To Design and Investigate the Effectiveness of a Gaze Stabilization Application on Patients with Impaired Visual Vestibulo-ocular Reflex

Authors

  • Riddhi D. Thakkar Krishna College of Physiotherapy, Krishna Institute of Medical Sciences “Deemed to be” University, Karad – 415110, Maharashtra
  • Dr.Suraj Kanase Krishna College of Physiotherapy, Krishna Institute of Medical Sciences “Deemed to be” University, Karad – 415110, Maharashtra

DOI:

https://doi.org/10.18311/jeoh/2022/29644

Keywords:

Gaze Stabilization Application, Vestibular Dysfunction/Hypofunction, Vestibular Rehabilitation, Visual Vestibulo Ocular Reflex

Abstract

Purpose: Vestibulo-ocular Reflex is the main vision stabilizing system during rapid head movements. In keeping the eyes still during head motion which is referred to as the gaze stability, the VOR has a censorious role. Loss of this vestibular function produces instability of gaze which worsens on motion and activity. Vestibular rehabilitation is one of the treatment modalities for patients with vestibular insufficiency. These exercises include gaze stability, central programming and balance exercise. Here this study is an instrument-based study and this device focuses on visually tracking, using smooth pursuit eye movements on a moving object. It shall not only provide a combined gaze stability adaptive exercise but it will also provide various progressions and biofeedback to the patients. Methods: An interventional study, with a sum of 30 participants having significant vestibular hypofunction or dysfunction who voluntarily participated in the study. It was a comparative study and it took place in Krishna Institute of Medical Sciences deemed to be University, Karad city in Maharashtra, India. 6 months was the total time span required to complete this trial. Consecutive sampling with random allocation was done. Those fulfilling the inclusion criteria were recruited and divided into two groups: control and interventional. Results and Conclusion: Vestibular dysfunction significantly affected the quality of life and lead to serious disability. Virtual mode of rehabilitation training by tracking the object with the eye, built interest and motivated the patient to regularly exercise as well as to perform smooth eye movements with lower range of saccades.

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References

Cullen K, Sadeghi S. Vestibular system. Scholarpedia. 2008 Jan 24; 3(1): 3013. https://doi.org/10.4249/scholarpedia.3013

Casale J, Browne T, Murray I, Gupta G. Physiology, vestibular system. Stat Pearls [Internet]. 2020 May 24.

Khan S, Chang R. Anatomy of the vestibular system: A review. Neuro Rehabilitation. 2013 Jan 1; 32(3):437–43. PMid: 23648598. https://doi.org/10.3233/NRE-130866

Leigh RJ, Zee DS. The neurology of eye movements. OUP USA. 2015. https://doi.org/10.1093/med/9780199969289.001.0001

Chen PY, Hsieh WL, Wei SH, Kao CL. Interactive wiimote gaze stabilization exercise training system for patients with vestibular hypofunction. Journal of Neuroengineering and Rehabilitation. 2012 Dec; 9(1):1–0. PMid: 23043886 PMCid: PMC3481473. https://doi.org/10.1186/1743-0003-9-77

Schweigart G, Mergner T, Evdokimidis I, Morand S, Becker W. Gaze stabilization by Optokinetic Reflex (OKR) and Vestibuloocular Reflex (VOR) during active head rotation in man. Vision Research. 1997 Jun 1; 37(12):1643–52. https://doi.org/10.1016/ S0042-6989(96)00315-X

Dougherty JM, Carney M, Emmady PD. Vestibular Dysfunction. Stat Pearls [Internet]. 2020 Jul 6.

Thompson TL, Amedee R. Vertigo: A review of common peripheral and central vestibular disorders. Ochsner Journal. 2009 Mar 20; 9(1):20–6.

Scherer M, Schubert MC. High-velocity angular Vestibuloocular Reflex adaptation to position error signals. Journal of Neurologic Physical Therapy: JNPT. 2010 Jun; 34(2):82. PMid: 20588093 PMCid: PMC2954113. https://doi.org/10.1097/ NPT.0b013e3181dde7bc

O’Sullivan SB, Schmitz TJ, Fulk G. Physical rehabilitation. FA Davis; 2019 Jan 25.

Mahfuz MM, Schubert MC, Figtree WV, Todd CJ, Khan SI, Migliaccio AA. Optimal human passive Vestibulo-ocular Reflex adaptation does not rely on passive training. Journal of the Association for Research in Otolaryngology. 2018 Jun; 19(3):261–71. PMid: 29464411 PMCid: PMC5962472. https://doi.org/10.1007/s10162-018-0657-9

Haripriya GR, Mary P, Dominic M, Goyal R, Sahadevan A. Incidence and treatment outcomes of post traumatic BPPV in traumatic brain injury patients. Indian Journal of Otolaryngology and Head and Neck Surgery. 2018 Sep; 70(3):337–41. PMid: 30211085 PMCid: PMC6127059. https://doi.org/10.1007/s12070-018-1329-0

Elbeltagy R, Abd El-Hafeez M. Efficacy of vestibular rehabilitation on quality of life of patients with unilateral vestibular dysfunction. Indian Journal of Otology. 2018 Oct 1; 24(4):231. https://doi.org/10.4103/indianjotol.INDIANJOTOL_26_18

Dai C, Fridman GY, Chiang B, Davidovics NS, Melvin TA, Cullen KE, Della Santina CC. Cross-axis adaptation improves 3D Vestibulo-ocular Reflex alignment during chronic stimulation via a head-mounted multichannel vestibular prosthesis. Experimental Brain Research. 2011 May 1; 210(3-4):595–606.

PMid: 21374081 PMCid: PMC3270066. https://doi.org/10.1007/ s00221-011-2591-5

Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD, Furman JM, Getchius TS, Goebel JA, Shepard NT, Woodhouse SN. Vestibular rehabilitation for peripheral vestibular hypofunction: An evidence-based clinical practice guideline: from the American Physical Therapy Association Neurology Section. Journal of Neurologic Physical Therapy. 2016 Apr; 40(2):124. PMid: 26913496 PMCid: PMC4795094. https://doi.org/10.1097/NPT.0000000000000120

Danion FR, Flanagan JR. Different gaze strategies during eye versus hand tracking of a moving target. Scientific Reports. 2018 Jul 3; 8(1):1–9. PMid: 29968806 PMCid: PMC6030130. https://doi.org/10.1038/s41598-018-28434-6

Micarelli A, Viziano A, Augimeri I, Micarelli D, Alessandrini M. Three-dimensional head-mounted gaming task procedure maximizes effects of vestibular rehabilitation in unilateral vestibular hypofunction: A randomized controlled pilot trial. International Journal of Rehabilitation Research. 2017 Dec 1; 40(4):325–32. PMid: 28723718. https://doi.org/10.1097/MRR.0000000000000244

Masters K. Edgar Dale’s Pyramid of Learning in medical education: a literature review. Med Teach. 2013 Nov;35(11):e1584-93. doi: 10.3109/0142159X.2013.800636. Epub 2013 Jun 11. PMID: 23758180.

Saxena A, Prabhakar MC. Performance of DHI score as a predictor of benign paroxysmal positional vertigo in geriatric patients with dizziness/vertigo: A cross-sectional study. PloS one. 2013 Mar 5; 8(3):e58106. PMid: 23472142 PMCid: PMC3589349. https://doi.org/10.1371/journal.pone.0058106

Sheikh M, Kanase SB. The effect of eye-hand coordination device on coordination in subjects with in-coordination. Executive Editor. 2020 Jan; 11(01):202. https://doi.org/10.37506/v11/i1/2020/ijphrd/193813

Chang TP, Schubert MC. Convergence Vestibulo-ocular Reflex in unilateral vestibular hypofunction: Behavioral evidence in support of a novel gaze stability exercise. Journal of Neurologic Physical Therapy. 2021 Jan 1; 45(1):3–11. PMid: 33065632. https://doi.org/10.1097/NPT.0000000000000335

Herdman SJ, Clendaniel RA, Mattox DE, Holliday MJ, Niparko JK. Vestibular adaptation exercises and recovery: Acute stage after acoustic neuroma resection. Otolaryngology-Head and Neck Surgery. 1995 Jul; 113(1):77–87. https://doi.org/10.1016/S0194-5998(95)70148-6

Perez Fornos A, Guinand N, van de Berg R, Stokroos R, Micera S, Kingma H, Pelizzone M, Guyot JP. Artificial balance: Restoration of the Vestibulo-ocular Reflex in humans with a prototype vestibular

neuroprosthesis. Frontiers in Neurology. 2014 Apr 29; 5:66. PMid: 24808890 PMCid: PMC4010770. https://doi.org/10.3389/fneur.2014.00066

Herdman SJ. Role of vestibular adaptation in vestibular rehabilitation. Otolaryngology-Head and Neck Surgery. 1998 Jul; 119(1):49–54. https://doi.org/10.1016/S0194-5998(98)70195-0

Byung In Han, Hyun Seok Song, Ji Soo Kim Vestibular rehabilitation therapy: review indications, mechanisms & key exercises, J Clin Neurol.2011 Dec;7(4):184-196, https://doi.org/10.3388/10.3988/jcn.2011.7.4.184

Brown KE, Whitney SL, Marchetti GF, Wrisley DM, Furman JM. Physical therapy for central vestibular dysfunction. Archives of Physical Medicine and Rehabilitation. 2006 Jan 1; 87(1):76–81. PMid: 16401442. https://doi.org/10.1016/j.apmr.2005.08.003

Marousa pavlov, the use of optokinetic stimulation in vestibular rehabilitation, journal of neurologic physical therapy, JNPT. 34(2):105-10.

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Published

2022-07-12

How to Cite

Thakkar, R. D., & Kanase, D. (2022). To Design and Investigate the Effectiveness of a Gaze Stabilization Application on Patients with Impaired Visual Vestibulo-ocular Reflex. Journal of Ecophysiology and Occupational Health, 22(2), 94–103. https://doi.org/10.18311/jeoh/2022/29644

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