The vestibuloocular reflex can be manually elicited by tilting or rotating the head. Manual techniques serve their purpose well and is the golden standard in the clinical work, but they lack control of velocity and movement pattern. However, motion simulation platforms enable automatic control of both velocity and movement pattern. One motion simulation platform, named BIRGIT, has been built at the Department of Clinical Neurosciences at Karolinska Institutet but has not yet been in service and require a performance evaluation. The objectives with this thesis is to evaluate the accuracy and precision of BIRGIT and evaluate how bodyweight and movement direction impact the performance. The thesis also evaluate whether it is possible to stabilize the head of the patient during the acceleration phase. Repeated measurements of acceleration with different loads, desired ac- celeration, direction and motion type (rotational and translational), are per- formed. Dummies are used to simulate bodyweight in the performance study and real persons are used in the head stabilization study. Analysis of variance (ANOVA) is the main statistical tool. The results suggest that the platform does not perform equally at dif- ferent load or directions and that there is a bias between desired and true acceleration. The main problems are an inclination of the rails, upon which the chair is mounted, that causes differences between directions and an un- desirable performance characteristic for rotational motions. The stabilization study suggest that the head can be stabilized. / Den vestibulo-okul ̈ara reflexen kan framkallas genom att manuellt rotera eller rycka p ̊a huvudet. Att manuellt framkalla reflexen fungerar i de flesta sam- manhang va ̈l och a ̈r standard i m ̊anga underso ̈kningar. Dock g ̊ar det inte att till fullo kontrollera vare sig hastighet eller ro ̈relsebana perfekt. Emellertid g ̊ar detta att kontrollera genom att anva ̈nda sig av en s ̊a kallad ro ̈relsesimu- leringsplatform. En s ̊adan platform, d ̈opt till BIRGIT, har byggts vid Institutionen f ̈or kliniska neurovetenskaper vid Karolinska Institutet. Denna har ej bo ̈rjat anva ̈ndas ̈annu d ̊a dess prestanda fo ̈rst beho ̈ver utv ̈arderas. Syftet med denna uppsats ̈ar att utva ̈rdera precision och noggrannhet hos BIRGIT. Dessutom, att utv ̈ardera hur kroppsvikt och ro ̈relseriktning inverkar p ̊a prestandan. I arbetet ing ̊ar ̈aven att testa om det a ̈r m ̈ojligt att stabilisera huvudet under accelerationsfasen. Repeterade ma ̈tningar av sann acceleration med olika last, riktning, bo ̈rac- celeration och r ̈orelsetyp (rotation eller sidledes) genomfo ̈rdes. Testdockor anva ̈ndes fo ̈r att simulera lasten i prestandatesterna och riktiga testpersoner anva ̈ndes i huvudstabiliseringsdelen. Variansanalys (ANOVA) var det hu- vudsakliga statistiska verktyget. Resultatet antyder att last och ro ̈relseriktning inverkar p ̊a acceleratio- nen och prestandan och att den sanna accelerationen alltigenom a ̈r la ̈gre a ̈n bo ̈raccelerationen. Det finns tv ̊a sto ̈rre problem hos plattformen, det fo ̈rsta a ̈r att uppha ̈ngningen till stolen lutar och detta resulterar i en skillnad mellan riktningarna (det g ̊ar fortare nedf ̈ors). Det andra problemet a ̈r ett cykliskt uppfo ̈rande na ̈r flera rotationsr ̈orelser skall fo ̈lja p ̊a varandra. Stabiliseringsstudien visade att det g ̊ar att stabilisera huvudet.

The vestibuloocular reflex can be manually elicited by tilting or rotating the head. Manual techniques serve their purpose well and is the golden standard in the clinical work, but they lack control of velocity and movement pattern. However, motion simulation platforms enable automatic control of both velocity and movement pattern. One motion simulation platform, named BIRGIT, has been built at the Department of Clinical Neurosciences at Karolinska Institutet but has not yet been in service and require a performance evaluation. The objectives with this thesis is to evaluate the accuracy and precision of BIRGIT and evaluate how bodyweight and movement direction impact the performance. The thesis also evaluate whether it is possible to stabilize the head of the patient during the acceleration phase. Repeated measurements of acceleration with different loads, desired ac- celeration, direction and motion type (rotational and translational), are per- formed. Dummies are used to simulate bodyweight in the performance study and real persons are used in the head stabilization study. Analysis of variance (ANOVA) is the main statistical tool. The results suggest that the platform does not perform equally at dif- ferent load or directions and that there is a bias between desired and true acceleration. The main problems are an inclination of the rails, upon which the chair is mounted, that causes differences between directions and an un- desirable performance characteristic for rotational motions. The stabilization study suggest that the head can be stabilized. / Den vestibulo-okul ̈ara reflexen kan framkallas genom att manuellt rotera eller rycka p ̊a huvudet. Att manuellt framkalla reflexen fungerar i de flesta sam- manhang va ̈l och a ̈r standard i m ̊anga underso ̈kningar. Dock g ̊ar det inte att till fullo kontrollera vare sig hastighet eller ro ̈relsebana perfekt. Emellertid g ̊ar detta att kontrollera genom att anva ̈nda sig av en s ̊a kallad ro ̈relsesimu- leringsplatform. En s ̊adan platform, d ̈opt till BIRGIT, har byggts vid Institutionen f ̈or kliniska neurovetenskaper vid Karolinska Institutet. Denna har ej bo ̈rjat anva ̈ndas ̈annu d ̊a dess prestanda fo ̈rst beho ̈ver utv ̈arderas. Syftet med denna uppsats ̈ar att utva ̈rdera precision och noggrannhet hos BIRGIT. Dessutom, att utv ̈ardera hur kroppsvikt och ro ̈relseriktning inverkar p ̊a prestandan. I arbetet ing ̊ar ̈aven att testa om det a ̈r m ̈ojligt att stabilisera huvudet under accelerationsfasen. Repeterade ma ̈tningar av sann acceleration med olika last, riktning, bo ̈rac- celeration och r ̈orelsetyp (rotation eller sidledes) genomfo ̈rdes. Testdockor anva ̈ndes fo ̈r att simulera lasten i prestandatesterna och riktiga testpersoner anva ̈ndes i huvudstabiliseringsdelen. Variansanalys (ANOVA) var det hu- vudsakliga statistiska verktyget. Resultatet antyder att last och ro ̈relseriktning inverkar p ̊a acceleratio- nen och prestandan och att den sanna accelerationen alltigenom a ̈r la ̈gre a ̈n bo ̈raccelerationen. Det finns tv ̊a sto ̈rre problem hos plattformen, det fo ̈rsta a ̈r att uppha ̈ngningen till stolen lutar och detta resulterar i en skillnad mellan riktningarna (det g ̊ar fortare nedf ̈ors). Det andra problemet a ̈r ett cykliskt uppfo ̈rande na ̈r flera rotationsr ̈orelser skall fo ̈lja p ̊a varandra. Stabiliseringsstudien visade att det g ̊ar att stabilisera huvudet.

The thesis deals with the issues of balance disorders in patients after vestibular schwannoma surgery. The aim of this thesis is to evaluate the effect of targeted rehabilitation with biofeedback on balance disorders and subjective visual vertical compensation. During the period of one year, a group of 20 vestibular schwannoma patients were examined and treated in University Hospital Motol. The compensation of vestbuloocular refex was assessed by a tilt of subjective visual vertical. The level of vestibulospinal compensation was determined according to score of the Activities-Specific Balance Confidence Scale. Patients were examined before the surgery, after the surgery and after the rehabilitation. The Homebalance system, developed by Support center for application outputs and spin-off companies at the 1st Faculty of Medicine, Charles University in Prague, branch office in Kladno, was used for the therapy with visual biofeedback. Another aim of this thesis was to monitor the effect of vestibular prehabituation with ototoxic gentamicin application two months before surgery. The statistical analysis of data proved in the case of subjective visual vertical tilt a significant increase of deviation after surgery and a decrease after rehabilitation. According to the ABC questionnaire the confidence of...