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Updated: May 14, 2025
Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction
Published on: August 30, 2019
Posturographic sensory ratios provide evidence for neuroplasticity after computerized vestibular rehabilitation
Eytan A David1, Navid Shahnaz2
1Otology, Neurotology, Skull Base Surgery, Clinical Instructor, Department of Surgery, University of British Columbia, Vancouver, Canada. dr.david@shaw.ca.
Background:
Vestibular deficits are common and debilitating. Many patients do not achieve satisfactory resolution of their symptoms with standard rehabilitation techniques. This study seeks to measure changes in computerized dynamic posturography sensory ratio information after computerized vestibular retraining therapy (CVRT).
Methods:
This prospective, single group, interventional study enrolled adult participants with stable, unilateral vestibular deficits. Before and after twelve twice weekly sessions of CVRT, and 4-6 and 10-12 months post-treatment, participants completed the Sensory Organization Test, from which sensory ratios (somatosensory - SOM, visual - VIS, vestibular - VEST, and visual preference - PREF) were calculated.
Results:
13 participants completed the intervention and post-retraining assessment; 9 completed the 4-6 and 10-12 month assessments. After CVRT, VIS increased by 11.6 (1.6 to 21.7) and VEST increased by 9.5 (0.6 to 18.3) and both remained significantly above baseline 10-12 months after treatment. The SOM and PREF ratios changed negligibly. Participants with mild disability (DHI ≤ 30) showed no change while participants with moderate-to-severe disability (DHI > 30) had significantly greater improvements in VIS (P = 0.0006) and VEST (P = 0.02) across all three post-treatment assessments.
Conclusions:
CVRT was associated with durable improvement in VIS and VEST sensory ratios and improved postural control under conditions that favour use of vestibular information, consistent with increased weighting of vestibular information over vision.
Trial Registration:
Clinicaltrials.gov registration NCT04875013; 04/27/2021.
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