Aim: Mal de debarquement syndrome (MdDS) is a neurological condition characterized by a constant sensation of self-motion; onset may be motion-triggered (MT) or non-motion-triggered/spontaneous (NMT/SO). People with MdDS experience similar symptoms to those with vertical heterophoria, a subset of binocular visual dysfunction. Hence, we aimed to explore potential visual symptom overlaps. Methods: MdDS patients (n = 196) and controls (n = 197) completed a visual health questionnaire. Results: Compared with controls, the MdDS group demonstrated higher visual disorder scores and visual complaints. NMT/SO participants reported unique visual symptoms and a higher prevalence of mild traumatic brain injury. Conclusion: Our findings suggest visual disorders may coexist with MdDS, particularly the NMT/SO subtype. The difference in visual dysfunction frequency and medical histories between subtypes, warrants further investigation into differing pathophysiological mechanisms.
IntroductionConcussion is a form of mild traumatic brain injury that disrupts brain function. Although symptoms are mostly transient, recovery can be delayed and result in persistent postconcussive symptoms (PPCS). Vestibular and oculomotor dysfunction are among the most debilitating impairments associated with PPCS. However, pharmacological interventions for these impairments are associated with deleterious side effects. Accordingly, increasing research has examined the utility of non-pharmacological interventions for PPCS. The aim of this review is to synthesise and evaluate the effectiveness of non-pharmacological interventions for the treatment of vestibular and oculomotor dysfunction for patients with PPCS.Methods and analysisSystematic searches of MEDLINE, PubMed, Web of Science and Scopus will identify randomised controlled trials employing non-pharmacological treatments for vestibular and/or oculomotor dysfunction for PPCS. Such interventions may include, but are not limited to, vestibular rehabilitation, optokinetic stimulation and vestibulo-ocular reflex exercises. Assessments of oculomotor function will include versional eye movements, vergence eye movements, visual-fixation movements and accommodation response. Assessments of vestibular function will include the Fukuda Step test, functional balance tests, force displacement tests, and subjective reports of balance disruption or vertigo. Where appropriate, meta-analyses of standardised mean differences will be conducted using a random effects model for continuous outcomes. For dichotomous outcomes (improved vs not improved following treatment), effects will be expressed as relative risk. The impact of heterogeneity will be calculated using the I2statistic. The Physiotherapy Evidence Database scale will be used to determine the methodological quality of individual studies and Grading of Recommendations, Assessment, Development and Evaluations used to assess the certainty and quality of evidence for each outcome.Ethics and disseminationEthical approval is not required for this review. Findings will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42021254720.
Background: Concussion is a form of mild traumatic brain injury (mTBI) that disrupts brain function. Although symptoms are mostly transient, recovery can be delayed and result in post-concussive syndrome (PCS). Vestibular and oculomotor deficits are among the most debilitating impairments associated with PCS. Non-pharmacological interventions provide treatment with limited side effects in comparison to pharmacological interventions. The aim of this review is to synthesise and evaluate the effectiveness of non-pharmacological interventions that have been used to target vestibular and oculomotor deficits in PCS.Methods: Advanced searches will be conducted in electronic databases to identify articles eligible for inclusion. Studies employing non-pharmacological treatments for vestibular and/or oculomotor dysfunction in PCS will be included if they meet the eligibility criteria. Outcomes will be those pertaining to measures of oculomotor and vestibular function, in addition to adverse events. Meta-analysis will be undertaken using a random effects model followed by an assessment of clinical significance for each outcome as published in literature. Discussion: While non-pharmacological interventions are used commonly to treat vestibular and oculomotor deficits in PCS, the effectiveness of these treatments is yet to be completely elucidated. The present review will explore the effectiveness of non-pharmacological treatments for vestibular and oculomotor deficits in PCS to inform practice and future research.Systematic review registration: PROSPERO CRD42021254720
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