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Decrease in head sway as a measure of sensory integration following vestibular rehabilitation: A randomized
Anat V Lubetzky1, Daphna Harel2, Santosh Krishnamoorthy3,4
1Department of Physical Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, USA.
Journal of Vestibular Research : Equilibrium & Orientation
|March 13, 2023
Summary
Vestibular rehabilitation effectively reduced head sway in individuals with vestibular disorders, as measured by head-mounted display (HMD) technology. This HMD-based assessment shows promise for tracking patient progress in clinical settings.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Vestibular disorders significantly impact balance and mobility.
- Current rehabilitation methods aim to improve sensory integration and reduce symptoms.
- Objective measurement of head sway is crucial for assessing treatment efficacy.
Purpose of the Study:
- To evaluate changes in head sway using a Head-Mounted Display (HMD) in individuals with vestibular disorders undergoing rehabilitation.
- To compare the effectiveness of virtual reality-based sensory integration training versus traditional vestibular rehabilitation.
- To determine if sensory integration strategies influence head sway dynamics.
Main Methods:
- A randomized controlled trial involving 30 participants with vestibular dysfunction and 21 controls.
- Participants underwent assessments with varying visual surround (static/moving) and auditory (white noise) stimuli using an HMD (HTC Vive).
- Head sway was quantified using Directional Path (DP), Root Mean Square Velocity (RMSV), and Power Spectral Density (PSD) before and after an 8-week intervention.
Main Results:
- Vestibular participants exhibited increased anterior-posterior (AP) head sway (DP, RMSV, PSDs) with altered visual input.
- Both rehabilitation groups showed significant reductions in medio-lateral, pitch, and roll head sway (DP, RMSV) and AP PSD 2.
- Post-rehabilitation, vestibular participants' head sway measures approached those of controls, indicating improved function.
Conclusions:
- Vestibular rehabilitation, irrespective of intervention type or visual load, effectively decreases head sway.
- Head kinematics measured by a portable HMD provide a sensitive tool for monitoring patient improvement in vestibular rehabilitation.
- Sensory integration strategies, assessed via HMD-derived head sway, are valuable in understanding and treating vestibular dysfunction.
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