Background. The vestibular system is vital for gaze stability via the vestibulo-ocular reflex, which generates compensatory eye motion in the direction opposite to head motion. Consequently, individuals with peripheral vestibular loss demonstrate impaired gaze stability that reduces functional capacity and quality of life. To facilitate patients’ compensatory strategies, two classes of gaze stabilization exercises are often prescribed: (i) transient (eg, ballistic) and (ii) continuous. However, the relative benefits of these two classes of exercises are not well understood. Objective. To quantify head motion kinematics in patients with vestibular loss while they performed both classes of exercises. Methods. Using inertial measurement units, head movements of 18 vestibular schwannoma patients were measured before and after surgical deafferentation and compared with age-matched controls. Results. We found that the head movement during both classes of exercises paralleled those of natural head movement recorded during daily activities. However, head movement patterns were more informative for continuous than transient exercises in distinguishing patients from healthy controls. Specifically, we observed coupling between kinematic measures in control subjects that was absent in patients for continuous but not transient head motion exercises. In addition, kinematic measures (eg, cycle duration) were predictive of standard clinical measures for continuous but not transient head motion exercises. Conclusions. Our data suggest that performing continuous head motion is a greater motor control challenge than transient head motion in patients with less reliable vestibular feedback during the sub-acute stage of recovery, which may also prove to be a reliable measure of progression in vestibular rehabilitation protocols.

背景。前庭系统通过前庭眼反射对凝视稳定性至关重要，前庭眼反射会在与头部运动相反的方向上产生补偿性眼球运动。因此，外周前庭丧失的个体表现出凝视稳定性受损，从而降低了功能能力和生活质量。为了促进患者的代偿策略，通常规定两类凝视稳定练习：(i) 短暂的（例如，弹道的）和 (ii) 连续的。然而，这两类练习的相对益处尚不清楚。客观的。量化前庭丧失患者在进行两类锻炼时的头部运动运动学。方法。使用惯性测量单元，测量了 18 名前庭神经鞘瘤患者在手术传入神经阻滞前后的头部运动，并与年龄匹配的对照组进行了比较。结果。我们发现，两类练习中的头部运动与日常活动中记录的自然头部运动相似。然而，在区分患者和健康对照方面，头部运动模式对于连续运动比瞬时运动更能提供信息。具体来说，我们观察到对照受试者的运动学测量之间的耦合，而患者在连续但不是短暂的头部运动练习中不存在这种耦合。此外，运动学测量（例如，循环持续时间）可预测连续但非瞬时头部运动练习的标准临床测量。结论。我们的数据表明，在亚急性恢复阶段，前庭反馈不太可靠的患者进行连续头部运动比瞬时头部运动更具运动控制挑战，这也可能被证明是前庭康复方案进展的可靠衡量标准。