5 Take-Aways from Using Optokinetic Stimulation in Vestibular Rehabilitation
We all agree that identifying the cause (or causes) of someone’s dizziness is critical for designing and customizing their care plan. Equally as critical is leaving the patient’s diagnosis “at the door.” We don’t want a diagnosis to define a patient. Instead, we want their story, their recovery, their behavior to define the process.
There is a growing effort to classify visually-induced dizziness (ViD) and persistent sensations of self-motion as a functional neurological disorder. These symptoms are commonly associated with vestibular-related disorders, such as MdDS, 3PD, and concussion. Researchers have related the cause of these symptoms as an improper use of the vestibular ocular reflex (VOR), decreased ability to properly use information from our visual, vestibular, and proprioceptive systems, and is likely correlated with neurochemical imbalances and hormonal changes.
Designing a customized vestibular rehab therapy (VRT) program with OPK stimulation has shown to be more beneficial than VRT alone (Pavlou, 2010) in patients with ViD. While exposure to OPK only has shown to be the most beneficial in those patients with persistent sensations of self-motion (Dai et al, 2014 & 2017). Choosing which approach to use with your patients will vary among clinician preferences and, most importantly, the patient’s presentation.
In this video, we discuss:
- how to define persistent sensations of self-motion vs visually-induced dizziness vs motion-induced dizziness vs dizziness with rapid head motion
- how these symptoms are associated with various disorders (e.g., MdDS, 3PD, PCS) and the impact of the chronicity of these diagnoses
- the importance of designing care plans around the person (not the diagnosis)
- OPK and VRT interventions
Optokinetic Video Progressions
This is the rationale for creating this series of optokinetic video progressions. You can use these videos in the clinic or provide to your patients as part of a home program. We typically start with shorter durations to minimize anxiety about the exposure.
We have also found that patients usually like the option of looking at a target, so we start with a fixed target in the center then progress to a moving target then to no target. Once the patient can tolerate this progression, we increase the duration of the exposure.
It is also recommended that you begin these exercises in a more stable position (e.g., standing) and progress to less stable positions (e.g., standing on a firm surface with a wide base of support to more narrow then progressing to unstable surfaces) and perform at varying distances from the screen. Although there is currently no clearly defined parameters on screen size, it is generally agreed that a phone is too small, so using a larger desktop screen or television monitor is recommended (Pavlou, 2013).
The Optokinetic Training Videos (48 total) are divided into the following sections:
- 10 Second Videos
- 30 Second Videos
- 60 Second Videos
- 120 Second Videos
Frequently Asked Questions:
How many videos are there in total?
There are 48 total videos: 12 ten-second videos, 12 thirty-second videos, 12 sixty-second videos, and 12 one hundred twenty-second videos.
What is the recommended screen size?
Although there are currently no clearly defined parameters on screen size, it is generally agreed that a phone is too small, so using a larger desktop screen or television monitor is recommended (Pavlou, 2013).
What is the recommendation on how to begin using these exercises?
It is also recommended that you begin these exercises in a more stable position (e.g., standing) and progress to less stable positions (e.g., standing on a firm surface with a wide base of support to more narrow then progressing to unstable surfaces) and perform at varying distances from the screen.
How do I purchase the optokinetic videos?
The optokinetic videos are available with 360NeuroGO Premium.
