Effects Of Maximal Exercise On Vestibular/Ocular Motor Screening And Postural Control

Abstract

Multifaceted, vestibular-related assessment tools have received increased consideration in the sideline assessment of concussion. Specifically, vestibular/ocular motor screening (VOMS) and postural control are two, vestibular-related tools that are receiving attention. Since athletes are often in a state of exertion during the immediate evaluation of a concussion, it is imperative to understand the effects of exercise on these screening tools. PURPOSE: To examine the effects of maximal exercise testing on VOMS and postural control. METHODS: Seventeen, healthy college-aged individuals (20.7±2.3 years) completed a baseline VOMS and modified Clinical Test for Sensory Interaction and Balance (m-CTSIB) for postural control, followed by a graded maximal exercise treadmill test. VOMS measures consisted of symptom provocation scores per item and distance (cm) for convergence. Measures of the m-CTSIB consisted of sway index scores per task. RESULTS: Pre- to post-exercise symptom provocation score differences did not exist on any VOMS item, specifically, smooth pursuits (0.12 vs. 0.29, p=0.18), saccades (horizontal: 0.18 vs. 0.29, p=0.70; vertical: 0.24 vs. 0.41, p=0.70), convergence (2.78cm vs. 3.99 cm, p=0.27), vestibular ocular reflex (VOR) (horizontal: 0.59 vs. 0.94, p=0.31; vertical: 0.41 vs. 0.65, p=0.27), and visual motion sensitivity (VMS) (0.47 vs. 0.94, p=0.13). However, m-CTSIB sway index score differences from pre- to post-exercise only existed on the eyes open-firm surface (0.43 vs. 0.57, p<0.001) task. No differences existed on sway index scores during eyes closed-firm surface (0.65 vs. 0.81 (p=0.06), eyes open-foam surface (0.68 vs. 0.74, p=0.15) and eyes closed-foam surface (1.80 vs. 1.96, p=0.11) tasks. CONCLUSION: Eyes open-firm surface (using somatosensory, visual, and vestibular sensory input) task of the m-CTSIB was negatively influenced by exercise. VOMS items remained consistent from pre- to post-exercise, along with eyes closed-firm surface and both foam surface conditions, further validating their utility on sideline assessment.