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BACKGROUND: Current vestibular rehabilitation for peripheral vestibular hypofunction is an exercise-based approach that improves symptoms and function in most, but not all patients, and includes gaze stabilization exercises focused on duration of head movement. One factor that may impact rehabilitation outcomes is the speed of head movement during gaze stability exercises. OBJECTIVE: Examine outcomes of modified VOR X1 exercises that emphasize a speed-based approach for gaze stabilization while omitting substitution and habituation exercises. Balance training focused on postural realignment and hip strategy performance during altered visual and somatosensory inputs. METHODS: A retrospective chart review of 159 patients with vestibular deficits was performed and five outcome measures were analyzed. RESULTS: All outcomes – self-report dizziness and balance function, dynamic gait index, modified clinical test of sensory interaction and balance, and clinical dynamic visual acuity improved significantly and approached or achieved normal scores. CONCLUSIONS: The combination of modified VOR X1 gaze stability exercises, wherein patients achieved high-velocity head movement (240°/s) during short exercise bouts, with “forced use” gait and balance exercises for postural realignment and hip strategy recruitment, achieved 93–99% of normal scores for all five outcomes. These results compare favorably to the outcomes for current VR techniques and warrant further investigation.

Thesis (M.S.)--California Polytechnic State University, 2009. / Mode of access: Internet. Title from PDF title page; viewed on Jan. 20, 2010. Major professor: Dr. Lynne Slivovsky. "Presented to the faculty of the College of Engineering, California Polytechnic State University." "In partial fulfillment of the requirements for the degree [of] Master of Science in Electrical Engineering." "July 2009." Includes bibliographical references (p. 102-104).

Thesis (M. Aud.)--University of Canterbury, 2009. / Typescript (photocopy). Includes bibliographical references (p. 87-98). Also available via the World Wide Web.

Cervical vestibular evoked myogenic potential (cVEMP) testing is widely used in the assessment of vestibular disorders in clinical practice (Welgampola & Colebatch, 2003). Ocular vestibular evoked myogenic potentials (oVEMPs) are similar to the cervical VEMPs in that the vestibular system is also stimulated by a loud sound. The difference is that the response is measured on the inferior oblique muscle of the eye as opposed to the sternocleidomastoid muscle (SCM) of the neck (Chihara, Iwasaki, Ushio, & Murofushi, 2007). The current study compares the standard cervical VEMP to the ocular VEMP in both control subjects and participants with “clinically certain” Ménière’s disease. By investigating cervical VEMPs in comparison to ocular VEMPs we aimed to improve the ability to stage and diagnose Ménière’s disease using the ocular VEMP. 22 control participants and 19 participants with confirmed unilateral Ménière’s disease took part in the study. The peak latency and amplitudes of the ocular and cervical VEMP tests were recorded and analysed. In addition, the background electromyographic (EMG) activity of both the inferior oblique and sternocleidomastoid muscles was recorded throughout testing. A questionnaire was also distributed to all participants to compare the relative difficulty of the VEMP tests. Statistical analysis using the paired t-test, standard t-test and the one-way ANOVA on ranks test was applied to determine a difference between the control and patient groups for both the ocular and cervical VEMP tests. Overall, the threshold and IAD ratio measures did not produce any significant results when sound was presented to the affected ear for the cervical and ocular VEMP tests. A significant reduction in amplitude of the VEMPs from the Ménière’s groups was found compared to the control groups for the ocular the cervical VEMPs. Overall, an increase in P2 and N3 latency of the ocular VEMP response in Ménière’s patients was determined. Results from the questionnaire suggest that the ocular VEMP test was more tolerable to the cervical VEMP test in this current study. Furthermore, statistical analyses revealed no significant differences in EMG level between the control and Ménière’s group for both the ocular and cervical VEMP data. Overall, results suggest that both the cervical and ocular VEMP tests provide information regarding the integrity of the saccule, owing to the abnormal VEMP findings in the participants with Ménière’s disease. In addition, this study provides evidence that the ocular VEMP is as useful a tool in diagnosing Ménière’s disease as the cervical VEMP.

Cervical vestibular evoked myogenic potential (cVEMP) testing is widely used in the assessment of vestibular disorders in clinical practice (Welgampola & Colebatch, 2003). Ocular vestibular evoked myogenic potentials (oVEMPs) are similar to the cervical VEMPs in that the vestibular system is also stimulated by a loud sound. The difference is that the response is measured on the inferior oblique muscle of the eye as opposed to the sternocleidomastoid muscle (SCM) of the neck (Chihara, Iwasaki, Ushio, & Murofushi, 2007). The current study compares the standard cervical VEMP to the ocular VEMP in both control subjects and participants with “clinically certain” Ménière’s disease. By investigating cervical VEMPs in comparison to ocular VEMPs we aimed to improve the ability to stage and diagnose Ménière’s disease using the ocular VEMP. 22 control participants and 19 participants with confirmed unilateral Ménière’s disease took part in the study. The peak latency and amplitudes of the ocular and cervical VEMP tests were recorded and analysed. In addition, the background electromyographic (EMG) activity of both the inferior oblique and sternocleidomastoid muscles was recorded throughout testing. A questionnaire was also distributed to all participants to compare the relative difficulty of the VEMP tests. Statistical analysis using the paired t-test, standard t-test and the one-way ANOVA on ranks test was applied to determine a difference between the control and patient groups for both the ocular and cervical VEMP tests. Overall, the threshold and IAD ratio measures did not produce any significant results when sound was presented to the affected ear for the cervical and ocular VEMP tests. A significant reduction in amplitude of the VEMPs from the Ménière’s groups was found compared to the control groups for the ocular the cervical VEMPs. Overall, an increase in P2 and N3 latency of the ocular VEMP response in Ménière’s patients was determined. Results from the questionnaire suggest that the ocular VEMP test was more tolerable to the cervical VEMP test in this current study. Furthermore, statistical analyses revealed no significant differences in EMG level between the control and Ménière’s group for both the ocular and cervical VEMP data. Overall, results suggest that both the cervical and ocular VEMP tests provide information regarding the integrity of the saccule, owing to the abnormal VEMP findings in the participants with Ménière’s disease. In addition, this study provides evidence that the ocular VEMP is as useful a tool in diagnosing Ménière’s disease as the cervical VEMP.

Thesis (M.S)--Texas State University, San Marcos, 2005. / Includes bibliographical references (leaves 158-166). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.S)--Texas State University, San Marcos, 2005. / Includes bibliographical references (leaves 158-166).

Thesis (M. Sc.)--University of British Columbia, 2006. / Includes bibliographical references.