A new method to improve the imbalance in chronic unilateral vestibular loss: the organization of refixation saccades

• Published in: Acta oto-laryngologica Vol. 136; no. 9; pp. 894 - 900
• Main Authors: Matiñó-Soler, Eusebi, Rey-Martinez, Jorge, Trinidad-Ruiz, Gabriel, Batuecas-Caletrio, Angel, Pérez Fernández, Nicolás
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.09.2016
• Subjects: Adult; Aged; Female; Humans; Male; Middle Aged; Physical Therapy Modalities; Postural Balance; Refixation saccades; Reflex, Vestibulo-Ocular; Saccades; unilateral vestibular loss; Vestibular Diseases - therapy; vestibule-ocular reflex; vHIT; Refixation saccades; vHIT; unilateral vestibular loss; vestibule-ocular reflex
• ISSN: 0001-6489; 1651-2251; 1651-2251
• DOI: 10.3109/00016489.2016.1172730

Conclusion: VOR adaptation and organization of refixation saccades in a gathered pattern is a process that can be artificially induced in patients with unilateral vestibular loss who have not developed it naturally, improving imbalance and vestibular disability. Objective: To test that temporary grouping of refixation saccades should be linked to better clinical status without gain recovery. Methods: A training to induce the refixation saccades into gathered fashion is performed. The outcome measures are handicap level measured by the dizziness handicap index (DHI) and refixation saccades organization pattern measured by a numeric score called 'PR' given by a software developed by the authors. Analysis is done before the training and 1 and 3 months after ending, Non-parametric tests were used for statistical analysis. Results: This study has included 10 healthy subjects (four males, six females), and 16 patients with chronic unsteadiness due to unilateral vestibular loss (nine vestibular neuritis, four post-surgical vestibular schwannoma, and three cases after intra-tympanic gentamycin in patients with Ménière's disease). The reduction in the DHI score was significant at 1 (p = 0.028) and 3 months (p = 0.042) post-treatment. Also, statistically significant differences were found between the PR score before and PR score 1 (p = 0.005) and 3 months after the treatment (p = 0.003).