title: Outward versus inward head thrusts with video-head impulse testing in normal subjects: does it matter?
abstract: OBJECTIVE
  To investigate the effect of outward and inward head thrusts on the efficacy of compensatory eye movements generated during the video-Head Impulse Test (v-HIT) in healthy subjects.
  
  
  METHODS
  Diagnostic. Rapid movements of the head were performed either from the midline towards the side (outward thrusts) or from the side towards the midline (inward thrusts).
  
  
  METHODS
  Gain of the vestibulo-ocular reflex (VOR) as reported by two different v-HIT devices.
  
  
  RESULTS
  A small but statistically significant increase of the VOR gain was found for outward impulses. This small difference is likely to be attributed to increased neck strain during outward impulses, and/or hypothetically, that an effect of Alexander's law during fast, high-frequency VOR could play a role. However, the differences are minute.
  
  
  CONCLUSIONS
  We conclude that because the difference in the VOR gain between outward and inward thrusts was slight, both methods are acceptable for clinical use.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Nyström
authors.forename: Fredrik
authors.initials: F
authors.lastname: Tjernström
authors.forename: Måns
authors.initials: M
authors.lastname: Magnusson
mesh_terms: D000293:Adolescent; D000328:Adult; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D019416:Head Movements / Q000502:physiology*; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology*; D012399:Rotation; D014741:Video Recording; D055815:Young Adult