Preliminary study on an added vestibular-ocular reflex visual conflict task for postural control
Background: Using the modified-Clinical Test of Sensory Integration and Balance (m-CTSIB), clinicians can assess sensory feedback systems of the visual, vestibular, and somatosensory systems on postural control. However, with growing vestibular-ocular reflex (VOR) assessment, the addition of a VOR task, for sensory feedback on postural control has yet to be investigated. Aim. To study the preliminary effect of an added VOR visual conflict task during postural control conditions of the m-CTSIB at baseline and re-test reliability.
Methods: Seventeen healthy college-aged individuals completed a baseline m-CTSIB with an added VOR visual conflict condition consisting of a lateral headshake and follow-up assessment occurring 72-hours after baseline. Measures consisted of m-CTSIB sway scores on individual conditions of eyes open and eyes closed tasks on firm and foam surfaces. A series of Wilcoxson matched-pairs signed rank tests were conducted to determine differences between the VOR condition and the m-CTSIB conditions. A Spearman Rank Order correlation was used to examine the retest reliability.
Results: The VOR visual conflict task condition produced worse sway index scores than eyes-open firm and foam (ps<.001), but better scores than eyes-closed foam (p=.01) conditions at baseline. VOR tasks on their respective firm (rs=.81) and foam surface (rs=.83) were strongly correlated at 72-hours retest.
Conclusions: The addition of a VOR visual conflict task condition differed from the other conditions of the m-CTSIB, further targeting the vestibular-ocular system from the vestibular-spinal system during postural control. Incorporating a VOR task during postural stability may create greater postural control deficits in individuals with vestibular-ocular dysfunction. Test-retest correlations at 72-hours were clinically acceptable.
Relevance for patients: Addition of a VOR task as visual conflict condition of the m-CTSIB may assist in additional sensory system feedback for concussion assessment.
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