An adaptive vestibular rehabilitation technique

Crane, Benjamin T.; Schubert, Michael C.

doi:10.1002/lary.26661

Cited by 21 publications

(14 citation statements)

References 32 publications

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“…Both intervention groups improved significantly compared with usual care for dizziness handicap and vertigo symptoms and there were no differences between the intervention groups. At-home DVA training using software algorithms to determine optotype size and wearable sensors to track head velocity led to reduction in DHI scores in a small sample of individuals with UVH (Crane and Schubert,167 level III). Software algorithms have the potential to remotely supervise exercise participation based on predefined objective criteria such as symptom reports, DVA score, or peak head velocity.…”

Section: Update and Revision Of Guidelinesmentioning

confidence: 99%

“…Crane and Schubert 167 (level III) studied individuals with chronic UVH with DHI scores of greater than 30 out of 100. In this small study (n = 4), subjects performed a 10-minute daily computer-based DVA task that encouraged angular head velocity.…”

Section: Evidence Updatementioning

confidence: 99%

mentioning

confidence: 99%

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Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association

Hall

Herdman

Whitney

et al. 2021

Journal of Neurologic Physical Therapy

199

203

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Background: Uncompensated vestibular hypofunction can result in symptoms of dizziness, imbalance, and/or oscillopsia, gaze and gait instability, and impaired navigation and spatial orientation; thus, may negatively impact an individual's quality of life, ability to perform activities of daily living, drive, and work. It is estimated that one-third of adults in the United States have vestibular dysfunction and the incidence increases with age. There is strong evidence supporting vestibular physical therapy for reducing symptoms, improving gaze and postural stability, and improving function in individuals with vestibular hypofunction. The purpose of this revised clinical practice guideline is to improve quality of care and outcomes for individuals with acute, subacute, and chronic unilateral and bilateral vestibular hypofunction by providing evidence-based recommendations regarding appropriate exercises. Methods: These guidelines are a revision of the 2016 guidelines and involved a systematic review of the literature published since 2015 through June 2020 across 6 databases. Article types included meta-analyses, systematic reviews, randomized controlled trials, cohort studies, case-control series, and case series for human subjects, published in English. Sixty-seven articles were identified as relevant to this clinical practice guideline and critically appraised for level of evidence. Results: Based on strong evidence, clinicians should offer vestibular rehabilitation to adults with unilateral and bilateral vestibular hypofunction who present with impairments, activity limitations, and participation restrictions related to the vestibular deficit. Based on strong evidence and a preponderance of harm over benefit, clinicians should not include voluntary saccadic or smooth-pursuit eye movements in isolation (ie, without head movement) to promote gaze stability. Based on moderate to strong evidence, clinicians may offer specific exercise techniques to target identified activity limitations and participation restrictions, including virtual reality or augmented sensory feedback. Based on strong evidence and in consideration of patient preference, clinicians should offer supervised vestibular rehabilitation. Based on moderate to weak evidence, clinicians may prescribe weekly clinic visits plus a home exercise program of gaze stabilization exercises consisting of a minimum of: (1) 3 times per day for a total of at least 12 minutes daily for individuals with acute/subacute unilateral vestibular hypofunction; (2) 3 to 5 times per day for a total of at least 20 minutes daily for 4 to 6 weeks for individuals with chronic unilateral vestibular hypofunction; (3) 3 to 5 times per day for a total of 20 to 40 minutes daily for approximately 5 to 7 weeks for individuals with bilateral vestibular hypofunction. Based on moderate evidence, clinicians may prescribe static and dynamic balance exercises for a minimum of 20 minutes daily for at least 4 to 6 weeks for individuals with chronic unilateral vestibular hypofunction and, bas...

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Section: Update and Revision Of Guidelinesmentioning

confidence: 99%

Section: Evidence Updatementioning

confidence: 99%

See 1 more Smart Citation

Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association

Hall

Herdman

Whitney

et al. 2021

Journal of Neurologic Physical Therapy

199

203

View full text Add to dashboard Cite

show abstract

“…In the study by Sparrer et al [ 27 ] who divided their patients into the experimental group who performed customized exercise using the Nintendo Wii Balance Board with medication treatment, and a control group who performed exercise with medical treatment for patients with vestibular neuritis, a significant decrease in dizziness was observed in the experimental group, and the patients’ return to everyday life was faster in the experimental group than in the control group. Crane and Schubert [ 28 ] showed an average decrease of 71% in dizziness after one month of implementing a computer-based adaptation of the vestibular rehabilitation program as compared to the traditional VRE. Preceding studies suggest that habituation exercises can reduce symptoms even if the same situation occurs by repeatedly performing various postures or situations in everyday life in which the patient's symptoms occur.…”

Section: Discussionmentioning

confidence: 99%

Effects of stabilizing reversal technique and vestibular rehabilitation exercise on dizziness and balance ability in patients with vestibular neuritis

2022

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Vestibular neuritis is a common disease of peripheral dizziness. Studies have shown that vestibular rehabilitation exercise (VRE) and proprioceptive neuromuscular facilitation (PNF) are effective to treat the symptoms of vestibular neuritis. However, the effect of VRE and PNF on the balance ability and dizziness in this patient cohort remains unclear. The aim of our observational study was to determine the changes in dizziness and balance ability of patients with vestibular neuritis who participated in the VRE program with stabilizing reversal technique (SRT). The reporting of this study conforms to the STROBE statement. Ten men and women aged ≥ 20 years who were diagnosed with vestibular neuritis were included. Patients performed VRE with SRT for 4 weeks with assistance from a therapist. VRE without SRT can also be performed at home. Dizziness was evaluated using the dizziness handicap inventory (DHI) and visual analog scale (VAS). Balance ability was assessed using the Berg's balance scale (BBS) and timed up and go test (TUG). At pre- and post-exercise, paired t test was performed to compare the within-group differences. After the program, DHI (45.40 ± 6.74 to 21.00 ± 7.07), VAS (5.90 ± 1.20 to 2.80 ± 0.92), BBS (45.10 ± 2.77 to 52.70 ± 1.83), and TUG (15.29 ± 1.13 to 12.06 ± 1.61) scores improved significantly in the VRE program group ( P = .05). The VRE program combined with SRT was effective in reducing dizziness and increasing balance ability in patients with vestibular neuritis.

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“…This could be due in part to a lack of equipment in the clinical and home setting to measure speed and/or excursion of head movement. However, our review found several different technologies being used or in development that can assist with measuring speed and excursion 17 19–22 26 31–33. Most involved wearable head mounted technology that might be more accessible to a clinical environment 19 20 22 31–33.…”

Section: Discussionmentioning

confidence: 99%

Reporting of exercise dose and dosage and outcome measures for gaze stabilisation in the literature: a scoping review

2022

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ObjectivesThe concept of this review is to examine and quantify the reporting of parameters of dose (duration, speed, head excursion) and dosage (daily and weekly frequency, duration) for gaze stabilisation exercises and to report on outcome measures used to assess change in gaze stabilisation following intervention. This review includes any population completing gaze stabilisation exercises.DesignScoping review.MethodsWe searched key terms in the following databases: PubMed, CINAHL, Scopus and Cochrane. Two researchers reviewed titles, abstracts and full-text articles for inclusion. Data retrieved included: patient diagnosis, specific interventions provided, dose and dosage of gaze stabilisation interventions and outcome measures.ResultsFrom the initial 1609 results, 138 studies were included. Data extraction revealed that only 13 studies (9.4%) reported all parameters of dose and dosage. Most studies used other interventions in addition to gaze stabilisation exercises. Half of the studies did not use a clinical or instrumented outcome measure of gaze stability, using only patient-reported outcome measures. Clinical tests of gaze stability were used in 21.1% of studies, and instrumented measures of gaze stability were used in 14.7% of studies.ConclusionsFull reporting of the dose and dosage of gaze stabilisation interventions is infrequent, impairing the ability to translate current evidence into clinical care. Most studies did not use a clinical or instrumented measure of gaze stabilisation as outcome measures, questioning the validity of intervention effects. Improved reporting and use of outcome measures are necessary to establish optimal intervention parameters for those with gaze stability impairments.

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An adaptive vestibular rehabilitation technique

Abstract: 2b. Laryngoscope, 128:713-718, 2018.

Cited by 21 publications

References 32 publications

Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association

Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association

Effects of stabilizing reversal technique and vestibular rehabilitation exercise on dizziness and balance ability in patients with vestibular neuritis

Reporting of exercise dose and dosage and outcome measures for gaze stabilisation in the literature: a scoping review

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