Rehabilitation of dynamic visual acuity in patients with unilateral vestibular hypofunction: earlier is better

Lacour, Michel; Tardivet, Laurent; Thiry, Alain

doi:10.1007/s00405-019-05690-4

Cited by 47 publications

(44 citation statements)

References 37 publications

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“…Furthermore, the improvements we report supersede the established MCID for the DHI, DGI, and gait speed (18,26,35). Recently, it has been reported that the VOR gain to passive head impulses improved 246% after completing a unique form of vestibular rehabilitation involving active ipsilesional head impulse rotation only (14). Lacour et al also reveal limited change in the gain of the VOR in those patient groups that delayed their rehabilitation.…”

Section: Discussionsupporting

confidence: 66%

“…not). Prior studies have shown that the frequency and velocity of CS do change over time with VPT (13,14,(40)(41)(42). Together, these data suggest that the current standard of care prescribing gaze stability exercises for VPT (sinusoidal head rotation) may not be restoring slow phase (i.e., vestibular) eye velocity during passive head rotation, but instead lead to an altered CS velocity putatively to improve gaze stability.…”

Section: Discussionmentioning

confidence: 75%

“…Additionally, the patient subjects recruited a larger number of compensatory saccades (saccades in the direction of the deficient VOR) to assist with gaze stability that was dependent on magnitude of the VOR gain (9,13). Others have shown a similar inverse relationship with the presence of compensatory saccades and magnitude of VOR gain change after vestibular rehabilitation (14).…”

Section: Introductionmentioning

confidence: 69%

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Improvement After Vestibular Rehabilitation Not Explained by Improved Passive VOR Gain

et al. 2020

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 69%

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Improvement After Vestibular Rehabilitation Not Explained by Improved Passive VOR Gain

et al. 2020

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“…Therefore, improving gait is an important goal of vestibular rehabilitation ( 1 , 18 ) and this goal may be achieved by specifically including head movements into the exercise programs ( 19 ). Gaze stabilization rehabilitation may lead to some improvements in visual acuity and vestibulo-ocular reflex in these patients ( 20 , 21 ), especially when applied in early disease stages ( 22 ). Next to gaze stabilization, balance training, and walking exercise for endurance, habituation exercise is one of four main exercise categories that can be used for rehabilitation ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Exergaming With Integrated Head Turn Tasks Improves Compensatory Saccade Pattern in Some Patients With Chronic Peripheral Unilateral Vestibular Hypofunction

et al. 2020

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Background: This study aimed to determine whether vestibular rehabilitation using active video games (Exergames), including promoted head turns and unsupported locomotion, may facilitate vestibular compensation and gait in subjects with one-sided chronic peripheral vestibular hypofunction (cPVH). Methods: 12 patients with cPVH (mean age of 65 ± 12 years, 8 male) were recruited for this study. The study consisted of a four-week baseline control period T1-T2 followed by a four-week intervention period T2-T3. The intervention included exergames that required physical tasks such as steps, weight shifts or balance control to cognitive challenges, in a virtual environment to play the game. The subjects participated in a total of 176 min of exergaming in eight sessions. Because of the changing projection direction of the game to the wall, the subjects had to turn their heads constantly while playing the game. Dynamic visual acuity (DVA) was assessed. Vestibulo-Ocular reflex (VOR) gain deficit and cumulative overt saccade amplitude (COSA) were measured with the video head-impulse test. Additionally, the functional gait assessment (FGA), Extended Timed Get-Up-and-Go (ETGUG), and the Dizziness handicap inventory (DHI), were assessed. Results: DVA showed no significant group level change (p = 0.475, z = −0.714, d = 0.295) with a small effect size and improvements in five out of 12 subjects. Ipsilesional VOR gain did not improve (p = 0.157, z = −1.414, d = 0.481) on group level while there was an intermediate effect size and improvements in six out of 12 subjects. COSA got significant smaller (p = 0.006, z = −2.746, d = 1.354) with improvements in seven out of 12 subjects. The contralesional sides did not change. The FGA for the group significantly improved with an intermediate effect size (p < 0.001, z = −3.08, d = 1.617) and five individuals showed clinically relevant improvements. The ETGUG group value improved significantly with a strong effect size (p < 0.001, z = −2.67, d = 1.030), with Swanenburg et al. Exergaming With Integrated Head Turn seven individuals contributing to this change. The DHI showed no change (p = 0.172, z = −1.381, d = 0.592) neither on the group nor on the individuals' level. The game scores of the subjects improved during the intervention period of the intervention for every game. Conclusion: The results of this study demonstrate that exergaming with promoted head turns facilitates vestibular compensation in some subjects with cPVH. This is the first study that shows an improvement in cumulative overt saccade amplitude after exergaming in chronic vestibular subjects.

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“…Nos estudos de Barbosa et al (4) e Rocha (11) foram utilizados sujeitos com diagnóstico de HVU, com idade média de 60 anos. Em Migliaccio, Schubert (13) foram avaliados três grupos de indivíduos, sendo seis voluntários saudáveis, três com HVU e um com HVB e Fernandes (14) utilizou sujeitos com No estudo de Rocha (11) , as variáveis (15) , avaliou- Assim, o estudo de Meldrum et al (16) , aborda Em relação aos benefícios gerados pelos tratamentos, Lehnen et al (17) descreveram melhora na visão dinâmica; Bayat e Saki (21) juntamente com Horning e Gorman (26) e Verdecchia et al (24) apontaram melhora no DHI, na funcionalidade e, consequentemente, redução do risco de quedas; por fim, Chen et al (23) relataram melhoras no equilíbrio e acuidade visual, na tontura, na ansiedade e no humor…”

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Protocolos De Reabilitação Vestibular Para Pacientes Diagnosticados Com Hipofunção Vestibular Unilateral E Bilateral: Revisão De Literatura

2020

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Objetivo: Realizar uma análise crítica dos protocolos de reabilitação vestibular voltados para indivíduos diagnosticados com hipofunção vestibular, com base em artigos científicos. Métodos: Trata-se de uma revisão de literatura sobre os protocolos de reabilitação para indivíduos que possuem hipofunção vestibular, utilizando para a pesquisa as bases de dados eletrônicas SCIELO (Scientific Electronic Library Online), MEDLINE (Medical Literature Analysis and Retrieval System Online), Directory of Open Access Journals, World Wide Science, ScienceDirect e PUBMED (Public Medline or Publisher Medline) em um corte temporal de 2007 a 2019. Foram selecionados estudos na língua portuguesa, utilizando como descritores: Reabilitação; Qualidade de Vida; Doenças Vestibulares; Equilíbrio Postural; Canais Semicirculares e seus correspondentes na língua inglesa e espanhola. Resultados: Durante a busca, a triagem foi composta por 45 artigos, porém a amostra remanescente foi de 18 artigos. Observou-se que a idade média foi de 56,94 e o número médio de sessões/ tempo realizadas para melhora satisfatória destes pacientes foi de 13,42/ 8 semanas, bem como os protocolos de reabilitação vestibular variavam entre o tratamento convencional e não convencional incluindo realidade virtual, posturografia e dispositivo portátil de capacete com frequência semanal média de atendimento de quatro vezes. Conclusão: Os estudos realizados apontam diferentes tipos de protocolos de reabilitação vestibular, os quais são realizados de maneira convencional e não convencional e que possuem resultados positivos diante das desordens relatadas pelos sujeitos. Dessa forma, a fisioterapia representa uma importante ferramenta para o tratamento das vestibulopatias. Ademais, a escassez de estudos voltados para a temática abordada neste trabalho evidencia a necessidade de mais pesquisas sobre a atuação da fisioterapia na hipofunção vestibular.

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Rehabilitation of dynamic visual acuity in patients with unilateral vestibular hypofunction: earlier is better

Cited by 47 publications

References 37 publications

Improvement After Vestibular Rehabilitation Not Explained by Improved Passive VOR Gain

Improvement After Vestibular Rehabilitation Not Explained by Improved Passive VOR Gain

Exergaming With Integrated Head Turn Tasks Improves Compensatory Saccade Pattern in Some Patients With Chronic Peripheral Unilateral Vestibular Hypofunction

Protocolos De Reabilitação Vestibular Para Pacientes Diagnosticados Com Hipofunção Vestibular Unilateral E Bilateral: Revisão De Literatura

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