Abstract

PurposeTo create an index that is a measure of the amount of vestibular compensation and for which only functional balance performance is needed.MethodsThe medical charts of 62 eligible peripheral vestibular dysfunction (PVD) patients were analyzed retrospectively. To be included, the following vestibulo-ocular reflex (VOR) and balance performance data had to be available: (1) caloric and sinusoidal harmonic acceleration test (SHA) and (2) standing balance sum-eyes closed (SBS-EC), Timed Up and Go Test and Dynamic Gait Index. Patients were divided into three groups: normal caloric- and SHA test (group 1), abnormal caloric- and normal SHA test (group 2, PVD compensated) and abnormal caloric- and SHA test (group 3, PVD uncompensated). Next to the use of non-parametric tests to study the VOR and balance variables, logistic regression was used to identify the balance measures that predict whether PVD patients were compensated or uncompensated. This resulted also in the construction of a continuous measure representing the degree of compensation.ResultsLogistic regression identified SBS-EC and age to classify uncompensated from compensated patients with sensitivity of 83.9% and specificity of 72.4%. Then an index was created, called the Antwerp Vestibular Compensation Index, AVeCI = − 50 + age × 0.486 + SBS-EC × 0.421. A patient belongs to the uncompensated group when AVeCI < 0 and to the compensated group when AVeCI > 0, with respective group means of − 5 and 5.ConclusionAVeCI stages the degree of compensation of PVD patients and can serve to evaluate rehabilitation effects.

Highlights

  • Patients with acute peripheral vestibular dysfunction (PVD) complain about vertigo, nausea, spatial disorientation, gaze- and postural instability in the first few days after the onset of vestibular function loss [1,2,3,4,5]

  • The sinusoidal harmonic acceleration test (SHA) phase had a low correlation with the Romberg with Jendrassik maneuver (RJ) eyes closed (EC), standing on foam (SOF) EC, tandem stance (TS) EC and single les stance (SLS) EC (ρ = − 0.282/− 0.462/− 0.431/− 0.400), but a moderate correlation with the standing balance sum-eyes closed (SBS-EC) (ρ = − 0.531)

  • The initial aim of the present study was to examine the relationship between selected vestibulo-ocular reflex (VOR) and vestibulo-spinal reflex (VSR) variables and to the investigate whether functional balance performance can be used to identify uncompensated PVD patients

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Summary

Introduction

Patients with acute peripheral vestibular dysfunction (PVD) complain about vertigo, nausea, spatial disorientation, gaze- and postural instability in the first few days after the onset of vestibular function loss [1,2,3,4,5]. These symptoms result from deficient vestibulo-ocular reflex (VOR) and vestibulo-spinal reflex (VSR) systems and abnormally activated vestibulo-thalamo-cortical pathways [1, 2, 4]. The delay within the vestibular system decreases in such way that the typical visible catch-up saccades during head impulses become covert [11]

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