The Gaze Stabilization Test Following Concussion.
The Gaze Stabilization Test Following Concussion.
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DOI：
10.3766/jaaa.18015
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发表时间：
2018-11-29
影响因子：
1.2
通讯作者：
Sparto, Patrick J
中科院分区：
文献类型：
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作者：
Dunlap, Pamela M;Mucha, Anne;Sparto, Patrick J
背景：脑震荡可引起前庭功能障碍和眼部异常，导致头晕和恢复时间延长。有几个临床上有用的，功能性措施的前庭眼反射（VOR）postconcussion.Purpose：本研究的目的是检查凝视稳定试验（GST）在那些提到前庭物理治疗脑震荡后，以确定GST和其他措施恢复脑震荡后，并检查人口统计学变量对GST性能的影响。回顾性图表review.研究样本：一百五十八个人谁持续脑震荡，并被称为前庭physicaltherapy.DATA收集和分析：水平和垂直GST分数（HGST和VGST），神经认知测试结果，和人口统计学数据，从病人的健康记录中提取回顾性。GST速度和神经认知测试结果之间的相关性和GST和患者报告的结果进行了检查。GST患者亚组之间的性能差异进行了检查，采用单向方差分析。结果：受试者包括个人年龄在12至43岁（平均值= 20，标准差[SD] = 7），与大多数有运动相关的脑震荡（67%）。从受伤到GST的平均时间为215天（SD = 241），从物理治疗评估到GST的平均时间为48天（SD = 54）。HGST和VGST与活动平衡信心量表呈弱正相关（r = 0.20，r = 0.21），与头晕障碍量表呈弱负相关（r =-0.18，r = -0.22）。HGST与脑震荡后即刻评估和认知测试的视觉运动处理速度域呈弱正相关（r = 0.20）。男性患者取得了显着较高的速度比女性患者的HGST和VGST（p = 0.02，p = 0.01）。结论：本研究详细介绍了GST在脑震荡患者中的使用，并证明了与前庭康复的共同结果的措施。结果表明，患者谁实现了较高的速度GST认为较低的障碍，由于头晕，并有较高的信心，在他们的平衡。GST可能是该人群VOR的相关测试，因为它是运动所需VOR的功能测试。未来的工作需要进一步评估GST在脑震荡管理中的作用。
BACKGROUND: Concussion can cause vestibular dysfunction and oculomotor abnormalities which can lead to dizziness and protracted recovery time. There are few clinically useful, functional measures of the vestibulo-ocular reflex (VOR) post-concussion.PURPOSE: The purpose of this study was to examine the gaze stabilization test (GST) in those referred for vestibular physical therapy following concussion, to determine the association between GST and other measures of recovery following concussion, and to examine the effect of demographic variables on GST performance.RESEARCH DESIGN: Retrospective chart review.STUDY SAMPLE: One hundred fifty-eight individuals who sustained a concussion and were referred to vestibular physical therapy.DATA COLLECTION AND ANALYSIS: Horizontal and vertical GST scores (HGST and VGST), neurocognitive testing results, and demographic data were extracted retrospectively from the patient health record. Correlations between GST velocity and neurocognitive test results and between GST and patient-reported outcomes were examined. Differences in GST performance among patient subgroups were examined using one-way analysis of variance.RESULTS: Subjects included individuals aged 12 to 43 years (mean = 20, standard deviation [SD] = 7), with most having sport-related concussion (67%). The mean time from injury to GST was 215 days (SD = 241) and the mean time from physical therapy evaluation to GST was 48 days (SD = 54). HGST and VGST had a weak positive correlation to the Activities-Specific Balance Confidence Scale (r = 0.20, r = 0.21) and weak negative correlation to the Dizziness Handicap Inventory (r = -0.18, r = -0.22). HGST had a weak positive correlation to the visual motor processing speed domain of the immediate post-concussion assessment and cognitive test (r = 0.20). Male patients achieved significantly higher velocities than female patients on HGST and VGST (p = 0.02, p = 0.01).CONCLUSIONS: The present study details the use of GST in patients with concussion and demonstrates an association with common outcome measures in vestibular rehabilitation. Results indicate that patients who achieved higher velocities on GST perceived lower handicap due to dizziness and had higher confidence in their balance. GST may be a relevant test of VOR in this population, as it is a more functional test of the VOR required for sports. Future work is needed to further evaluate the role of GST in concussion management.