Acute VOR gain differences for outward vs. inward head impulses

Michael C Schubert, Georgios Mantokoudis, Li Xie, Yuri Agrawal

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Vestibular rehabilitation is a sub-specialization within the practice of physical therapy that includes treatments designed to reduce gaze instability. Gaze stability exercises are commonly given for head rotations to the left and right, even in subjects with one healthy vestibular system (as in unilateral loss). Few studies have investigated the difference in the angular vestibular ocular reflex gain (aVOR) measured in the acute phase after deafferentation for ipsilesional head rotations that move the head away from center or towards center. OBJECTIVE: The purpose of this study was to compare differences in acute aVOR gain when the head was passively rotated outward from an initially centered position (neck neutral) versus the head being rotated inward. METHODS: We recorded head and eye velocity using video head impulse test equipment in patients with unilateral vestibular pathology scheduled for tumor resection via retrosigmoid approach (n=5) or labyrinthectomy due to Meniere's disease (n=2). RESULTS: We found 1) no difference in the ipsilesional aVOR gain for inward or outward directed head impulse rotations and 2) head velocity is inversely correlated with aVOR gain for ipsilesional but not contralesional rotations. CONCLUSIONS: Bedside testing of the ipsilesional aVOR following acute vestibular ablation can be done with head impulse rotations to either side. In the acute stages, physical therapists should prescribe ipsilesional and contralesional gaze stability exercises.

Original languageEnglish (US)
Pages (from-to)397-402
Number of pages6
JournalJournal of Vestibular Research: Equilibrium and Orientation
Volume24
Issue number5-6
DOIs
StatePublished - 2014

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Head
Reflex
Head Impulse Test
Exercise
Meniere Disease
Physical Therapists
Neck
Rehabilitation
Pathology
Equipment and Supplies
Therapeutics
Neoplasms

Keywords

  • Head impulse test
  • vestibular rehabilitation
  • VOR gain

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems
  • Neuroscience(all)
  • Medicine(all)

Cite this

Acute VOR gain differences for outward vs. inward head impulses. / Schubert, Michael C; Mantokoudis, Georgios; Xie, Li; Agrawal, Yuri.

In: Journal of Vestibular Research: Equilibrium and Orientation, Vol. 24, No. 5-6, 2014, p. 397-402.

Research output: Contribution to journalArticle

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