TY - JOUR
T1 - Decrease in head sway as a measure of sensory integration following vestibular rehabilitation
T2 - A randomized controlled trial
AU - Lubetzky, Anat V.
AU - Harel, Daphna
AU - Krishnamoorthy, Santosh
AU - Fu, Gene
AU - Morris, Brittani
AU - Medlin, Andrew
AU - Wang, Zhu
AU - Perlin, Ken
AU - Roginska, Agnieszka
AU - Cosetti, Maura
AU - Kelly, Jennifer
N1 - Funding Information:
This study was funded by the National Institutes of Health National Rehabilitation Research Resource to Enhance Clinical Trials (REACT). Drs. Lubetzky, Harel and Cosetti were funded by an R21DC018101 Early Career Researcher grant from the National Institute on Deafness and Other Communication Disorders (NIDCD). The sponsors had no role in the study design, collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2023 - IOS Press. All rights reserved.
PY - 2023/6/19
Y1 - 2023/6/19
N2 - Objective: The purpose of this study was to determine the extent to which sensory integration strategies via head sway, derived from a Head-Mounted Display (HMD), change in people with vestibular disorders following vestibular rehabilitation. Design: Randomized Controlled Trial Setting: Vestibular Rehabilitation Clinic Participants: Thirty participants with vestibular dysfunction and 21 age-matched controls. Main Outcome Measures: Participants experienced two levels of visual surround (static or moving 'stars', front to back at 0.2Hz, 32mm) and white noise (none or rhythmic) while their head sway was recorded via the HTC Vive. We quantified head sway via Directional Path (DP) and Root Mean Square Velocity (RMSV) in 5 directions: anterior-posterior, medio-lateral, pitch, yaw, and roll and Power Spectral Density in low (PSD 1), medium (PSD 2) and high (PSD 3) frequencies in the anterior-posterior direction. Interventions: Participants performed the assessment prior to being randomized into 8-weeks of contextual sensory integration training in virtual reality or traditional vestibular rehabilitation and once again following completion of the intervention. Controls performed the assessment once. Twelve participants dropped out, half due to covid lock-down. We applied an intention to treat analysis. Results: We observed significant increases in AP DP, RMSV and all PSDs with change in visual level. Both intervention groups significantly decreased medio-lateral, pitch and roll DP and RMSV and anterior-posterior PSD 2 with no group differences. Vestibular participants were significantly higher than controls on all outcomes pre rehabilitation. Post rehabilitation they were only significantly higher on PSD 2. Sound was not a significant predictor of head sway in this protocol. Conclusions: Head sway decreased following vestibular rehabilitation regardless of visual load or type of intervention applied.
AB - Objective: The purpose of this study was to determine the extent to which sensory integration strategies via head sway, derived from a Head-Mounted Display (HMD), change in people with vestibular disorders following vestibular rehabilitation. Design: Randomized Controlled Trial Setting: Vestibular Rehabilitation Clinic Participants: Thirty participants with vestibular dysfunction and 21 age-matched controls. Main Outcome Measures: Participants experienced two levels of visual surround (static or moving 'stars', front to back at 0.2Hz, 32mm) and white noise (none or rhythmic) while their head sway was recorded via the HTC Vive. We quantified head sway via Directional Path (DP) and Root Mean Square Velocity (RMSV) in 5 directions: anterior-posterior, medio-lateral, pitch, yaw, and roll and Power Spectral Density in low (PSD 1), medium (PSD 2) and high (PSD 3) frequencies in the anterior-posterior direction. Interventions: Participants performed the assessment prior to being randomized into 8-weeks of contextual sensory integration training in virtual reality or traditional vestibular rehabilitation and once again following completion of the intervention. Controls performed the assessment once. Twelve participants dropped out, half due to covid lock-down. We applied an intention to treat analysis. Results: We observed significant increases in AP DP, RMSV and all PSDs with change in visual level. Both intervention groups significantly decreased medio-lateral, pitch and roll DP and RMSV and anterior-posterior PSD 2 with no group differences. Vestibular participants were significantly higher than controls on all outcomes pre rehabilitation. Post rehabilitation they were only significantly higher on PSD 2. Sound was not a significant predictor of head sway in this protocol. Conclusions: Head sway decreased following vestibular rehabilitation regardless of visual load or type of intervention applied.
KW - Balance
KW - dizziness
KW - head kinematics
KW - postural control
KW - virtual reality
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U2 - 10.3233/VES-220107
DO - 10.3233/VES-220107
M3 - Article
C2 - 36911951
AN - SCOPUS:85164039890
SN - 0957-4271
VL - 33
SP - 213
EP - 226
JO - Journal of Vestibular Research: Equilibrium and Orientation
JF - Journal of Vestibular Research: Equilibrium and Orientation
IS - 3
ER -