Variables associated with outcome in patients with bilateral vestibular hypofunction: Preliminary study

Herdman, Susan J.; Hall, Courtney D.; Maloney, Brian J.; Knight, Sara J.; Ebert, Marti; Lowe, Jessica

doi:10.3233/ves-150556

Cited by 53 publications

(66 citation statements)

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“…There are now several commercially available, video-based systems (most head-mounted, one wall-mounted) [91–93], with which a clinician can measure the VOR from each of the six canals in a reasonably co-operative adult or child [94, 95] in about 10 min. Audiologists [96] and physiotherapists [97] are already doing so. Here, we consider four common clinical situations in which the video head impulse test (vHIT) can help with diagnosis.…”

Section: Video Head Impulse Testingmentioning

confidence: 99%

Neuro-otology- some recent clinical advances

2016

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Section: Video Head Impulse Testingmentioning

confidence: 99%

Neuro-otology- some recent clinical advances

2016

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“…Patients with BVH are at higher risk for falls compared to those with UVH. 22 Approximately 35–50% of BVH patients have a history of falls. 2,23 BVH patients may be refractory to the benefits of vestibular rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Can the Video Head Impulse Test Define Severity of Bilateral Vestibular Hypofunction?

Judge

Janky

Barin

2017

Otology &Amp; Neurotology

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Objective The objective of the study was to compare rotary chair and video head impulse test (vHIT) findings in patients with bilateral vestibular hypofunction (BVH) to determine whether vHIT can: 1) define severity of BVH and 2) accurately predict rotary chair findings in patients with BVH. Study Design Retrospective chart review Setting Research Hospital Patients Twenty subjects with bilateral vestibular hypofunction as assessed by rotary chair. Intervention Rotary chair and vHIT Main Outcome Measures The main outcome measures were rotary chair phase, gain, and symmetry and vHIT vestibulo-ocular reflex (VOR) gain. Rotary chair and vHIT results were assessed and subjects were stratified into groups according to the severity of their vestibular hypofunction. For rotary chair, subjects were classified as Mild, Moderate, or Severe BVH. For vHIT, subjects were classified as normal, unilateral or bilateral. Results Average lateral canal vHIT VOR gain: 1) significantly increased as severity of BVH decreased, and 2) demonstrated a significant and positive, linear relationship with rotary chair gains. vHIT was in disagreement with rotary chair in the classification of 5 subjects, which could be due to right-left asymmetry of BVH. Conclusion vHIT can serve as an initial tool for identifying patients with BVH. Lower vHIT gains are consistent with having Severe BVH. There was disagreement between vHIT and rotary chair, though not for any patients with Severe BVH. Compared to rotary chair, the clinical gold standard for identifying BVH, vHIT possesses 100% sensitivity for identifying Severe BVH when average vHIT gains are < 0.46.

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“…Symptoms of BVD include oscillopsia, vertigo, headaches, nystagmus and chronic imbalance [2]. These are attributable to severely reduced or absent function of vestibular nerves, end organs or both [9]. Diminished function of the vestibular system adversely affects the VOR and postural-righting reflexes, which reduces ability to balance in both static and dynamic situations.…”

Section: Vestibular Dysfunctionmentioning

confidence: 99%

“…BVD has an adverse effect on quality of life; 84% of patients reported a significant decrease in their quality of life and one study reported a 31-fold increase in the risk of falls [9]. Patients commonly quote a lack of independence, inability to drive and the need for assistance with daily activities as prevalent negative factors [10].…”

Section: Vestibular Dysfunctionmentioning

confidence: 99%

“…The VOR, postural sway and gait speed are all behaviours that contribute to balance and that rely on sensory input from the vestibular system [5]. All three behaviours are also quantifiable and are therefore commonly used to assess the effectiveness of different prostheses [9]. Two different mechanisms are explored as a potential means of artificial vestibular stimulation which are vestibular implants and galvanic vestibular stimulation (GVS).…”

Section: Prosthetic Devicesmentioning

confidence: 99%

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Finding a Balance: A Systematic Review of the Biomechanical Effects of Vestibular Prostheses on Stability in Humans

Haxby

Akrami

Zamani

2020

JFMK

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The vestibular system is located in the inner ear and is responsible for maintaining balance in humans. Bilateral vestibular dysfunction (BVD) is a disorder that adversely affects vestibular function. This results in symptoms such as postural imbalance and vertigo, increasing the incidence of falls and worsening quality of life. Current therapeutic options are often ineffective, with a focus on symptom management. Artificial stimulation of the vestibular system, via a vestibular prosthesis, is a technique being explored to restore vestibular function. This review systematically searched for literature that reported the effect of artificial vestibular stimulation on human behaviours related to balance, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) technique. A total of 21 papers matched the inclusion criteria of the literature search conducted using the PubMed and Web of Science databases (February 2019). The populations for these studies included both healthy adults and patients with BVD. In every paper, artificial vestibular stimulation caused an improvement in certain behaviours related to balance, although the extent of the effect varied greatly. Various behaviours were measured such as the vestibulo-ocular reflex, postural sway and certain gait characteristics. Two classes of prosthesis were evaluated and both showed a significant improvement in at least one aspect of balance-related behaviour in every paper included. No adverse effects were reported for prostheses using noisy galvanic vestibular stimulation, however, prosthetic implantation sometimes caused hearing or vestibular loss. Significant heterogeneity in methodology, study population and disease aetiology were observed. The present study confirms the feasibility of vestibular implants in humans for restoring balance in controlled conditions, but more research needs to be conducted to determine their effects on balance in non-clinical settings.

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Variables associated with outcome in patients with bilateral vestibular hypofunction: Preliminary study

Abstract: Consideration of baseline factors may provide guidance for setting patient goals. Further research is needed determine what factors predict outcome and to develop more effective treatment strategies for those patients who do not improve.

Cited by 53 publications

References 0 publications

Neuro-otology- some recent clinical advances

Neuro-otology- some recent clinical advances

Can the Video Head Impulse Test Define Severity of Bilateral Vestibular Hypofunction?

Finding a Balance: A Systematic Review of the Biomechanical Effects of Vestibular Prostheses on Stability in Humans

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