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Reduced Purposeful Head Movements During Community Ambulation Following Unilateral Vestibular Loss

Background. Individuals with unilateral vestibular hypofunction (UVH) alter their movement and reduce mobility to try to stabilize their gaze and avoid symptoms of dizziness and vertigo. Objective. To determine if individuals with UVH 6 weeks after surgery demonstrate altered head and trunk kinematics during community ambulation. Methods. A total of 15 vestibular schwannoma patients with documented postoperative unilateral vestibular loss and 9 healthy controls with symmetrical vestibulo-ocular reflexes participated in this cross-sectional study. Head kinematics (head turn frequency, amplitude, and velocity) and head-trunk coordination during community ambulation were obtained from inertial measurement units for all head movements and within specific amplitudes of head movement. Results. Individuals with UVH made smaller (mean 26° [SD = 3°] vs 32° [SD = 6°]), fewer (mean 133 [SD = 59] vs 221 [SD = 64]), and slower (mean 75°/s [SD = 8°/s] vs 103°/s [SD = 23°/s]) head turns than healthy individuals (P < .05) but did not demonstrate significantly increased head-trunk coupling (mean 38% [SD = 18%] vs 31% [SD = 11%], P = .22). When small (≤45°) and large (>45°) head turns were considered separately, individuals with UVH demonstrated increased head-trunk coupling compared with healthy individuals for large head turns (mean 54% [SD = 23%] vs 33% [SD = 10%], P = .005). Conclusions. This study demonstrated that although walking at an adequate speed, individuals with UVH made fewer, smaller, and slower head movements symmetrically in both directions compared with healthy individuals and did not decouple their head movement relative to their trunk when required to make larger purposeful head turns during community ambulation.