Incremental vestibulo-ocular reflex (VOR) adaptation In subjects with peripheral vestibular hypofunction

The vestibulo-ocular reflex (VOR) is the main retinal-image stabilizing mechanism during rapid (i.e. high-frequency content) head movements. When the peripheral vestibular system is impaired, i.e. vestibular hypofunction, through disease, trauma or the aging process, the VOR response is reduced resulting in retinal image slip. Subsequently, along with other vestibular conditions, the image of the world are blurred during head movements. In these conditions, vestibular information is less accurate and reliable, introducing perceptual uncertainty due to the sensory mismatch, leading to compromised balance, gait and ability to perform daily activities. Vestibular rehabilitation therapy (VRT) is a set of prescribed exercises that help improve function and reduce symptoms. The main pillar of VRT are gaze-stabilization exercises (GSE) which aim to improve the VOR response (by a process we call adaptation) or compensate for vestibular hypofunction by improving other related (lower-frequency operating) systems via substitution or habituation. To date, despite their acceptance in clinical guidelines, little evidence exists showing GSE improves the high-frequency VOR response using quantitative measures. Recently, the incremental VOR adaptation (IVA) technique has shown promising results, with marked VOR adaptation after as little as 15 minutes of training. However, these preliminary studies mostly looked at healthy subjects. The few IVA patient studies had small numbers, minimal follow up, and were not compared to conventional GSE or evaluated for clinical effect. In the following thesis, I sought to determine GSE training parameters for optimal VOR adaptation, as well as perform studies to compare short and long-term clinical outcomes after conventional GSE versus IVA training in patients with isolated vestibular hypofunction.

Grantor dc:publisher

UNSW, Sydney

Year dc:date

2021

Author dc:creator

• Rinaudo, Carlo

• incremental VOR technique
• Vestibular ocular reflex
• vestibular rehabilitation
• dizziness
• vertigo
• gaze stabilization exercices

Statement dc:rights

• open access
• CC BY-NC-ND 3.0
• free_to_read

Licence

• https://purl.org/coar/access_right/c_abf2
• https://creativecommons.org/licenses/by-nc-nd/3.0/au/

Language dc:language

EN

Identifier

https://doi.org/10.26190/unsworks/22665

OAI identifier oai:identifier

oai:unsworks.library.unsw.edu.au:1959.4/71033