title: Effect of oculomotor rehabilitation on accommodative responsivity in mild traumatic brain injury.
abstract: Accommodative dysfunction is a common oculomotor sequelae of mild traumatic brain injury (mTBI). This study evaluated a range of dynamic (objective) and static (subjective) measures of accommodation in 12 nonstrabismic individuals with mTBI and near vision-related symptoms before and after oculomotor training (OMT) and placebo (P) training (6 wk, two sessions per week, 3 h of training each). Following OMT, the dynamics of accommodation improved markedly. Clinically, there was a significant increase in the maximum accommodative amplitude both monocularly and binocularly. In addition, the near vision symptoms reduced along with improved visual attention. None of the measures were found to change significantly following P training. These results provide evidence for a significant positive effect of the accommodatively based OMT on accommodative responsivity. Such improvement is suggestive of oculomotor learning, demonstrating considerable residual brain-visual system plasticity in the adult compromised brain.
authors.affiliation: Retina Foundation of the Southwest, 9600 N Central Expy, Ste 200, Dallas, TX 75231. pthiagarajan@retinafoundation.org.
authors.forename: Preethi
authors.initials: P
authors.lastname: Thiagarajan
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Ciuffreda
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D001288:Attention / Q000502:physiology*; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D018592:Cross-Over Studies; D005133:Eye Movements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D009801:Oculomotor Muscles / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D011932:Reading; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
keywords: accommodation; accommodative dysfunction; accommodative training; acquired brain injury; mild traumatic 
  brain injury; neuroplasticity; oculomotor 
  rehabilitation; oculomotor learning; traumatic brain injury; vision rehabilitation