Gaze Stability Exercises Research Articles

Comparative Effects of Gaze Stabilization Exercises and Cawthorne-Cooksey Exercises on Craniovertebral Angle and Vestibulo-Ocular Reflex in IT Students

Background: Vestibular dysfunction affects balance and spatial orientation, leading to symptoms like dizziness and impaired gaze stability. Forward head posture (FHP) is common among IT students due to prolonged screen time, exacerbating vestibular and postural issues.Objective: To compare the effects of Gaze Stabilization Exercises (GSE) and Cawthorne-Cooksey Exercises (CCE) on craniovertebral angle (CVA) and vestibulo-ocular reflex (VOR) among IT students.Methods: A single-blinded randomized clinical trial was conducted on 50 IT students aged 19-25 years with FHP. Participants were randomly assigned to GSE (n=25) or CCE (n=25) groups. Interventions were performed thrice weekly for 3 weeks. CVA and VOR were assessed pre- and post-intervention using a goniometer and clinical scale, respectively. Data were analyzed using SPSS version 27 with Wilcoxon signed-rank and Mann-Whitney U tests.Results: Post-intervention, Group B (CCE) showed a significant increase in CVA (mean rank 26.80, U = 280.000, p = 0.527). Group A (GSE) demonstrated a significant reduction in VOR (mean rank 30.80, U = 180.00, p = 0.003).Conclusion: GSE effectively improved VOR, while CCE significantly enhanced CVA, indicating the potential for targeted rehabilitation in addressing vestibular and postural dysfunctions.

The effects of gaze stability exercises on balance, gait ability, and fall efficacy in patients with chronic stroke: A 2-week follow-up from a randomized controlled trial.

This study aimed to examine the effect of gaze stability exercises on balance, gait ability, and fall efficacy in patients with chronic stroke, as well as to investigate whether any observed effects were maintained 2 weeks later. In this experiment, 30 chronic stroke patients were selected. The patients were randomly divided into 3 groups (10 patients in each group). All patients in the 3 groups performed basic neurodevelopmental treatment. Group 1 performed balance exercises accompanied by gaze stability exercises. Group 2 performed gaze stability exercises, and group 3 performed balance exercises. Each exercise program for 40 minutes 3 times a week for 4 weeks. After the intervention period, the patient's balance, gait ability, and fall efficacy were measured again. In order to know whether the training effect is maintained, a 2-week follow-up test was conducted after the training. The results of this study showed that there was a significant improve in balance (overall stability index, limit of stability test, and Berg Balance Scale), gait ability (gait velocity, cadence, step time and step length, Timed Up and Go [TUG] test), and fall efficacy over the different time within the 3 groups. The effect was observed to be maintained in follow-up tests after 2 weeks. In the comparison among 3 groups, the overall stability index, limit of stability test in the balance test and the gait velocity, cadence, step time, step length and Timed Up and Go test in the gait test all showed statistically significant differences, and the other items did not have significant differences. In most of the assessments, group 1 that used balance exercise combined with gaze stability exercise showed a better improvement than the other 2 groups. As a result, for stroke patients, gaze stability exercise is an effective arbitration method to improve balance and gait ability and fall efficacy. With balance exercise combined with gaze stability exercise, a greater effect can be seen than with gaze stability exercise or balance exercise alone. Thus, this combination exercise program can be recommended as effective.

Aging Delays Completion of Head Rotation Cycles in Continuous Gaze Stabilization Exercises despite Putative Healthy Vestibular Function

Introduction: Aging is associated with loss of balance, with falls being one of the leading causes of death among the elderly in the USA. Gaze stabilization exercises (GSE) improve balance control in vestibular populations and could be useful to prevent falls in healthy individuals. However, the extent to which aging affects head kinematics in GSE is unknown. Methods: Forty-eight younger (n = 25, 24 ± 6 years, 60% female) and older (n = 23, 66 ± 5 years, 56% female) adults completed six 30-s GSE. Participants were asked to maintain gaze fixation on a stationary target while continuously performing head movements in pitch (e.g., vertical) and yaw (e.g., horizontal) directions. The visual target was placed on the wall 1 m or 2 m away or handheld at arm’s length. Head kinematics were recorded with an inertial measurement unit placed on the back of the participants’ head. Results: Older adults took significantly more time (e.g., delay) to complete cycles of head rotation in both pitch and yaw compared to younger participants across all GSE. Such delay was further increased during yaw head rotation while fixating gaze of the 1 m target. The average peak velocity (APV) and average angular displacement (AAD), however, were equivalent between groups in all GSE. Conclusion: Aging leads to the maintenance of head rotation APV and AAD at the expense of delayed cycles of head rotation, suggesting an age-dependent prioritization strategy (e.g., adapt duration first, range second) during continuous head movements. The distance of the visual target and head movement direction influenced elderly performance and should be considered when prescribing GSE to older populations.

Wearable sensor and smartphone assisted vestibular physical therapy for multiple sclerosis: usability and outcomes.

Vertigo, dizziness, gaze instability and disequilibrium are highly prevalent in people with MS (PwMS) and head movement induced dizziness is commonly reported. Vestibular physical therapy (VPT) is a specialised, non-invasive and effective therapy for these problems but usually involves travel for the person to a specialist center with both personal and carbon costs. The use of wearable sensors to track head movement and smartphone applications to deliver and track programs has potential to improve VPT in MS. This study investigated the usability and effects of a commercially available digital VPT system (wearable head sensor, smartphone app and clinician software) to deliver VPT to PwMS. A pre/post treatment design was employed and the primary outcome was the System Usability Scale (SUS). Other patient reported outcomes were the Service User Acceptability Questionnaire (SUTAQ), the Patient Enablement Instrument (PEI) and the Dizziness Handicap Inventory (DHI). Physical outcomes measurements included Mini-BESTest (MB), Modified Dynamic Gait Index (mDGI), Gait Speed (GS), Dynamic Visual Acuity (DVA) and head kinematics and symptoms during exercise. Sixteen PwMS (14 female), mean age 44(±14) years were recruited to the study and twelve completed VPT. Mean adherence to exercise, measured digitally was 60% (±18.4). SUS scores were high at 81 (±14) and SUTAQ scores also demonstrated high levels of satisfaction and acceptability of the system. Statistically significant improvements in MB (mean change 2.25; p = 0.004), mDGI (median change 1.00; p = 0.008), DVA (median change -1.00; p = 0.004) were found. Head frequencies significantly improved with concurrent decreased intensity of dizziness during head movements (mean change across 4 gaze stabilization exercises was 23 beats per minute; p < 0.05). Non-significant improvements were seen in DHI (p = 0.07) and GS (p = 0.15). 64.5% of follow up visits were conducted remotely (video or phone), facilitated by the system. This study had two main outcomes and benefits for PwMS. Firstly, we showed that the system used was both acceptable and could be used by PwMS. Secondly, we demonstrated an improvement in a range of dizziness, balance and gait metrics with remotely delivered care. This system has the potential to positively impact on MS physiotherapy service provision with the potential to deliver effective remote care.

Comparison of effects of Otago exercise program vs gaze stability exercise on balance and fear of fall in older adults: A randomized trial.

Fall occurrences and the associated risk of injury are debilitating and major health concerns in the older population. Several interventions have been investigated and implemented to address the needs of balance impairments and to reduce the increased risk of falls. This study aimed to compare the effectiveness of the Otago exercise program (OEP) and gaze stability exercises (GSE) on balance and the risk of falls in older adults residing at an old age home facility. Thirty elderly participants were equally and randomly divided into 2 groups: Group OEP received the OEP, and group GSE received GSE for 8 weeks (thrice a week). In addition, both groups also performed core muscle-strengthening exercises. The outcome measures were the Berg balance scale (BBS) and the Fall efficacy scale-International (FES-I). The interventions resulted in significant improvements (P < .001) in both outcome measures in both groups. The mean pretest BBS scores of groups OEP and GSE increased from 40.4 and 39.2 to the mean post-test scores of 48 and 45.2, respectively. Similarly, the mean pretest FES-I scores of groups OEP and GSE also improved from 39.47 and 40.4 to the mean post-test scores of 32.73 and 36.07. The between-group comparison showed greater improvement (P < .05) in OEP group in both variables. OEP and GSE were found to be beneficial rehabilitation programs in improving balance and fear of falls in healthy older adults. However, the OEP was found to be a more effective intervention and may allow better balance and fall prevention improvements. The study has been registered in clinicaltrials.gov (ID: NCT05781776; on 23/03/2023).

Implementation Of Gaze Stability Exercise With Ergonomic Approach Based On Home Training Program in Improving Balance in The Elderly

Implementation Of Gaze Stability Exercise With Ergonomic Approach Based On Home Training Program in Improving Balance in The Elderly

Comparison of Effects of Balance Training Exercise and Gaze Stability Exercises on Balance and Postural Control in Elderly With Fall Risk: A Randomized Controlled Trial

Aim To compare the changes in outcomes of balance and postural control after balance training exercise and gaze stability exercise in the elderly population with fall risk. Methods After the screening process, 44 subjects were randomized into three groups: Experimental Group A (Balance training exercises, BTE); Experimental Group B (Gaze stability exercises, GSE), and Control Group C (Fall prevention education only). The outcome measures were center of pressure (COP) range, COP sway, reaction time, proprioception, static balance, Clinical Test for Sensory Interaction in Balance (CTSIB), and Short Falls Efficacy Scale (SFES). The pre and post-data were recorded at baseline and after 8 weeks. The normality of the distribution was assessed using the Shapiro-Wilk test. Demographic data and baseline measures were compared using one-way ANOVA considering group as between factor and mixed model ANOVA was used to find out the group effect and time effect and time × group interaction effect. Statistical significance was indicated if p ≤ 0.05. Results GSE had significant changes only in CTSIB 4 whereas BTE had significant changes in CTSIB 4, 5, and 6. COP range showed a significant time effect in the front direction (p = 0.02). For proprioception, there was a significant time effect in the left (p = 0.018) and right direction (p = 0.005), whereas changes in front and back directions were found to be insignificant. SFES showed a significant time effect (p < 0.001), group effect (p = 0.21), and time × group interaction effect (p < 0.001). Conclusion Balance training exercises may be a more effective form of intervention to improve balance and postural control in the elderly population.

Comparative Study to Assess the Effect of Gaze Stability Exercises and Perturbation Based Balance Exercises on Balance for Stroke Patients

Comparative Study to Assess the Effect of Gaze Stability Exercises and Perturbation Based Balance Exercises on Balance for Stroke Patients

Remote assessment and management of patients with dizziness: development, validation, and feasibility of a gamified vestibular rehabilitation therapy platform.

Dizziness is a growing public health concern with as many as 95 million adults in Europe and the United States experiencing vestibular hypofunction, which is associated with reduced quality of life, poorer health, and falls. Vestibular rehabilitation therapy (VRT) is effective in reducing symptoms and improving balance; however, limited access to qualified clinicians and poor patient adherence impedes optimal delivery. The goal of this study was to develop and evaluate the feasibility of a remote therapeutic monitoring VRT Platform application (APP) for the assessment and treatment of vestibular dysfunction. User-centered iterative design process was used to gather and integrate the needs of users (clinicians and patients) into the design at each stage of development. Commonly used vestibular patient-reported outcome measures (PROs) were integrated into the APP and adults with chronic dizziness were enrolled to evaluate validity and reliability of the APP compared to standard clinical measures (CLIN). Gaze stabilization exercises were gamified to provide an engaging experience and an off-the-shelf sensor captured eye and head movement to provide feedback on accuracy of performance. A prospective, pilot study design with pre-and post-treatment assessment assessed feasibility of the APP compared to standard VRT (CLIN). Participants with dizziness wanted a summary rehabilitation report shared with their clinicians, felt that an app could help with accountability, and believed that a gaming format might help with exercise adherence. Clinicians felt that the app should include features to record and track eye and head movement, monitor symptoms, score accuracy of task performance, and measure adherence. Validity and reliability of the digital PROs (APP) were compared to scores from CLIN across two sessions and found to have good validity, good to excellent test-retest reliability, and excellent usability (≥88%ile). The pilot study demonstrated feasibility for use of the APP compared to CLIN for treatment of vestibular hypofunction. The mean standard system usability score of the APP was 82.5 indicating excellent usability. Both adult patients with chronic dizziness and VRT clinicians were receptive to the use of technology for VRT. The HiM-V APP is a feasible alternative to clinical management of adults with chronic peripheral vestibular hypofunction.

Concurrent vestibular activation and postural training recalibrate somatosensory, vestibular and gaze stabilization processes.

Postural instability is a common symptom of vestibular dysfunction that impacts a person's day-to-day activities. Vestibular rehabilitation is effective in decreasing dizziness, visual symptoms and improving postural control through several mechanisms including sensory reweighting of the vestibular, visual and somatosensory systems. As part of the sensory reweighting mechanisms, vestibular activation exercises with headshaking influence vestibular-ocular reflex (VOR). However, combining challenging vestibular and postural tasks to facilitate more effective rehabilitation outcomes is under-utilized. Understanding how and why this may work is unknown. The aim of the study was to assess sensory reweighting of postural control processing and VOR after concurrent vestibular activation and weight shift training (WST) in healthy young adults. Forty-two participants (18-35years) were randomly assigned into four groups: No training/control (CTL), a novel visual feedback WST coupled with a concurrent, rhythmic active horizontal or vertical headshake activity (HHS and VHS), or the same WST with no headshake (NHS). Training was performed for five days. All groups performed baseline- and post-assessments using the video head impulse test, sensory organization test, force platform rotations and electro-oculography. Significantly decreased horizontal eye movement variability in the HHS group compared to the other groups suggests improved gaze stabilization (p = .024). Significantly decreased horizontal VOR gain (p = .040) and somatosensory downweighting (p = .050) were found in the combined headshake groups (HHS and VHS) compared to the other two groups (NHS and CTL). The training also showed a significantly faster automatic postural response (p = .003) with improved flexibility (p = .010) in the headshake groups. The concurrent training influences oculomotor function and suggests improved gaze stabilization through vestibular recalibration due to adaptation and possibly habituation. The novel protocol could be modified into progressive functional activities that would incorporate gaze stabilization exercises. The findings may have implications for future development of vestibular rehabilitation protocols.

Symptoms in unilateral vestibular hypofunction are associated with number of catch-up saccades and retinal error: results from the population-based KORA FF4 study

ObjectiveThe presence and intensity of symptoms vary in patients with unilateral vestibular hypofunction. We aimed to determine which saccadic and vestibulo-ocular reflex parameters best predict the presence of symptoms in unilateral vestibular hypofunction in order to better understand vestibular compensation and its implications for rehabilitation therapy.MethodsVideo head impulse test data were analyzed from a subpopulation of 23 symptomatic and 10 currently symptom-free participants with unilateral vestibular hypofunction, embedded in the KORA (Cooperative Health Research in the Region of Augsburg) FF4 study, the second follow-up of the KORA S4 population-based health survey (2,279 participants).ResultsA higher number of catch-up saccades, a higher percentage of covert saccades, and a larger retinal error at 200 ms after the onset of the head impulse were associated with relevant symptoms in participants with unilateral vestibular hypofunction (p = 0.028, p = 0.046, and p = 0.038, respectively). After stepwise selection, the number of catch-up saccades and retinal error at 200 ms remained in the final logistic regression model, which was significantly better than a null model (p = 0.014). Age, gender, saccade amplitude, saccade latency, and VOR gain were not predictive of the presence of symptoms.ConclusionThe accuracy of saccadic compensation seems to be crucial for the presence of symptoms in unilateral vestibular hypofunction, highlighting the role of specific gaze stabilization exercises in rehabilitation. Early saccades, mainly triggered by the vestibular system, do not seem to compensate accurately enough, resulting in a relevant retinal error and the need for more as well as more accurate catch-up saccades, probably triggered by the visual system.

Effectiveness of Vestibular Rehabilitation for Patients with Degenerative Cerebellar Ataxia: A Retrospective Cohort Study.

Many patients with cerebellar ataxia have dizziness caused by oculomotor or peripheral vestibular deficits; however, there is little evidence supporting the use of vestibular rehabilitation for this population. The purpose of this study was to determine whether patients with degenerative cerebellar diseases improve following rehabilitation including vestibular exercises. A secondary aim was to identify variables associated with the outcomes. A retrospective chart review identified 42 ambulatory patients (23 men and 19 women; mean age = 54.5 ± 14.4 years) with cerebellar degeneration. Fourteen patients had ataxia only, twenty had ataxia and oculomotor abnormalities, and eight had ataxia with oculomotor and peripheral vestibular deficits. Patients received customized physical therapy including balance and gait training, as well as gaze stabilization and habituation exercises for vestibular hypofunction and motion-provoked dizziness. Primary outcome measures (Activities-specific Balance Confidence Scale, Tinetti Performance Oriented Mobility Assessment, Dynamic Gait index, and Sensory Organization Test) were evaluated at baseline and discharge. Patients improved (p < 0.05) on all outcome measures. Patients with vestibular deficits were seen for more visits compared to those with gait ataxia only (7.1 vs. 4.8 visits). This study provides evidence that patients with degenerative cerebellar disease improve in balance confidence, fall risk and sensory integration with therapy that includes vestibular rehabilitation.

Developing a serious game for gaze stability rehabilitation in children with vestibular hypofunction

BackgroundChildren with vestibular hypofunction (VH) may have gaze instability, balance disorders, and delayed postural-motor development. Gaze stabilization exercises (GSE) are designed to improve dynamic visual acuity (DVA). We aimed to assess the acceptability of a serious game prototype called Kid Gaze Rehab (KGR) designed to implement GSE training in children with VH, combined with traditional vestibular rehabilitation. Effects on DVA and motor performance were also analyzed.MethodsTwelve children (6 to 9 years old) were included. Sessions were held at the hospital twice a week, for 5 weeks. An adapted French version of The Child Simulator Sickness Questionnaire (SSQ) and the Face Scale Pain-Revised (FPS-R) were used to assess pain in the cervical region and undesirable side effects after each session. Vestibular and motor function parameters (active and passive DVA and Movement Assessment Battery for Children–Second Edition, MABC-2) were assessed before and after the training.ResultsAll children included completed the 10 sessions. The FPS-R visual analog scale and SSQ showed good cervical tolerance and no oculomotor or vegetative adverse effects nor spatial disorientation. After training, active DVA scores were significantly improved for the right, left, and up directions (p < 0.05). Passive DVA scores were significantly improved for the left and down directions (p < 0.01 and p < 0.05, respectively). MABC-2 scores were improved in the balance and ball skill sections (p < 0.05).ConclusionAn innovative pediatric training method, the use of a dedicated serious game for gaze stabilization was well-tolerated as a complement to conventional vestibular rehabilitation in children with VH. Moreover, both DVA and motor performance were found to improve in the study sample. Although replication studies are still needed, serious game-based training in children with VH could represent a promising rehabilitation approach for years to come.Trial registrationThe study was conducted in accordance with the Declaration of Helsinki and approved by an Institutional Review Board (local ethics committee, CPP Sud-Est IV, ID 2013–799). The study protocol was registered on ClinicalTrials.gov (NCT04353115).

Vestibular rehabilitation therapy on balance and gait in patients after stroke: a systematic review and meta-analysis

BackgroundThere is limited evidence to support the use of vestibular rehabilitation therapy (VRT) on improving balance and gait in patients after stroke. This systematic review aimed to evaluate the effects of VRT in addition to usual rehabilitation compared with usual rehabilitation on improving balance and gait for patients after stroke.MethodsThis review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement guidelines. Ten electronic databases were searched up to 1 June 2023 without restrictions in language and publication status. The PEDro scale and the Grading of Recommendations Assessment Development, and Evaluation were used to evaluate the risk of bias and the certainty of evidence. The meta-analysis was conducted with Review Manager 5.3.ResultsFifteen randomised controlled trials with 769 participants were included. PEDro scale was used to assess the risk of bias with a mean score of 5.9 (0.7). VRT was effective in improving balance for patients after stroke (SMD = 0.59, 95% CI (0.40, 0.78), p < 0.00001), particularly for patients after stroke that occurred within 6 months (SMD = 0.56, 95% CI (0.33, 0.79), p < 0.00001) with moderate certainty of evidence. Subgroup analysis showed that VRT provided as gaze stability exercises combined with swivel chair training (SMD = 0.85, 95% CI (0.48, 1.22), p < 0.00001) and head movements (SMD = 0.75, 95% CI (0.43, 1.07), p < 0.00001) could significantly improve balance. Four-week VRT had better effect on balance improvement (SMD = 0.64, 95% CI (0.40, 0.89), p < 0.00001) than the less than 4-week VRT. The pooled mean difference of values of Timed Up-and-Go test showed that VRT could significantly improve gait function for patients after stroke (MD = −4.32, 95% CI (−6.65, −1.99), p = 0.0003), particularly for patients after stroke that occurred within 6 months (MD = −3.92, 95% CI (−6.83, −1.00), p = 0.008) with moderate certainty of evidence.ConclusionsThere is moderate certainty of evidence supporting the positive effect of VRT in improving balance and gait of patients after stroke.Trial registrationPROSPERO CRD42023434304

The combined effect of gaze stability and balance exercises using telerehabilitation in individuals with vestibular disorders during the COVID-19 pandemic: A pilot study.

Vestibular rehabilitation is recognized as the most effective intervention to relieve symptoms of dizziness and imbalance related to vestibular disorders. This study aimed to examine the combined effect of gaze stability and balance exercises using telerehabilitation in individuals with vestibular disorders during the COVID-19 pandemic. This pilot study was a quasi-experimental, single-group design pre- to post-telerehabilitation intervention. Individuals with vestibular disorders between the ages of 25-60 participated in this study (n = 10). Participants underwent four weeks of combined gaze stability and balance exercises using telerehabilitation at their homes. The Arabic version of the Activities-Specific Balance Confidence scale (A-ABC), Berg Balance Scale (BBS), and the Arabic version of the Dizziness Handicap Inventory (A-DHI) were assessed pre- and post-vestibular telerehabilitation. Wilcoxon signed rank test was used to examine the magnitude of difference pre- and post-intervention scores of outcome measures. The effect size (r) for the Wilcoxon signed rank was calculated. After four weeks of vestibular telerehabilitation, there was an improvement in BBS and A-DHI outcome measures (p < .001), with moderate effect size for both scales (r = 0.6). However, A-ABC showed no significant improvement among participants. This pilot study found that the combined effect of gaze stability and balance exercises using telerehabilitation appear to be effective in improving balance and activities of daily living in individuals with vestibular disorders.

Effectiveness of vestibular exercises on balance impairment in patients affected with stroke - A systematic review

Introduction and Aim: The patients who have been suffered with stroke have severe balance problems, it is difficult to tell with certainty how balance performance in stroke patients is impacted by vestibular impairment. The study's purpose was to determine if oculomotor and gaze stability exercises may help post-stroke individuals improve their balance. Materials and Methods: This study includes all articles of various databases from 2000 to 2020 was included for study selection. The google scholar, research gate databases were comprehensively studied. 100 articles were searched and out of which 60 articles were selected to be assessed for eligibility in full text. Finally, 9 articles were chosen for inclusion and for analysis, although 7 of them did not match our proposed inclusion criteria. Results: Exercises for the vestibular system have been demonstrated to be effective for stroke patients whose balance has been compromised. Conclusion: The study finds that more high -quality experimental research on vestibular exercises and balance impairment after stroke is necessary because there is very little evidence from earlier experimental studies to draw firm conclusions about their effects.

Multi-Modal Neurorehabilitation for Persisting Post-Concussion Symptoms.

Treatment of the chronic sequela that persist after a mild traumatic brain injury has been challenging with limited efficacy. The aim of this work was to report outcomes obtained from persons who met the criteria of persisting post-concussive symptoms (PPCS), utilizing a novel combination of modalities in a structured neurorehabilitation program. This work was designed as a retrospective, pre-post chart review of objective and subjective measures collected from 62 outpatients with PPCS a mean of 2.2 years post-injury, before and after a multi-modal 5-day treatment protocol. The subjective outcome measure was the 27-item modified Graded Symptom Checklist (mGSC). Objective outcome measures were motor speed/reaction time, coordination, cognitive processing, visual acuity, and vestibular function. Interventions included non-invasive neuromodulation, neuromuscular re-education exercises, gaze stabilization exercises, orthoptic exercises, cognitive training, therapeutic exercises, and single/multi-axis rotation therapy. Pre-post differences in measures were analyzed using the Wilcoxon signed-rank test, with effect size determined by the rank-biserial correlation coefficient. Pre-post treatment comparisons for the subjective mGSC overall, combined symptom measures, individual components of the mGSC, and cluster scores significantly improved for all items. Moderate strength relationships were observed for the mGSC composite score, number of symptoms, average symptom score, feeling in a "fog," "don't feel right," irritability, and physical, cognitive, and affective cluster scores. Objective symptom assessment significantly improved for trail making, processing speed, reaction time, visual acuity, and Standardized Assessment of Concussion. Patients suffering from PPCS ∼2 years after injury may have significant benefits with some moderate effect sizes from an intensive, multi-modal neurorehabilitation program.

Evaluation of the Efficacy of Vestibular Rehabilitation Home Program Based on Brandt Daroff and Gaze Stabilization Exercises in Patients with Idiopathic Vertigo

Amaç: Bu çalışmanın amacı, tanısı konmuş nörolojik ve otolojik hastalığı olmayan, 3 ay ve daha uzun süredir başdönmesi şikayeti olan bireyler için Brandt Daroff ve bakış stabilizasyon egzersizlerinden oluşturulan vestibüler rehabilitasyon ev programının etkinliğinin değerlendirilmesidir. Yöntem: Çalışmaya baş dönmesi şikayeti olan, otolojik ve nörolojik hastalığı olmayan, 25–45 yaş arası, 13 birey dahil edildi. Baş dönmesinin katılımcıların günlük yaşam aktiviteleri üzerindeki olumsuz etkisi Aktiviteye Özgü Denge Güven Ölçeği (AÖDGÖ) ile değerlendirildi. Kişiye özel vestibüler rehabilitasyon programı, günlük yaşam aktiviteleri sırasında baş dönmesinin artış gösterdiği baş hareketlerinin yönüne göre belirlendi. Brandt-Daroff Egzersizleri ve bakış stabilizasyon egzersizleri ev programı şeklinde verildi. Hastalar 3 hafta sonra ve 3 ay sonra AÖDGÖ ile tekrar değerlendirildi. Sonuçlar karşılaştırıldı. Bulgular: AÖDGÖ skorlarının sonuçlarına göre 3. hafta ile 3. ay değerlendirmeleri arasındaki fark (p&amp;lt;0,001) ve ilk değerlendirme ile 3. ay değerlendirmeleri arasındaki fark (p=0,014) istatistiksel olarak anlamlı bulundu. İlk değerlendirme ile 3 hafta sonraki değerlendirme skorları arasındaki fark istatistiksel olarak anlamlı değildi (p=0,118). Sonuç: Uzun süredir baş dönmesi şikayeti olan bireyler için hazırlanacak vestibüler rehabilitasyon egzersizleri ile günlük yaşam aktiviteleri sırasında baş dönmesinin yaratacağı olumsuzluklar azaltılabilir. Bireylerin günlük yaşam aktivitelerinde iyileşme gözlenebilmesi için vestibüler rehabilitasyon egzersizlerini düzenli olarak yapmaları önerilmelidir.

The Effect of Gaze Stability Exercise Intervention on Increasing Dynamic Balance in the Elderly

Background: Physiological changes from decreased muscle strength, posture change, somatosensory system (visual, vestibular, proprioception) causes balance disorders in elderly. Gaze stability exercise is a proper exercise since it is based on pathophysiology of elderly imbalance caused by aging of sensory system and skeletal muscle. Objective: to find out the effect of Gaze Stability Exercise Intervention on increasing dynamic balance in elderly. Method: a pre-experimental with one group pre-posttest design. There were 11 elderly as samples selected with purposive sampling technique. Intervention was done twice a week for four weeks with duration of 60 minutes. Dynamic balance measurement used Time Up and Go Test (TUGT). Data analysis used was paired- t test. Result: The average time up and go test before intervention was 17.82 and after invention was 13.82.the result of before and after statistical test showed p value of 0.000 (p&lt;0.05). Conclusion: There is an effect of Gaze Stability Exercise Intervention on increasing dynamic balance in elderly&#x0D;

Effect of gaze stability exercise on mild lateropulsion, dizziness, and dynamic balance disorder after acute stroke in the left thalamus and rostral red nucleus of the midbrain

Effect of gaze stability exercise on mild lateropulsion, dizziness, and dynamic balance disorder after acute stroke in the left thalamus and rostral red nucleus of the midbrain