Compensation of the Postural Instability in Patients  with Acute Unilateral Vestibular Neuritis:  The Usefulness of Computerized Dynamic  Posturography as an Objective Indicator

Kim

2021

Sci Rep

Although symptoms of unilateral vestibular neuritis (uVN) resolve spontaneously within several weeks, recovery of gait function has unclearness in gait parameter changes and mediolateral stability improvements. In addition, prospective longitudinal studies on gait parameters after uVN are lacking. This study was conducted to reveal longitudinal change of gait function after acute uVN and to help the precise rehabilitation planning. Twenty three participants with uVN and 20 controls were included. 3D gait analyses were conducted three times after uVN onset at monthly intervals. From the gait analysis data, spatio-temporal parameters, inclination angle (IA) representing the relationship between center of mass (CoM) and center of pressure (CoP) in the frontal plane, and IA variability were obtained. Time effects on gait metrics were tested. Walking speed of participants with uVN improved significantly between the 1st and 3rd tests, but they were not significantly different to that of control, even in the 1st test. The step width of participants with uVN was significantly larger than that of control in the 1st test and improved significantly in the 2nd test. Variability of IA in affected side was significantly larger than that in controls in the 1st test and improved significantly in the 3rd test compared to the 1st test. Improvement of overall gait function and mediolateral stability during gait continued after acute stage of uVN (two months from onset in this study). Rehabilitation intervention should be continued after the acute stage of uVN to enhance appropriate adaptation in gait.

Section: Discussionsupporting

confidence: 87%

Change of gait after unilateral vestibular neuritis: a prospective longitudinal observation study

Kim

2021

Sci Rep

“…In the present study, limitations in daily life after uVN was measured by DHI (18). In the present study, average of DHI (38.52) at the 1st test corresponded to the results of previous studies for acute uVN, ranging 37 ~ 45 (19)(20)(21). DHI improved signi cantly between the 1st and the 2nd test.…”

Section: Discussionsupporting

confidence: 91%

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

Kim³

2020

Preprint

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.

“…In the present study, perception of limitations in the activities of daily life after uVN were measured using the DHI 17 . The average DHI (38.52) in the 1 st test corresponded to the results of previous studies for acute uVN (range: 37-45) [18][19][20] . DHI improved signi cantly between the 1 st and the 2 nd tests.…”

Section: Discussionsupporting

confidence: 85%

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

Kim

2020

Preprint

Although symptoms of unilateral vestibular neuritis (uVN) resolve spontaneously, there is unclearness in the recovery of gait. Prospective longitudinal studies on gait parameters after uVN are lacking. In this study, twenty three participants with uVN and 20 controls were included. 3D gait analyses were conducted thrice after uVN onset. From the gait analysis data, spatio-temporal parameters, inclination angle (IA) representing the relationship between CoM and CoP in the frontal plane, and IA variability were obtained. Time effects on gait metrics were tested. Walking speed improved significantly between the 1st and 3rd tests, but they were within normal range, even in the 1st test. The step width of participants with uVN was significantly larger than that of control in the 1st test and improved to normal in the 2nd test. Variability of IA in affected side was significantly larger than that in controls in the 1st test and improved significantly in the 3rd test compared to the 1st test. Improvement of overall gait function and neural adaptation of mediolateral stability during gait continued during the recovery stage of uVN (after two months from onset). Rehabilitation intervention should be continued during the recovery stage of uVN to enhance appropriate adaptation in gait.