Change of Gait After Unilateral Vestibular Neuritis: A Prospective Longitudinal Observation Study

Abstract

Background: Although symptoms of unilateral vestibular neuritis (uVN) resolve spontaneously and quickly, there are uncertainties in the recovery of gait function. There is lack of prospective longitudinal study for gait function after acute uVN. In addition, there is no report for longitudinal changes in medio-lateral stability during gait after uVN. Therefore, the present study tested time effects on spatio-temporal parameters and on the medio-lateral CoM-CoP relationship. In addition, we explored differences of gait metrics between uVN and controls. Methods: This is a prospective longitudinal observation study. Of 122 participants with vestibular symptoms, 23 participants with uVN and 20 controls were included in data analysis. 3D gait analysis, dizziness handicap inventory (DHI) and computerized dynamic posturography (CDP) were conducted 3 times after uVN onset: the 1st test was conducted within 2weeks after onset, 2nd test after 1 month of 1st test and 3rd test after 1 month of 2nd test. From gait analysis data, spatio-temporal parameters, inclination angle in frontal plane (IA) and variability of IA were obtained. Time effects on gait metrics were tested with linear mixed model.Results: Walking speed improved significantly between the 1st and 3rd test but they were within normal range, even at the 1st test. Step width was significantly larger than control at the 1st test and improved to normal at the 2nd test. IA did not show significant difference between uVN and control. Variability of IA in the affected side was significantly larger than that in controls at the 1st test and improved significantly at the 3rd test compared to the 1st test. Conclusions: Improvement of overall gait function and neural adaptation of medio-lateral stability during gait continued during recovery stage of uVN (after 2 months of onset). Vestibular rehabilitation for gait should be continued during recovery stage of uVN to enhance appropriate adaptation.