽  
Ana Serrano
Keyword(s):  
Virtual Reality ◽  
Knowledge Transfer ◽  
User Experience ◽  
Virtual World ◽  
Sensory Information ◽  
The Body ◽  
Overall Performance ◽  
The Way

Virtual reality (VR) is rapidly growing, with the potential to change the way we create and consume content. In VR, users integrate multimodal sensory information they receive, to create a unified perception of the virtual world. In this survey, we review the body of work addressing multimodality in VR, and its role and benefits in user experience, together with different applications that leverage multimodality in many disciplines. These works thus encompass several fields of research, and demonstrate that multimodality plays a fundamental role in VR; enhancing the experience, improving overall performance, and yielding unprecedented abilities in skill and knowledge transfer.

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 Clinical dynamic visual acuity in patients with cerebellar ataxia and vestibulopathy

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255299
Author(s):  
Michaela Dankova ◽  
Jaroslav Jerabek ◽  
Dylan J. Jester ◽  
Alena Zumrova ◽  
Jaroslava Paulasova Schwabova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Vestibular Function ◽  
Head Impulse Test ◽  
Dynamic Visual Acuity ◽  
Bilateral Vestibulopathy ◽  
Caloric Irrigation ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Cerebellar Ataxias ◽  
Central Adaptation

Deterioration of dynamic visual acuity (DVA) as a result of impaired vestibulo-ocular reflex (VOR) has been well described in peripheral vestibulopathies, however, changes in DVA in patients with degenerative cerebellar ataxias (CA) and its relation to VOR impairment in these patients has not yet been evaluated. Our aim was to assess the alterations of DVA in CA and to evaluate its relation to vestibular function. 32 patients with CA and 3 control groups: 13 patients with unilateral and 13 with bilateral vestibulopathy and 21 age matched healthy volunteers were examined by clinical DVA test, VOR was assessed by video Head Impulse Test and caloric irrigation. The severity of ataxia in CA was assessed by Scale for the assessment and rating of ataxia (SARA). Relationship between DVA and vestibular function in CA patients was examined by linear regressions. DVA impairment was highly prevalent in CA patients (84%) and its severity did not differ between CA and bilateral vestibulopathy patients. The severity of DVA impairment in CA was linked mainly to VOR impairment and only marginally to the degree of ataxia. However, DVA impairment was present also in CA patients without significant vestibular lesion showing that central mechanisms such as impairment of central adaptation of VOR are involved. We suggest that the evaluation of DVA should be a standard part of clinical evaluation in patients with progressive CA, as this information can help to target vestibular and oculomotor rehabilitation.

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

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

Cerebellar Dizziness and Vertigo: Etiologies, Diagnostic Assessment, and Treatment

2019 ◽  
Vol 40 (01) ◽  
pp. 087-096 ◽  
Author(s):  
Andreas Zwergal ◽  
Katharina Feil ◽  
Roman Schniepp ◽  
Michael Strupp
Keyword(s):  
Balance Training ◽  
Vestibular Function ◽  
Downbeat Nystagmus ◽  
Ocular Reflex ◽  
Assessment And Treatment ◽  
Gaze Holding ◽  
Risk Of Falls ◽  
Vestibulo Ocular Reflex ◽  
Cerebellar Ataxias ◽  
Vertical Nystagmus

AbstractCerebellar dizziness and vertigo account for approximately 10% of diagnoses in a tertiary dizziness center. This term summarizes a large group of disorders with chronic (degenerative, hereditary, acquired cerebellar ataxias), recurrent (episodic ataxias), or acute (stroke, inflammation) presentations. Key to the diagnosis is a comprehensive examination of central ocular motor and vestibular function. Patients with cerebellar dizziness and vertigo usually show a pattern of deficits in smooth pursuit, gaze-holding, saccade accuracy, or fixation-suppression of the vestibulo-ocular reflex. Central fixation nystagmus (e.g., downbeat nystagmus), gaze-evoked nystagmus, central positional nystagmus, or head-shaking nystagmus with cross-coupling (i.e., horizontal head shaking causing inappropriate vertical nystagmus) occurs frequently. Overlap syndromes with peripheral vestibular disorders, such as cerebellar ataxia, neuropathy, and vestibular areflexia, exist rarely. Posturography and gait analysis can contribute to diagnostic differentiation, estimation of the risk of falls, as well as quantification of progression and treatment effects. Patients with cerebellar dizziness and vertigo should receive multimodal treatment, including balance training, occupational therapy, and medication.

Diazepam Tolerance Effects on Vestibular Function Testing, Part II: Vestibulo-Ocular Reflex Parameters during Rotational Testing

2005 ◽  
Vol 114 (9) ◽  
pp. 722-729 ◽  
Author(s):  
Patricia A. Blau ◽  
Nathan Schwade ◽  
Peter Roland
Keyword(s):  
Repeated Measures ◽  
Statistical Significance ◽  
Vestibular Function ◽  
Normal Male ◽  
Repeated Measures Design ◽  
Ocular Reflex ◽  
Normal Ranges ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain ◽  
Double Blinded

Objectives: The purpose of this prospective study was to determine whether clinical doses of diazepam (DZ; 10 mg/d) administered for 14 days result in tolerance as measured by the sinuosidal harmonic acceleration (SHA) rotational test. It has been shown that repeated dosing with DZ leads to accumulation and tolerance in outcome measures that assess memory, sedation, and psychomotor tasks. Methods: In a double-blinded, repeated-measures design, 30 normal male subjects who ranged in age from 20 to 36 years were randomly assigned to a placebo group or a DZ group and participated in 6 SHA rotational sessions over a 2-week period. Analysis of drug-placebo differences in percent change from baseline was performed with a 1-way analysis of variance. Results: Vestibulo-ocular reflex gain and phase frequencies at 0.01, 0.02, 0.04, and 0.08 Hz were significant (p < .05) for treatment group. No significant effect was observed for gain and phase frequency at 0.16 Hz — a finding that indicates selective effects on different central nervous system mechanisms. There was no statistical significance for time. Conclusions: Clinically, the DZ subjects' scores remained within the normal ranges for vestibulo-ocular phase and gain, suggesting that patients in whom drug cessation is problematic may not have to discontinue DZ before testing with the SHA rotational system.

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