Observational studyPhysiotherapy research international : the journal for researchers and clinicians in physical therapy2026
Anti-Compensatory Saccades Changes After Visuo-Vestibular Physical Therapy in People With Acute Unilateral Vestibulopathy: A Prospective Observational Study.
Observational study in Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
background and purposeAcute unilateral vestibulopathy (AUVP) impairs the vestibulo-ocular reflex (VOR), leading to gaze instability and significant functional disability. Anti-compensatory saccades (AcS) assessed using the Suppression Head Impulse Paradigm (SHIMP) reflect vestibulo-saccadic interaction and may represent a marker of central compensation. The aim of the study was to analyze changes in AcS following structured visuo-vestibular physical therapy (VVPT).
methodsNinety-two patients with AUVP (mean age 59 years, 57 women and 35 men) completed an 8-week VVPT program (one session per week). Assessments at baseline (T0) and post-intervention (T1) included the video Head Impulse test (vHIT- HIMP and SHIMP) and the Dizziness Handicap Inventory (DHI). The primary outcome was the change in AcS amplitude. Secondary outcomes included changes in VOR gain and DHI score. Paired comparisons were performed using the Wilcoxon signed rank-test.
resultsAcS amplitude increased significantly after VVPT (median 189.5°-239.0°; p < 0.001). VOR gain showed a modest but significant increase (0.37-0.40; p < 0.001), remaining within dysfunctional ranges. DHI scores decreased markedly (51-26; p < 0.001). No significant association was found between baseline VOR gain and AcS variation (R DISCUSSION: A significant increase in AcS amplitude was observed after an 8-week VVPT program in people with AUVP, despite only limited improvement in VOR gain. These findings suggest that AcS may provide clinically relevant information on vestibulo-saccadic adaptation during recovery after unilateral vestibular loss and may complement traditional VOR gain and patient-reported outcome measures. However, given the study design, the observed changes should be interpreted with caution.
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