- Title
- Comparison of incremental vestibulo-ocular reflex adaptation training versus x1 training in patients with chronic peripheral vestibular hypofunction: a two-year randomized controlled trial
- Creator
- Rinaudo, Carlo N.; Schubert, Michael C.; Cremer, Phillip D.; Figtree, William V. C.; Todd, Chistopher J.; Migliaccio, Americo A.
- Relation
- NHMRC.APP105550
- Relation
- Journal of Neurologic Physical Therapy Vol. 45, Issue 4, p. 246-258
- Publisher Link
- http://dx.doi.org/10.1097/NPT.0000000000000369
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2021
- Description
- Background and Purpose: A crossover, double-blinded randomized controlled trial to investigate once-daily incremental vestibulo-ocular reflex (VOR) adaptation (IVA) training over 2 years in people with stable and chronic peripheral vestibular hypofunction. Methods: Twenty-one patients with peripheral vestibular hypofunction were randomly assigned to intervention-then-control (n = 12) or control-then-intervention (n = 9) groups. The task consisted of either x1 (control) or IVA training, once daily every day for 15 minutes over 6-months, followed by a 6-month washout, then repeated for arm 2 of the crossover. Primary outcome: vestibulo-ocular reflex gain. Secondary outcomes: compensatory saccades, dynamic visual acuity, static balance, gait, and subjective symptoms. Multiple imputation was used for missing data. Between-group differences were analyzed using a linear mixed model with repeated measures. Results: On average patients trained once daily 4 days per week. IVA training resulted in significantly larger VOR gain increase (active: 20.6% ± 12.08%, P = 0.006; passive: 30.6% ± 25.45%, P = 0.016) compared with x1 training (active: −2.4% ± 12.88%, P = 0.99; passive: −0.6% ± 15.31%, P = 0.68) (P < 0.001). The increased IVA gain did not significantly reduce with approximately 27% persisting over the washout period. x1 training resulted in greater reduction of compensatory saccade latency (P = 0.04) and increase in amplitude (P = 0.02) compared with IVA training. There was no difference between groups in gait and balance measures; however, only the IVA group had improved total Dizziness Handicap Inventory (P = 0.006). Discussion and Conclusions: Our results suggest IVA improves VOR gain and reduces perception of disability more than conventional x1 training. We suggest at least 4 weeks of once-daily 4 days-per-week IVA training should be part of a comprehensive vestibular rehabilitation program. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww. com/JNPT/A356).
- Subject
- gaze stability; vestibular hypofunction; vestibular rehabilitation; vestibulo-ocular reflex
- Identifier
- http://hdl.handle.net/1959.13/1447778
- Identifier
- uon:43227
- Identifier
- ISSN:1557-0576
- Language
- eng
- Reviewed
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