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Objective: Previous studies have reported that developmental, environmental, medical, psychological, visual, and other sensory-related factors can influence the outcome of vestibular rehabilitation. However, only a few studies have used patient's daily lives as the main outcome. In addition, in some studies, rehabilitation was not supervised by a physical therapist. This study aimed to determine the factors associated with the outcome of physical-therapist-supervised vestibular rehabilitation in patients with peripheral vestibular disorders, with the impact of dizziness on quality of life as the main outcome., Methods: This retrospective cohort study included 47 patients with peripheral vestibular disorders. A physical therapist provided 40 min of vestibular rehabilitation once a week for 4 weeks. Age, sex, disease duration, Dizziness Handicap Inventory (DHI), Timed Up-and-Go test (TUG), Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), Activity-Specific Balance Confidence Scale (ABC scale), and Hospital Anxiety and Depression Scale (HADS) were investigated. Multiple regression analysis was performed, with the DHI rate of change before and after the intervention as the objective variable., Results: Vestibular rehabilitation improved all outcomes. In the multiple regression analysis, the ABC scale was identified as a factor that significantly influenced the DHI rate of change (β = -0.428, p < 0.01)., Conclusion: A higher ABC scale score was associated with a lower DHI rate of change (i.e., better improvement). Therefore, it may be important to assess psychological aspects, especially confidence in balance, when implementing vestibular rehabilitation in patients with peripheral vestibular disorders., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2022. Published by Elsevier B.V.)

Objective: To investigate the utilization and demographic characteristics of in-hospital rehabilitation for patients with acute vestibular neuritis using the Japan Medical Data Center (JMDC) database., Methods: We gathered information on patients that were at least 20 years of age who were admitted with a diagnosis of VN (ICD-10 code: H81.2). We defined in-hospital rehabilitation service use as payment of insurance claims for at least one session of rehabilitation during admission., Results: We identified 809 patients that were eligible for this study; among these, 59 patients (7.3%) received rehabilitation while 750 patients did not. The median total time spent and the median time per day in inpatient rehabilitation were 140 min and 11.7 min, respectively. Factors that significantly affected the rehabilitation service use, in order of greater odds, were primary care, internal medicine, and age in multivariate logistic regression analysis (odds ratio = 4.42, 2.17, 1.33, respectively)., Conclusions: This study showed that (1) utilization of rehabilitation services by acute patients with VN was low; and (2) age, admission to internal medicine, and admission to primary care were associated with the use of rehabilitation services., Competing Interests: Declaration of Competing Interest None, (Copyright © 2022. Published by Elsevier B.V.)

Objective: A few studies have analyzed the physical activity in patients with dizziness. Levels of physical activity using 3-axial accelerometer were reported to be lower in patients with chronic dizziness compared to healthy adults. However, the sample size was small and confounding factors were not adjusted in the study. As the age, balance, anxiety, and depression likely contribute to dizziness, the contribution of physical activity to dizziness should be evaluated after adjusting for these potential confounders. We investigated the relationship between physical activity, postural stability, anxiety, and handicap in patients with dizziness using multivariate analysis., Methods: This cross-sectional study included 59 patients with dizziness. The physical activity was measured using a 3-axial accelerometer. We also assessed the Dizziness Handicap Inventory (DHI), Hospital and Anxiety and Depression Scale (HADS), and the total center of pressure path length eyes open and eyes closed (COP&#95;EO, COP&#95;EC). To be eligible for analysis, the participants were required to wear the accelerometer for at least four days, with at least 10 h/day of wear time each day., Results: There were significant differences in the light physical activity (LPA) and moderate to vigorous intensity physical activity (MVPA) between the mild (DHI ≦30) and severe (DHI > 60) groups. Factors that significantly affected the DHI&#95;T score, in order of greater β, were LPA, COP&#95;EC, female, and HADS&#95;A (β = -0.546, 0.459, 0.437, 0.239, respectively)., Conclusions: The present study demonstrated that the patients in the severe group had shorter LPA and MVPA times than that of the patients in the mild group. Additionally, LPA was associated with DHI&#95;T in patients with dizziness. Therefore, physical activity, especially LPA (e.g., activities of daily living), may need to be assessed in patients with dizziness., (Copyright © 2021. Published by Elsevier B.V.)

Objective: We examined plastic changes in the vestibulo-ocular reflex (VOR) during low-frequency vertical head rotation, a condition under which otolith inputs from the vestibular system are essential for VOR generation., Methods: For adaptive conditioning of the vertical VOR, 0.02Hz sinusoidal pitch rotation for one hour about the earth's horizontal axis was synchronized with out-of-phase vertical visual stimulation from a random dot pattern., Results: A vertical VOR was well evoked when the upright animal rotated around the earth-horizontal axis (EHA) at low frequency due to the changing gravity stimulus and dynamic stimulation of the otoliths. After adaptive conditioning, the amplitude of the vertical VOR increased by an average of 32.1%., Conclusion: Our observations showing plasticity in the otolithic contribution to the VOR may provide a new strategy for visual-vestibular mismatch training in patients with otolithic disorders. This low-frequency vertical head rotation protocol also provides a model for investigating the mechanisms underlying the adaptation of VORs mediated by otolith activation., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objective: We examined the emerging vertical component after cross-axis vestibulo-ocular reflex (VOR) adaptation., Methods: For the adaptive conditioning, the whole body of a subject was rotated horizontally while a visual pattern was rotated vertically for 1h., Results: During the conditioning period, the vertical component in response to the vertical visual stimulation was an up-down asymmetric, and its amplitude gradually increased as the stimulus progressed. After conditioning, the direction of VOR was changed via an emerging vertical component during horizontal head rotation in total darkness. Even though the retinal slip-velocity was greater for downward than for upward during the conditioning period, the emerging upward component was significantly larger than the emerging downward component., Conclusion: These results may be helpful for developing an optimal vestibular-compensation system by visual-vestibular mismatch/optokinetic training., (Copyright 2010 Elsevier Ireland Ltd. All rights reserved.)