The Clinical Use of the Suppression Head Impulse Paradigm in Patients with Vestibulopathy: A Systematic Review

Manzari, Leonardo; Angelis, Stefania De; Princi, Alessandro Antonio; Tramontano, Marco

doi:10.3390/healthcare10071182

Cited by 11 publications

(3 citation statements)

References 25 publications

(134 reference statements)

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“…24,25 Emerging evidence shows high sensitivity and specificity for measuring vestibular weakness, of more than 87 per cent and more than 83 per cent respectively, especially when paired with the video head impulse test. 26…”

Section: Video Head Impulse Testmentioning

confidence: 99%

Modernising vestibular assessment

Lennox-Bowley,

Dasgupta

2024

J. Laryngol. Otol.

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Background There is a high prevalence of dizziness, vertigo and balance symptoms in the general population. Symptoms can be generated by many inner-ear vestibular disorders and there are several diagnostic tests available that can help identify the site of the vestibular lesion. There is little consensus on what diagnostic tests are appropriate, with diagnostics either not completed or minimally performed, leading to missed diagnosis, unsatisfactory results for patients and costs to healthcare systems. Methods This study explored the literature for different neuro-vestibular diagnostic tests not currently considered in the traditional standard vestibular test battery, and examined how they fit effectively into a patient care pathway to help quickly and succinctly identify vestibular function. Results A vestibular patient care pathway is presented for acute and subacute presentation of vestibular disorders. Conclusion An accurate diagnosis following a rigorous anamnesis and vestibular testing is paramount for successful management and favourable outcomes.

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Section: Video Head Impulse Testmentioning

confidence: 99%

Modernising vestibular assessment

Lennox-Bowley,

Dasgupta

2024

J. Laryngol. Otol.

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“…Another limitation is the absence of an instrumental evaluation of the vestibular reflexes’ functions [ 55 , 56 ], but, even in a probable absence of specific vestibular damage for the enrolled sample, VR was not expected to lead to improvements in vestibular reflexes. In fact, it seems rather to act as a facilitator for improving a compensation strategy based on the enhancement of the vestibular network and sensory–motor integration for managing a correct trade-off between stability and advancement during gait.…”

Section: Limitationsmentioning

confidence: 99%

Vestibular Rehabilitation Improves Gait Quality and Activities of Daily Living in People with Severe Traumatic Brain Injury: A Randomized Clinical Trial

Tramontano

Belluscio

Bergamini

et al. 2022

Sensors

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Neurorehabilitation research in patients with traumatic brain injury (TBI) showed how vestibular rehabilitation (VR) treatments positively affect concussion-related symptoms, but no studies have been carried out in patients with severe TBI (sTBI) during post-acute intensive neurorehabilitation. We aimed at testing this effect by combining sensor-based gait analysis and clinical scales assessment. We hypothesized that integrating VR in post-acute neurorehabilitation training might improve gait quality and activity of daily living (ADL) in sTBI patients. A two-arm, single-blind randomized controlled trial with 8 weeks of follow-up was performed including thirty sTBI inpatients that underwent an 8-week rehabilitation program including either a VR or a conventional program. Gait quality parameters were obtained using body-mounted magneto-inertial sensors during instrumented linear and curvilinear walking tests. A 4X2 mixed model ANOVA was used to investigate session–group interactions and main effects. Patients undergoing VR exhibited improvements in ADL, showing early improvements in clinical scores. Sensor-based assessment of curvilinear pathways highlighted significant VR-related improvements in gait smoothness over time (p < 0.05), whereas both treatments exhibited distinct improvements in gait quality. Integrating VR in conventional neurorehabilitation is a suitable strategy to improve gait smoothness and ADL in sTBI patients. Instrumented protocols are further promoted as an additional measure to quantify the efficacy of neurorehabilitation treatments.

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“…Several studies [ 11 , 12 ] have already suggested the use of vHIT with HIMP to diagnose a VN in the acute phase and as a valid tool to diagnose peripheral vestibulopathy in the different stages of the disease [ 3 ]. A recent systematic review [ 13 ] highlighted the usefulness of the SHIMP in diagnosing a VOR alteration in patients with vestibulopathy suggesting to evaluate with new studies if this new paradigm could replace the HIMP in both the acute and chronic phases of vestibulopathy. For these reasons, we hypothesize that SHIMP could be compared, in terms of usefulness, to the HIMP in evaluating eye movement and visuo-vestibular interaction strategy alteration in patients with acute and chronic VN.…”

Section: Introductionmentioning

confidence: 99%

Video Suppression Head Impulses and Head Impulses Paradigms in Patients with Vestibular Neuritis: A Comparative Study

Manzari¹,

Bustos

Princi

et al. 2022

Healthcare

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Background: This study aims to explore the clinical relevance of the Suppression Head Impulse Paradigm (SHIMP) to better understand if it represents an additional clinical value compared to the Head Impulse Paradigm (HIMP) in patients with vestibular neuritis (VN) in different stages of the disease. Methods: From January 2020 to June 2022, patients with unilateral VN were found in a database of an ENT vestibular clinic. Clinical presentation, vestibular test outcomes, therapy, and recovery were examined in medical records. Results: A total of 42 patients (16 Females, mean age 51.06 ± 12.96; 26 Male, mean age 62.50 ± 9.82) met the inclusion criteria and were enrolled in the study. The means of the VOR gain for both paradigms were respectively 0.38 ± 0.12 (SHIMP) and 0.46 ± 0.13 (HIMP) at T0 and 0.55 ± 0.20 (SHIMP) and 0.64 ± 0.19 (HIMP) at T1 for the lesional side. For the HIMP, the gain value <0.76 identified the affected side of VN with 100% sensitivity (92–100) and 100% specificity (91–100). For the SHIMP, the gain value <0.66 identified the affected side of VN with 100% sensitivity (92–100) and 100% specificity (91–100) and an AUC of 1.0 (0.96–1.0, p < 0.0001). Conclusion: The SHIMP paradigm has a diagnostic accuracy equal to the classic HIMP paradigm in patients with VN. The assessment of VOR slow phase velocity and vestibulo-saccadic interaction in patients with VN could be easier with the use of the SHIMPs paradigm. SHIMPs paradigm provides helpful information about the evaluation of VOR slow phase velocity and vestibulo-saccadic interaction as new recovery strategies in patients with VN.

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The Clinical Use of the Suppression Head Impulse Paradigm in Patients with Vestibulopathy: A Systematic Review

Cited by 11 publications

References 25 publications

Modernising vestibular assessment

Modernising vestibular assessment

Vestibular Rehabilitation Improves Gait Quality and Activities of Daily Living in People with Severe Traumatic Brain Injury: A Randomized Clinical Trial

Video Suppression Head Impulses and Head Impulses Paradigms in Patients with Vestibular Neuritis: A Comparative Study

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