Vestibular rehabilitation for visual and somatosensory dependency.
Abstract Introduction: In the patient with chronic vestibular disfunction, it is very frequent to note more imbalance or dizziness produced by its own movement or the overloaded visual environment; this is called also visual dependence that is part of the visual vertigo syndrome.In other cases, like somatosensory dependence, the patient will lose balance easily when the support surface changes.The objective of this review was to describe the visual and somatosensory dependence patterns as well as how to treat them.Method: Narrative review.Results: Visual vertigo is currently a clinical diagnosis based on the patient’s history of disease presentation. Through repeated exposure to trigger stimuli, the central nervous system is able to increase tolerance and improve functional results. Traditional treatments for this disorder involve vestibular rehabilitation therapy, virtual reality simulators of moving objects, as well as graded exposureto optokinetic stimulation.Discussion/Conclusion: Although the real nature of the visual cues for posture stabilization remains an open debate, the goal of therapy is to promote desensitization to visual stimuli and increase tolerance.
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Alahmari KA, Sparto PJ, Marchetti GF, Redfern MS, Furman JM, Whitney SL. Comparison of virtual reality based therapy with customized vestibular physical therapy for the treatment of vestibular disorders. IEEE Trans Neural Syst Rehabil Eng. 2014 Mar;22(2):389-99. doi: 10.1109/TNSRE.2013.2294904.
Alghadir AH, Anwer S. Effects of Vestibular Rehabilitation in the Management of a Vestibular Migraine: A Review. Front Neurol. 2018 Jun 12;9:440. doi: 10.3389/fneur.2018.00440.
Balaban CD, Jacob RG. Background and history of the interface between anxiety and vertigo. J Anxiety Disord. 2001 Jan-Apr;15(1-2):27-51.
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13. doi: 10.3233/VES-2009-0343.
Bles W, Vianney de Jong JM, de Wit G. Compensation for labyrinthine defects examined by use of a tilting room. Acta Otolaryngol. 1983 May-Jun;95(5-6):576-9.
Brandt T, Arnold F, Bles W, Kapteyn TS. The mechanism of physiological height vertigo. I. Theoretical approach and psychophysics. Acta Otolaryngol. 1980 May-Jun;89(5-6):513-23.
Bronstein AM, Lempert T. Management of the patient with chronic dizziness. Restor Neurol Neurosci. 2010;28(1):83-90. doi: 10.3233/RNN-2010-0530.
Bronstein AM. Multisensory integration in balance control. En: Aminoff MJ, Boller F, Swaab D. Handbook of clinical neurology. Neuro-Otology. Furman JM, Lempert T eds. Vol. 137 (3rd series). Elsevier;2016. p.57-66.
Bronstein AM. Oscillopsia and visuo-vestibular symptoms. En: Bronstein AM. Oxford textbook of Vertigo and Imbalance. 1ª ed. United Kingdom: Oxford University Press;2013. p.137-44.
Bronstein AM. Under-rated neuro-otological symptoms: Hoffman and Brookler 1978 revisited. Br Med Bull. 2002;63:213-21.
Bronstein AM. Visual vertigo syndrome: clinical and posturography findings. J Neurol Neurosurg Psychiatry. 1995 Nov;59(5):472-6.
Bronstein AM. Vision and vertigo: some visual aspects of vestibular disorders. J Neurol. 2004 Apr;251(4):381-7.
Clark RA, Bryant AL, Pua Y, McCrory P, Bennell K, Hunt M. Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance. Gait Posture. 2010 Mar;31(3):307-10. doi: 10.1016/j.gaitpost.2009.11.012.
Cousins S, Cutfield NJ, Kaski D, Palla A, Seemungal BM, Golding JF, et al. Visual dependency and dizziness after vestibular neuritis. PLoS One. 2014 Sep 18;9(9):e105426. doi: 10.1371/journal.pone.0105426. eCollection 2014.
Dannenbaum E, Chilingarian G, Fung J. Validity and Responsiveness of the Visual Vertigo Analogue Scale. J Neurol Phys Ther. 2019 Apr;43(2):117-121. doi: 10.1097/NPT.0000000000000261.
Dannenbaum E, Chilingaryan G, Fung J. Visual vertigo analogue scale: an assessment questionnaire for visual vertigo.J Vestib Res. 2011;21(3):153-9. doi: 10.3233/VES-2011-0412.
Dichgans J, Held R, Young LR, Brandt T. Moving visual scenes influence the apparent direction of gravity. Science. 1972 Dec 15;178(4066):1217-9.
Furman JM, Jacob RG. Psychiatric dizziness. Neurology. 1997 May;48(5):1161-6.
Gottshall KR, Sessoms PH, Bartlett JL. Vestibular physical therapy intervention: utilizing a computer assisted rehabilitation environment in lieu of traditional physical therapy. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:6141-4. doi: 10.1109/EMBC.2012.6347395.
Guerraz M, Yardley L, Bertholon P, Pollak L, Rudge P, Gresty MA, et al. Visual vertigo: symptom assessment, spatial orientation and postural control. Brain. 2001 Aug;124(Pt 8):1646-56.
Han BI, Song HS, Kim JS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol. 2011 Dec;7(4):184-96. doi: 10.3988/jcn.2011.7.4.184.
Herdman SJ, Whitney SL. Physical therapy treatment of vestibular hypofunction. En: Herdman SJ, Clendaniel RA. Vestibular Rehabilitation. 4ª ed. Philadelphia: FA Davis Co;2014. p.394-431.
Herdman SJ. Advances in the treatment of vestibular disorders. Phys Ther. 1997 Jun;77(6):602-18.
Herdman SJ. Role of vestibular adaptation in vestibular rehabilitation. Otolaryngol Head Neck Surg. 1998 Jul;119(1):49-54.
Hester RB 3rd, Farris BK. Acetazolamide in the treatment of abnormal oculovestibular response. Am J Ophthalmol. 1991 Feb 15;111(2):215-20.
Hoffman RA, Brookler KH. Underrated neurotologic symptoms. Laryngoscope. 1978 Jul;88(7 Pt 1):1127-38.
Hood JD. Unsteadiness of cerebellar origin: an investigation into its cause. J Laryngol Otol. 1980 Aug;94(8):865-76.
Horak FB. Postural compensation for vestibular loss and implications for rehabilitation. Restor Neurol Neurosci. 2010;28(1):57-68. doi: 10.3233/RNN-2010-0515.
Longridge NS, Mallinson AI. Visual vestibular mismatch in work-related vestibular injury. Otol Neurotol. 2005 Jul;26(4):691-4.
Meldrum D, Herdman S, Vance R, Murray D, Malone K, Duffy D, et al. Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial. Arch Phys Med Rehabil. 2015 Jul;96(7):1319-1328.e1. doi: 10.1016/j.apmr.2015.02.032.
Pavlou M, Acheson J, Nicolaou D, Fraser CL, Bronstein AM, Davies RA. Effect of Developmental Binocular Vision Abnormalities on Visual Vertigo Symptoms and Treatment Outcome. J Neurol Phys Ther. 2015 Oct;39(4):215-24. doi: 10.1097/NPT.0000000000000105.
Pavlou M, Bronstein AM, Davies RA. Randomized trial of supervised versus unsupervised optokinetic exercise in persons with peripheral vestibular disorders. Neurorehabil Neural Repair. 2013 Mar-Apr;27(3):208-18. doi: 10.1177/1545968312461715.
Pavlou M, Davies RA, Bronstein AM. The assessment of increased sensitivity to visual stimuli in patients with chronic dizziness. J Vestib Res. 2006;16(4-5):223-31.
Pavlou M, Kanegaonkar RG, Swapp D, Bamiou DE, Slater M, Luxon LM. The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study. J Vestib Res. 2012;22(5-6):273-81. doi: 10.3233/VES-120462.
Pavlou M, Whitney SL, Alkathiry AA, Huett M, Luxon LM, Raglan E, et al. Visually Induced Dizziness in Children and Validation of the Pediatric Visually Induced Dizziness Questionnaire. Front Neurol. 2017 Dec 5;8:656. doi: 10.3389/fneur.2017.00656.
Pavlou M. The use of optokinetic stimulation in vestibular rehabilitation. J Neurol Phys Ther. 2010 Jun;34(2):105-10. doi: 10.1097/NPT.0b013e3181dde6bf.
Peterka RJ, Benolken MS. Role of somatosensory and vestibular cues in attenuating visually induced human postural sway. Exp Brain Res. 1995;105(1):101-10.
Pérez-Fernández N, Fernández-González S. Vértigo ocular. En: Bartual-Pastor J, Pérez-Fernández N. El sistema vestibular y sus alteraciones. Tomo II. 1ª ed. Barcelona: Masson, SA;1999. p.495-500.
Sanchez-Blanco C, Yañez-Gonzalez R, Benito-Orejas JI, Gordon CR, Batuecas-Caletrio A. Cinetosis. Rev Soc Otorrinolaringol Castilla Leon Cantab La Rioja. 2014 Nov. 5 (28): 233-251.
Sauvage JP. Rehabilitation vestibulaire: bilan et méthodes. En: Sauvage JP. Vertiges: manuel de diagnostic et de réhabilitation. 1ª ed. Paris: Elsevier Masson;2010. p.137-46.
Sluch IM, Elliott MS, Dvorak J, Ding K, Farris BK. Acetazolamide: A New Treatment for Visual Vertigo. Neuroophthalmology. 2017 Aug 2;41(6):315-320. doi: 10.1080/01658107.2017.1326944.
Smith-Wheelock M, Shepard NT, Telian SA. Physical therapy program for vestibular rehabilitation. Am J Otol. 1991 May;12(3):218-25.
Sugaya N, Arai M, Goto F. The effect of vestibular rehabilitation on sleep disturbance in patients with chronic dizziness. Acta Otolaryngol. 2017 Mar;137(3):275-278. doi: 10.1080/00016489.2016.1244859.
Sulway S, Whitney SL. Advances in Vestibular Rehabilitation. Adv Otorhinolaryngol. 2019;82:164-169. doi: 10.1159/000490285.
Szturm T, Ireland DJ, Lessing-Turner M. Comparison of different exercise programs in the rehabilitation of patients with chronic peripheral vestibular dysfunction. J Vestib Res. 1994 Nov-Dec;4(6):461-79.
Trinidad Ruiz G, Domínguez Pedroso M, Cruz de la Piedad E, Solís Vázquez R, Samaniego Regalado B, Rejas Ugena E. Rehabilitación vestibular domiciliaria guiada, asistida por medios audiovisuales. Acta Otorrinolaringol Esp. 2010 Nov-Dec;61(6):397-404. doi: 10.1016/j.otorri.2010.07.003.
Van Ombergen A, Lubeck AJ, Van Rompaey V, Maes LK, Stins JF, Van de Heyning PH, et al. The Effect of Optokinetic Stimulation on Perceptual and Postural Symptoms in Visual Vestibular Mismatch Patients. PLoS One. 2016 Apr 29;11(4):e0154528. doi: 10.1371/journal.pone.0154528.
Vitte E, Sémont A, Berthoz A. Repeated optokinetic stimulation in conditions of active standing facilitates recovery from vestibular deficits. Exp Brain Res. 1994;102(1):141-8.
Zee DS. Vestibular adaptation. En: Herdman SJ. Vestibular Rehabilitation. 3ª ed. Philadelphia: FA Davis Co;2007. p.77-90.
Alghadir AH, Anwer S. Effects of Vestibular Rehabilitation in the Management of a Vestibular Migraine: A Review. Front Neurol. 2018 Jun 12;9:440. doi: 10.3389/fneur.2018.00440.
Balaban CD, Jacob RG. Background and history of the interface between anxiety and vertigo. J Anxiety Disord. 2001 Jan-Apr;15(1-2):27-51.
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13. doi: 10.3233/VES-2009-0343.
Bles W, Vianney de Jong JM, de Wit G. Compensation for labyrinthine defects examined by use of a tilting room. Acta Otolaryngol. 1983 May-Jun;95(5-6):576-9.
Brandt T, Arnold F, Bles W, Kapteyn TS. The mechanism of physiological height vertigo. I. Theoretical approach and psychophysics. Acta Otolaryngol. 1980 May-Jun;89(5-6):513-23.
Bronstein AM, Lempert T. Management of the patient with chronic dizziness. Restor Neurol Neurosci. 2010;28(1):83-90. doi: 10.3233/RNN-2010-0530.
Bronstein AM. Multisensory integration in balance control. En: Aminoff MJ, Boller F, Swaab D. Handbook of clinical neurology. Neuro-Otology. Furman JM, Lempert T eds. Vol. 137 (3rd series). Elsevier;2016. p.57-66.
Bronstein AM. Oscillopsia and visuo-vestibular symptoms. En: Bronstein AM. Oxford textbook of Vertigo and Imbalance. 1ª ed. United Kingdom: Oxford University Press;2013. p.137-44.
Bronstein AM. Under-rated neuro-otological symptoms: Hoffman and Brookler 1978 revisited. Br Med Bull. 2002;63:213-21.
Bronstein AM. Visual vertigo syndrome: clinical and posturography findings. J Neurol Neurosurg Psychiatry. 1995 Nov;59(5):472-6.
Bronstein AM. Vision and vertigo: some visual aspects of vestibular disorders. J Neurol. 2004 Apr;251(4):381-7.
Clark RA, Bryant AL, Pua Y, McCrory P, Bennell K, Hunt M. Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance. Gait Posture. 2010 Mar;31(3):307-10. doi: 10.1016/j.gaitpost.2009.11.012.
Cousins S, Cutfield NJ, Kaski D, Palla A, Seemungal BM, Golding JF, et al. Visual dependency and dizziness after vestibular neuritis. PLoS One. 2014 Sep 18;9(9):e105426. doi: 10.1371/journal.pone.0105426. eCollection 2014.
Dannenbaum E, Chilingarian G, Fung J. Validity and Responsiveness of the Visual Vertigo Analogue Scale. J Neurol Phys Ther. 2019 Apr;43(2):117-121. doi: 10.1097/NPT.0000000000000261.
Dannenbaum E, Chilingaryan G, Fung J. Visual vertigo analogue scale: an assessment questionnaire for visual vertigo.J Vestib Res. 2011;21(3):153-9. doi: 10.3233/VES-2011-0412.
Dichgans J, Held R, Young LR, Brandt T. Moving visual scenes influence the apparent direction of gravity. Science. 1972 Dec 15;178(4066):1217-9.
Furman JM, Jacob RG. Psychiatric dizziness. Neurology. 1997 May;48(5):1161-6.
Gottshall KR, Sessoms PH, Bartlett JL. Vestibular physical therapy intervention: utilizing a computer assisted rehabilitation environment in lieu of traditional physical therapy. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:6141-4. doi: 10.1109/EMBC.2012.6347395.
Guerraz M, Yardley L, Bertholon P, Pollak L, Rudge P, Gresty MA, et al. Visual vertigo: symptom assessment, spatial orientation and postural control. Brain. 2001 Aug;124(Pt 8):1646-56.
Han BI, Song HS, Kim JS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol. 2011 Dec;7(4):184-96. doi: 10.3988/jcn.2011.7.4.184.
Herdman SJ, Whitney SL. Physical therapy treatment of vestibular hypofunction. En: Herdman SJ, Clendaniel RA. Vestibular Rehabilitation. 4ª ed. Philadelphia: FA Davis Co;2014. p.394-431.
Herdman SJ. Advances in the treatment of vestibular disorders. Phys Ther. 1997 Jun;77(6):602-18.
Herdman SJ. Role of vestibular adaptation in vestibular rehabilitation. Otolaryngol Head Neck Surg. 1998 Jul;119(1):49-54.
Hester RB 3rd, Farris BK. Acetazolamide in the treatment of abnormal oculovestibular response. Am J Ophthalmol. 1991 Feb 15;111(2):215-20.
Hoffman RA, Brookler KH. Underrated neurotologic symptoms. Laryngoscope. 1978 Jul;88(7 Pt 1):1127-38.
Hood JD. Unsteadiness of cerebellar origin: an investigation into its cause. J Laryngol Otol. 1980 Aug;94(8):865-76.
Horak FB. Postural compensation for vestibular loss and implications for rehabilitation. Restor Neurol Neurosci. 2010;28(1):57-68. doi: 10.3233/RNN-2010-0515.
Longridge NS, Mallinson AI. Visual vestibular mismatch in work-related vestibular injury. Otol Neurotol. 2005 Jul;26(4):691-4.
Meldrum D, Herdman S, Vance R, Murray D, Malone K, Duffy D, et al. Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial. Arch Phys Med Rehabil. 2015 Jul;96(7):1319-1328.e1. doi: 10.1016/j.apmr.2015.02.032.
Pavlou M, Acheson J, Nicolaou D, Fraser CL, Bronstein AM, Davies RA. Effect of Developmental Binocular Vision Abnormalities on Visual Vertigo Symptoms and Treatment Outcome. J Neurol Phys Ther. 2015 Oct;39(4):215-24. doi: 10.1097/NPT.0000000000000105.
Pavlou M, Bronstein AM, Davies RA. Randomized trial of supervised versus unsupervised optokinetic exercise in persons with peripheral vestibular disorders. Neurorehabil Neural Repair. 2013 Mar-Apr;27(3):208-18. doi: 10.1177/1545968312461715.
Pavlou M, Davies RA, Bronstein AM. The assessment of increased sensitivity to visual stimuli in patients with chronic dizziness. J Vestib Res. 2006;16(4-5):223-31.
Pavlou M, Kanegaonkar RG, Swapp D, Bamiou DE, Slater M, Luxon LM. The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study. J Vestib Res. 2012;22(5-6):273-81. doi: 10.3233/VES-120462.
Pavlou M, Whitney SL, Alkathiry AA, Huett M, Luxon LM, Raglan E, et al. Visually Induced Dizziness in Children and Validation of the Pediatric Visually Induced Dizziness Questionnaire. Front Neurol. 2017 Dec 5;8:656. doi: 10.3389/fneur.2017.00656.
Pavlou M. The use of optokinetic stimulation in vestibular rehabilitation. J Neurol Phys Ther. 2010 Jun;34(2):105-10. doi: 10.1097/NPT.0b013e3181dde6bf.
Peterka RJ, Benolken MS. Role of somatosensory and vestibular cues in attenuating visually induced human postural sway. Exp Brain Res. 1995;105(1):101-10.
Pérez-Fernández N, Fernández-González S. Vértigo ocular. En: Bartual-Pastor J, Pérez-Fernández N. El sistema vestibular y sus alteraciones. Tomo II. 1ª ed. Barcelona: Masson, SA;1999. p.495-500.
Sanchez-Blanco C, Yañez-Gonzalez R, Benito-Orejas JI, Gordon CR, Batuecas-Caletrio A. Cinetosis. Rev Soc Otorrinolaringol Castilla Leon Cantab La Rioja. 2014 Nov. 5 (28): 233-251.
Sauvage JP. Rehabilitation vestibulaire: bilan et méthodes. En: Sauvage JP. Vertiges: manuel de diagnostic et de réhabilitation. 1ª ed. Paris: Elsevier Masson;2010. p.137-46.
Sluch IM, Elliott MS, Dvorak J, Ding K, Farris BK. Acetazolamide: A New Treatment for Visual Vertigo. Neuroophthalmology. 2017 Aug 2;41(6):315-320. doi: 10.1080/01658107.2017.1326944.
Smith-Wheelock M, Shepard NT, Telian SA. Physical therapy program for vestibular rehabilitation. Am J Otol. 1991 May;12(3):218-25.
Sugaya N, Arai M, Goto F. The effect of vestibular rehabilitation on sleep disturbance in patients with chronic dizziness. Acta Otolaryngol. 2017 Mar;137(3):275-278. doi: 10.1080/00016489.2016.1244859.
Sulway S, Whitney SL. Advances in Vestibular Rehabilitation. Adv Otorhinolaryngol. 2019;82:164-169. doi: 10.1159/000490285.
Szturm T, Ireland DJ, Lessing-Turner M. Comparison of different exercise programs in the rehabilitation of patients with chronic peripheral vestibular dysfunction. J Vestib Res. 1994 Nov-Dec;4(6):461-79.
Trinidad Ruiz G, Domínguez Pedroso M, Cruz de la Piedad E, Solís Vázquez R, Samaniego Regalado B, Rejas Ugena E. Rehabilitación vestibular domiciliaria guiada, asistida por medios audiovisuales. Acta Otorrinolaringol Esp. 2010 Nov-Dec;61(6):397-404. doi: 10.1016/j.otorri.2010.07.003.
Van Ombergen A, Lubeck AJ, Van Rompaey V, Maes LK, Stins JF, Van de Heyning PH, et al. The Effect of Optokinetic Stimulation on Perceptual and Postural Symptoms in Visual Vestibular Mismatch Patients. PLoS One. 2016 Apr 29;11(4):e0154528. doi: 10.1371/journal.pone.0154528.
Vitte E, Sémont A, Berthoz A. Repeated optokinetic stimulation in conditions of active standing facilitates recovery from vestibular deficits. Exp Brain Res. 1994;102(1):141-8.
Zee DS. Vestibular adaptation. En: Herdman SJ. Vestibular Rehabilitation. 3ª ed. Philadelphia: FA Davis Co;2007. p.77-90.
Bauer, M., Benito-Orejas, J. I., & Ramírez-Salas, J. E. (2019). Vestibular rehabilitation for visual and somatosensory dependency. Revista ORL, 11(1), 79–88. https://doi.org/10.14201/orl.21241
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