Preliminary study on an added vestibular-ocular reflex visual conflict task for postural control

BACKGROUND: Using the modified-Clinical Test of Sensory Integration and Balance (m-CTSIB), clinicians can assess sensory feedback systems of the visual, vestibular, and somatosensory systems on postural control. However, with growing vestibulo-ocular reflex (VOR) assessment, the addition of a VOR task, for sensory feedback on postural control has yet to be investigated. AIM: The aim of the study was to examine the preliminary effect of an added VOR visual conflict task during postural control conditions of the m-CTSIB at baseline and re-test reliability. METHODS: Seventeen healthy college-aged individuals completed a baseline m-CTSIB with an added VOR visual conflict condition consisting of a lateral headshake and follow-up assessment occurring 72-h after baseline. Measures consisted of m-CTSIB sway scores on individual conditions of eyes open and eyes closed tasks on firm and foam surfaces. A series of Wilcoxon matched-pairs signed-rank tests were conducted to determine the differences between the VOR condition and the m-CTSIB conditions. A Spearman Rank Order correlation was used to examine the retest reliability. RESULTS: The VOR visual conflict task condition produced worse sway index scores than eyes-open firm and foam (p<0.001), but better scores than eyes-closed foam (P=0.01) conditions at baseline. VOR tasks on their respective firm (r(s)=0.81) and foam surface (r(s)=0.83) were strongly correlated at 72-h retest. CONCLUSIONS: The addition of a VOR visual conflict task condition differed from the other conditions of the m-CTSIB, further targeting the vestibular-ocular system from the vestibular-spinal system during postural control. Incorporating a VOR task during postural stability may create greater postural control deficits in individuals with vestibular-ocular dysfunction. Test-retest correlations at 72-h were clinically acceptable. RELEVANCE FOR PATIENTS: Addition of a VOR task as visual conflict condition of the m-CTSIB may assist in additional sensory system feedback for concussion assessment.