Vestibular rehabilitation outcomes: velocity trajectory analysis of repeated bench stepping

Objectives: To quantify vestibular rehabilitation (VR) outcomes in patients with vestibulospinal reflex pathology (VSP) using a new technique, high curvature analysis (HCA), that measures space trajectory stability. Methods: Twelve patients with VSP and 10 healthy controls performed a repeated stepping task in a motion analysis laboratory. Patients with VSP were tested before and after a 12 week VR program. Three dimensional whole body center of gravity (CG) was captured during repeated bench stepping trials (step up forward/step down backward), and the resulting horizontal plane CG velocity trajectories were analyzed using HCA. Results: VSP patients were significantly less stable than healthy subjects prior to VR (P=0.022), but these differences disappeared following VR (P=0.148). The stability of the VSP patients during the stepping task at 3 months increased significantly from baseline values (P=0.013). Conclusions: Evaluating the efficacy of VR requires analysis techniques that are sensitive to changes in stability. We conclude that HCA can be used for assessing improvements in CG stability of VSP patients while performing a repeated bench stepping activity.