HEAD MOVEMENT RESTRICTION AND POSTURAL STABILITY IN PATIENTS WITH COMPENSATED UNILATERAL VESTIBULAR LOSS

Objective: To study whether restriction of head-neck movements improve s postural performance in patients with compensated unilateral total v estibular loss. Design: Randomized controlled experimental study. Sett ing:Laboratory for clinical and experimental vestibular testing at a t ertiary referral center. Patients: Fifteen consecutive patients (seven men, eight women, mean age 53 years) at routine follow-up, 6 months a fter translabyrinthine extirpation of acoustic neurinomas (mean tumor size 13.5 mm, range 5 to 25 mm). None of the patients had signs or sym ptoms of central nervous system dysfunction. Intervention: Posturograp hic tests comparing patients with and without a semirigid neck collar. Test order was randomized between patients to reduce training effects . Main Outcome Measure: Posturography measuring velocity and variance of quiet stance and measuring body sway induced by vibration st 60, 80 , and 100Hz to the calf muscles. Tests were conducted with eyes open a nd closed. Results: In tests with vibration at 100Hz to the calf muscl es and with eyes open, body sway velocity was significantly higher whe n patients were wearing a neck collar. No significant difference was f ound in any other test. Conclusion: Restricting head-neck movements wi th a neck collar does not improve postural stability in patients with compensated unilateral total vestibular loss. A tendency toward impair ed postural performance leads to the conclusion that it is not appropr iate to treat such patients with neck collars to improve their balance . (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.