Association of the Video Head Impulse Test With Improvement of Dynamic Balance and Fall Risk in Patients With Dizziness

Chang, Tzu‐Pu; Schubert, Michael C.

doi:10.1001/jamaoto.2018.0650

Cited by 21 publications

(14 citation statements)

References 33 publications

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“…Gaze stability exercises have been proven to increase VOR gain for active head movements (26)(27)(28), and it has been suggested that the increase in VOR gain explains the subsequent improved dynamic visual performance (29). However, the majority of those without gain improvement after gaze stability exercises also report less symptoms while walking (30). This suggests that improved VOR gain may not be the only reason for functional improvement.…”

Section: Discussionmentioning

confidence: 99%

Short-Latency Covert Saccades - The Explanation for Good Dynamic Visual Performance After Unilateral Vestibular Loss?

et al. 2021

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Background: Functional head impulse test (fHIT) tests the ability of the vestibulo-ocular reflex (VOR) to allow visual perception during head movements. Our previous study showed that active head movements to the side with a vestibular lesion generated a dynamic visual performance that were as good as during movements to the intact side.Objective: To examine the differences in eye position during the head impulse test when performed with active and passive head movements, in order to better understand the role of the different saccade properties in improving visual performance.Method: We recruited 8 subjects with complete unilateral vestibular loss (4 men and 4 women, mean age 47 years) and tested them with video Head Impulse Test (vHIT) and Functional Head Impulse Test (fHIT) during passive and active movements while looking at a target. We assessed the mean absolute position error of the eye during different time frames of the head movement, the peak latency and the peak velocity of the first saccade, as well as the visual performance during the head movement.Results: Active head impulses to the lesioned side generated dynamic visual performances that were as good as when testing the intact side. Active head impulses resulted in smaller position errors during the visual perception task (p = 0.006) compared to passive head-impulses and the position error during the visual perception time frame correlated with shorter latencies of the first saccade (p < 0.001).Conclusion: Actively generated head impulses toward the side with a complete vestibular loss resulted in a position error within or close to the margin necessary to obtain visual perception for a brief period of time in patients with chronic unilateral vestibular loss. This seems to be attributed to the appearance of short-latency covert saccades, which position the eyes in a more favorable position during head movements.

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Section: Discussionmentioning

confidence: 99%

Short-Latency Covert Saccades - The Explanation for Good Dynamic Visual Performance After Unilateral Vestibular Loss?

et al. 2021

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“…In addition to statistical significance, a change score of 10% in the compensatory saccade physiologic metrics and dynamic visual acuity was considered improved. For VOR gain, a change in magnitude > 0.06 was considered significant (37).…”

Section: Discussionmentioning

confidence: 99%

Improvement After Vestibular Rehabilitation Not Explained by Improved Passive VOR Gain

et al. 2020

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“…Both horizontal and vertical GST scores have been associated with clinical measures of walking balance [10,11], suggesting that vestibuloocular reflex (VOR) function is related to walking balance ability. Recently, change in horizontal semicircular canal VOR gain was associated with change in walking balance measured using the Dynamic Gait Index [12]. In contrast, horizontal semicircular canal VOR gain measured with video head impulses and rotational chair tests was not significantly associated with measures of trunk sway during walking [13].…”

Section: Introductionmentioning

confidence: 98%

Reduced vestibular function is associated with longer, slower steps in healthy adults during normal speed walking

et al. 2019

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Background: Vestibular signals contribute to balance and walking. With aging, vestibular function declines and gait speed decreases. Vestibular loss contributes to decreasing gait speed, but this influence could be linked to spatial and/or temporal aspects of gait. We investigated the relationship between vestibular function (semicircular canal and otolith function) and spatial and temporal gait parameters in a cohort of adults. Methods: 113 community-dwelling healthy adults (mean age 72.2 (14.6) years) participating in the Baltimore Longitudinal Study of Aging were tested. Horizontal semicircular canal (SCC) function was evaluated using quantitative vestibulo-ocular reflex gain. Otolith function was measured with cervical and ocular vestibular evoked myogenic potentials. Gait kinematics were collected during normal speed walking. Multiple linear regressions examined the association between spatial and temporal gait parameters and SCC and otolith function separately, controlling for age, gender, height, and either cadence (for spatial gait outcomes) or stride length (for temporal gait outcomes) to account for gait speed effects. Results: Vestibular SCC function was significantly associated with both spatial and temporal gait parameters. Every 0.1 decrease in SCC function resulted in longer stride length (β = −.04 meters, p = 0.004), longer stance time (β = 15.8 ms, p < 0.003), and a slower cadence (β = −2.1 steps/ minute, p < 0.001). Otolith function was not associated with any gait parameter.

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Association of the Video Head Impulse Test With Improvement of Dynamic Balance and Fall Risk in Patients With Dizziness

Cited by 21 publications

References 33 publications

Short-Latency Covert Saccades - The Explanation for Good Dynamic Visual Performance After Unilateral Vestibular Loss?

Short-Latency Covert Saccades - The Explanation for Good Dynamic Visual Performance After Unilateral Vestibular Loss?

Improvement After Vestibular Rehabilitation Not Explained by Improved Passive VOR Gain

Reduced vestibular function is associated with longer, slower steps in healthy adults during normal speed walking

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