Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients

Abstract Gaze stability is the ability of the eyes to fixate a stable point when the head is moving in space. Because gaze stability is impaired in peripheral vestibular loss patients, gaze stabilization exercises are often prescribed to facilitate compensation. However, both the assessment and pres...

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Autores principales:	Lin Wang, Omid A. Zobeiri, Jennifer L. Millar, Michael C. Schubert, Kathleen E. Cullen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d2d04096946e41b0a561c2a26b34d52b
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spelling	oai:doaj.org-article:d2d04096946e41b0a561c2a26b34d52b2021-12-02T14:23:23ZHead movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients10.1038/s41598-021-86533-32045-2322https://doaj.org/article/d2d04096946e41b0a561c2a26b34d52b2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86533-3https://doaj.org/toc/2045-2322Abstract Gaze stability is the ability of the eyes to fixate a stable point when the head is moving in space. Because gaze stability is impaired in peripheral vestibular loss patients, gaze stabilization exercises are often prescribed to facilitate compensation. However, both the assessment and prescription of these exercises are subjective. Accordingly, here we quantified head motion kinematics in patients with vestibular loss while they performed the standard of care gaze stability exercises, both before and after surgical deafferentation. We also correlate the head kinematic data with standard clinical outcome measures. Using inertial measurement units, we quantified head movements in patients as they transitioned through these two vestibular states characterized by different levels of peripheral damage. Comparison with age-matched healthy control subjects revealed that the same kinematic measurements were significantly abnormal in patients both pre- and post-surgery. Regardless of direction, patients took a longer time to move their heads during the exercises. Interestingly, these changes in kinematics suggest a strategy that existed preoperatively and remained symmetric after surgery although the patients then had complete unilateral vestibular loss. Further, we found that this kinematic assessment was a good predictor of clinical outcomes, and that pre-surgery clinical measures could predict post-surgery head kinematics. Thus, together, our results provide the first experimental evidence that patients show significant changes in head kinematics during gaze stability exercises, even prior to surgery. This suggests that early changes in head kinematic strategy due to significant but incomplete vestibular loss are already maladaptive as compared to controls.Lin WangOmid A. ZobeiriJennifer L. MillarMichael C. SchubertKathleen E. CullenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lin Wang Omid A. Zobeiri Jennifer L. Millar Michael C. Schubert Kathleen E. Cullen Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients
description	Abstract Gaze stability is the ability of the eyes to fixate a stable point when the head is moving in space. Because gaze stability is impaired in peripheral vestibular loss patients, gaze stabilization exercises are often prescribed to facilitate compensation. However, both the assessment and prescription of these exercises are subjective. Accordingly, here we quantified head motion kinematics in patients with vestibular loss while they performed the standard of care gaze stability exercises, both before and after surgical deafferentation. We also correlate the head kinematic data with standard clinical outcome measures. Using inertial measurement units, we quantified head movements in patients as they transitioned through these two vestibular states characterized by different levels of peripheral damage. Comparison with age-matched healthy control subjects revealed that the same kinematic measurements were significantly abnormal in patients both pre- and post-surgery. Regardless of direction, patients took a longer time to move their heads during the exercises. Interestingly, these changes in kinematics suggest a strategy that existed preoperatively and remained symmetric after surgery although the patients then had complete unilateral vestibular loss. Further, we found that this kinematic assessment was a good predictor of clinical outcomes, and that pre-surgery clinical measures could predict post-surgery head kinematics. Thus, together, our results provide the first experimental evidence that patients show significant changes in head kinematics during gaze stability exercises, even prior to surgery. This suggests that early changes in head kinematic strategy due to significant but incomplete vestibular loss are already maladaptive as compared to controls.
format	article
author	Lin Wang Omid A. Zobeiri Jennifer L. Millar Michael C. Schubert Kathleen E. Cullen
author_facet	Lin Wang Omid A. Zobeiri Jennifer L. Millar Michael C. Schubert Kathleen E. Cullen
author_sort	Lin Wang
title	Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients
title_short	Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients
title_full	Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients
title_fullStr	Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients
title_full_unstemmed	Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients
title_sort	head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d2d04096946e41b0a561c2a26b34d52b
work_keys_str_mv	AT linwang headmovementkinematicsarealteredduringgazestabilityexercisesinvestibularschwannomapatients AT omidazobeiri headmovementkinematicsarealteredduringgazestabilityexercisesinvestibularschwannomapatients AT jenniferlmillar headmovementkinematicsarealteredduringgazestabilityexercisesinvestibularschwannomapatients AT michaelcschubert headmovementkinematicsarealteredduringgazestabilityexercisesinvestibularschwannomapatients AT kathleenecullen headmovementkinematicsarealteredduringgazestabilityexercisesinvestibularschwannomapatients
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Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients

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