TY - JOUR
T1 - Mechanism of Dynamic Visual Acuity Recovery With Vestibular Rehabilitation
AU - Schubert, Michael C.
AU - Migliaccio, Americo A.
AU - Clendaniel, Richard A.
AU - Allak, Amir
AU - Carey, John P.
N1 - Funding Information:
Supported by the Foundation for Physical Therapy, American Physical Therapy Association and the National Institute on Deafness and Other Communication Disorders (grant nos. K23-007926, R03-DC007346, R01-DC005040).
PY - 2008/3
Y1 - 2008/3
N2 - Schubert MC, Migliaccio AA, Clendaniel RA, Allak A, Carey JP. Mechanism of dynamic visual acuity recovery with vestibular rehabilitation. 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, 42-66y) and 4 age-matched controls (age, 39-67y) were studied. Patients had vestibular hypofunction (mean duration, 177±188d) 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±24d). 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.
AB - Schubert MC, Migliaccio AA, Clendaniel RA, Allak A, Carey JP. Mechanism of dynamic visual acuity recovery with vestibular rehabilitation. 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, 42-66y) and 4 age-matched controls (age, 39-67y) were studied. Patients had vestibular hypofunction (mean duration, 177±188d) 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±24d). 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.
KW - Reflex, vestibulo-ocular
KW - Rehabilitation
KW - Saccades
KW - Vestibular diseases
KW - Visual acuity
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U2 - 10.1016/j.apmr.2007.11.010
DO - 10.1016/j.apmr.2007.11.010
M3 - Article
C2 - 18295629
AN - SCOPUS:39449099372
SN - 0003-9993
VL - 89
SP - 500
EP - 507
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 3
ER -