TY - JOUR
T1 - Bilateral vestibulopathy and age
T2 - experimental considerations for testing dynamic visual acuity on a treadmill
AU - Starkov, D
AU - Snelders, M
AU - Lucieer, F
AU - Janssen, A M L
AU - Pleshkov, M
AU - Kingma, H
AU - van Rompaey, V
AU - Herssens, Nolan
AU - Hallemans, Ann
AU - Vereeck, L
AU - McCrum, C
AU - Meijer, K
AU - Guinand, Nils
AU - Perez-Fornos, A
AU - van de Berg, R
N1 - Funding Information:
The authors declare that they have no conflict of interest. Med-El has provided funding for research and travel for RvdB, AP, NG and HK. DS, MP, RvdB and HK were supported by The Tomsk State University competitiveness improvement programme.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12
Y1 - 2020/12
N2 - INTRODUCTION: Bilateral vestibulopathy (BVP) can affect visual acuity in dynamic conditions, like walking. This can be assessed by testing Dynamic Visual Acuity (DVA) on a treadmill at different walking speeds. Apart from BVP, age itself might influence DVA and the ability to complete the test. The objective of this study was to investigate whether DVA tested while walking, and the drop-out rate (the inability to complete all walking speeds of the test) are significantly influenced by age in BVP-patients and healthy subjects.METHODS: Forty-four BVP-patients (20 male, mean age 59 years) and 63 healthy subjects (27 male, mean age 46 years) performed the DVA test on a treadmill at 0 (static condition), 2, 4 and 6 km/h (dynamic conditions). The dynamic visual acuity loss was calculated as the difference between visual acuity in the static condition and visual acuity in each walking condition. The dependency of the drop-out rate and dynamic visual acuity loss on BVP and age was investigated at all walking speeds, as well as the dependency of dynamic visual acuity loss on speed.RESULTS: Age and BVP significantly increased the drop-out rate (p ≤ 0.038). A significantly higher dynamic visual acuity loss was found at all speeds in BVP-patients compared to healthy subjects (p < 0.001). Age showed no effect on dynamic visual acuity loss in both groups. In BVP-patients, increasing walking speeds resulted in higher dynamic visual acuity loss (p ≤ 0.036).CONCLUSION: DVA tested while walking on a treadmill, is one of the few "close to reality" functional outcome measures of vestibular function in the vertical plane. It is able to demonstrate significant loss of DVA in bilateral vestibulopathy patients. However, since bilateral vestibulopathy and age significantly increase the drop-out rate at faster walking speeds, it is recommended to use age-matched controls. Furthermore, it could be considered to use an individual "preferred" walking speed and to limit maximum walking speed in older subjects when testing DVA on a treadmill.
AB - INTRODUCTION: Bilateral vestibulopathy (BVP) can affect visual acuity in dynamic conditions, like walking. This can be assessed by testing Dynamic Visual Acuity (DVA) on a treadmill at different walking speeds. Apart from BVP, age itself might influence DVA and the ability to complete the test. The objective of this study was to investigate whether DVA tested while walking, and the drop-out rate (the inability to complete all walking speeds of the test) are significantly influenced by age in BVP-patients and healthy subjects.METHODS: Forty-four BVP-patients (20 male, mean age 59 years) and 63 healthy subjects (27 male, mean age 46 years) performed the DVA test on a treadmill at 0 (static condition), 2, 4 and 6 km/h (dynamic conditions). The dynamic visual acuity loss was calculated as the difference between visual acuity in the static condition and visual acuity in each walking condition. The dependency of the drop-out rate and dynamic visual acuity loss on BVP and age was investigated at all walking speeds, as well as the dependency of dynamic visual acuity loss on speed.RESULTS: Age and BVP significantly increased the drop-out rate (p ≤ 0.038). A significantly higher dynamic visual acuity loss was found at all speeds in BVP-patients compared to healthy subjects (p < 0.001). Age showed no effect on dynamic visual acuity loss in both groups. In BVP-patients, increasing walking speeds resulted in higher dynamic visual acuity loss (p ≤ 0.036).CONCLUSION: DVA tested while walking on a treadmill, is one of the few "close to reality" functional outcome measures of vestibular function in the vertical plane. It is able to demonstrate significant loss of DVA in bilateral vestibulopathy patients. However, since bilateral vestibulopathy and age significantly increase the drop-out rate at faster walking speeds, it is recommended to use age-matched controls. Furthermore, it could be considered to use an individual "preferred" walking speed and to limit maximum walking speed in older subjects when testing DVA on a treadmill.
KW - Dynamic visual acuity
KW - Bilateral vestibulopathy
KW - Oscillopsia
KW - Presbyvestibulopathy
KW - Stabilization
KW - WALKING
KW - GAIT
KW - OSCILLOPSIA
U2 - 10.1007/s00415-020-10249-z
DO - 10.1007/s00415-020-10249-z
M3 - Article
C2 - 33113022
SN - 0340-5354
VL - 267
SP - 265
EP - 272
JO - Journal of Neurology
JF - Journal of Neurology
IS - SUPPL 1
ER -