title: Recovery of dynamic visual acuity in unilateral vestibular hypofunction.
abstract: OBJECTIVE
  To determine the effect of vestibular exercises on the recovery of visual acuity during head movement in patients with unilateral vestibular hypofunction.
  
  
  METHODS
  Prospective, randomized, double-blind study.
  
  
  METHODS
  Ambulatory referral center.
  
  
  METHODS
  Twenty-one patients with unilateral vestibular hypofunction, aged 20 to 86 years.
  
  
  METHODS
  One group (13 patients) performed vestibular exercises designed to enhance the vestibulo-ocular reflex, and the other group (8 patients) performed placebo exercises. The placebo group was switched to vestibular exercises after 4 weeks.
  
  
  METHODS
  Measurements of dynamic visual acuity (DVA) during predictable (DVA-predictable) and unpredictable (DVA-unpredictable) head movements by means of a computerized test and measurement of intensity of oscillopsia by means of a visual analog scale.
  
  
  RESULTS
  As a group, patients who performed vestibular exercises showed a significant improvement in DVA-predictable (P<.001) and DVA-unpredictable (P<.001), while those performing placebo exercises did not (P =.07). On the basis of stepwise regression analysis, the leading factor contributing to improvement was vestibular exercises. This reached significance for DVA-predictable (P =.009) but not DVA-unpredictable (P =.11). Other factors examined included age, time from onset, initial DVA, oscillopsia, and duration of treatment. Changes in oscillopsia did not correlate with DVA-predictable or DVA-unpredictable.
  
  
  CONCLUSIONS
  Use of vestibular exercises is the main factor involved in recovery of DVA-predictable and DVA-unpredictable in patients with unilateral vestibular hypofunction. Exercises may foster the use of centrally programmed eye movements that could substitute for the vestibulo-ocular reflex. The DVA-predictable would benefit more from this than would DVA-unpredictable.
authors.affiliation: Department of Rehabilitation Medicine, Emory University, Atlanta, Ga., USA. sherdma@emory.edu
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Herdman
authors.forename: Michael C
authors.initials: MC
authors.lastname: Schubert
authors.forename: Vallabh E
authors.initials: VE
authors.lastname: Das
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Tusa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D015837:Vestibular Diseases / Q000503:physiopathology* / Q000628:therapy*; D014792:Visual Acuity / Q000502:physiology*