Novel gaze stability training improves dynamic visual acuity for 6 months.
Daniel Ludwig, Amrita Mukunda, Americo A Migliaccio et al.
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In 30 seconds
This randomized, controlled crossover trial compared Incremental VOR Adaptation (IVA) with traditional vestibular physical therapy (VPT) in 24 participants with chronic unilateral or bilateral peripheral vestibular hypofunction. Each intervention was delivered for 3 weeks, with a washout before participants received the alternate treatment; dynamic visual acuity (DVA) was assessed through 6-month follow-up. DVA scores were consistently lower in the group receiving IVA first than in the group receiving VPT first (treatment-group effect: F (1,19) = 7.75, p = 0.012). Scores showed no significant change over time, indicating that improvements remained stable through follow-up.
Key findings
- DVA scores were lower in the IVA-VPT sequence group than in the VPT-IVA group (F (1,19) = 7.75, p = 0.012).
- There was no significant effect of time on DVA scores from baseline through 6-month follow-up (F (4,76) = 1.44, p = 0.23).
- DVA scores were lower during contralesional than ipsilesional head rotation (F (1,19) = 13.35, p = 0.0017).
Why it matters
Impaired visual acuity during head movement can affect function in people with peripheral vestibular hypofunction. The findings suggest that gaze stability training may yield DVA improvements that persist over time, while the sequence-group result highlights that treatment order may influence observed outcomes in a crossover study. This provides evidence about both the durability of DVA changes and the need to interpret comparisons in light of intervention sequence.
What to keep in mind
The trial included 24 participants and used a crossover design; the reported treatment-group difference was between intervention sequences, and no significant group-by-time interaction was found.