Gaze stability in young adults with previous concussion history

2020 ◽  
Vol 30 (4) ◽  
pp. 259-266
Author(s):  
Linda J. D’Silva ◽  
Catherine F. Siengsukon ◽  
Hannes Devos
Keyword(s):  
Visual Acuity ◽  
Young Adults ◽  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Head Movements ◽  
Control Group ◽  
Dynamic Visual Acuity ◽  
Symptom Scale ◽  
Gaze Stability ◽  
Concussion History

BACKGROUND: Disruption of visual-vestibular interaction after concussion can cause gaze instability with head movements. The long-term impact of concussion on gaze stability is unknown. OBJECTIVE: This cross-sectional comparative pilot study examined gaze stability in the chronic stage after concussion (greater than one year). A secondary objective was to examine the relationship between gaze stability and sleep. METHODS: Outcome measures included: 1. Gaze stability in logMAR (mean loss of dynamic visual acuity (DVA) in the yaw and pitch planes); 2. Pittsburgh Sleep Quality Index (PSQI); 3. Epworth Sleepiness Scale (ESS). Post-Concussion Symptom Scale (PCSS), time since injury, and number of concussions were collected for the people with concussion. RESULTS: The study sample included thirty-four adults (mean age 23.35±1.3 years). Seventeen had a history of 1–9 concussions, with a mean duration of 4.4±1.9 years since last concussion; and 17 were age and sex-matched controls. Mean pitch plane DVA loss was greater in the concussion group compared to the control group (p = 0.04). Participants with previous concussion had lower sleep quality based on the PSQI (p = 0.01) and increased daytime sleepiness based on the ESS (p = 0.01) compared to healthy controls. Mean DVA loss in the pitch plane was significantly correlated with the PSQI (r = 0.43, p = 0.01) and the ESS (r = 0.41, p = 0.02). CONCLUSION: Significant differences in dynamic visual acuity may be found in young adults long after a concussion, compared with those who have no concussion history. Furthermore, loss of dynamic visual acuity was associated with poorer sleep quality and higher daytime sleepiness.

Effect of oculo-motor and gaze stability exercises on postural stability and dynamic visual acuity in healthy young adults

2011 ◽  
Vol 33 (4) ◽  
pp. 600-603 ◽  
Author(s):  
Hiroyuki Morimoto ◽  
Yuji Asai ◽  
Eric G. Johnson ◽  
Everett B. Lohman ◽  
Keiko Khoo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Young Adults ◽  
Postural Stability ◽  
Dynamic Visual Acuity ◽  
Gaze Stability

scholarly journals A brief sleep focused psychoeducation program for sleep-related outcomes in new mothers: a randomized controlled trial

SLEEP ◽  
2020 ◽  
Vol 43 (11) ◽  
Author(s):  
Liora Kempler ◽  
Louise A Sharpe ◽  
Nathaniel S Marshall ◽  
Delwyn J Bartlett
Keyword(s):  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Linear Mixed Model ◽  
Intervention Group ◽  
Control Group ◽  
Poor Sleep ◽  
Maternal Sleep ◽  
Pregnancy And Postpartum ◽  
Secondary Outcomes ◽  
Insomnia Symptoms

Abstract Study Objectives Poor sleep is commonly problematic during pregnancy and postpartum and is associated with depression. This trial investigated the efficacy of prenatal brief, group sleep psychoeducation in improving postpartum maternal sleep, and depression. Methods A total of 215 healthy expectant first-time mothers were cluster randomized (1:1) to receive either a 2 × 1.5 h psychoeducation intervention and a set of booklets, or a set of booklets only. Participants completed questionnaires during pregnancy (pre-intervention), and 6 weeks and 4 months postpartum. A post hoc subset of questionnaires was collected at 10 months postpartum. The primary hypothesis was the intervention group would have improved postpartum sleep quality, and reduced levels of insomnia symptoms, fatigue, and daytime sleepiness compared to the control group. Secondary outcomes included depression, anxiety, and stress. Results Linear mixed model analyses failed to confirm a group by time interaction on primary or secondary outcomes across all time points. There was no effect of the intervention on outcomes at 6 weeks, or 10 months postpartum. A significant time by group interaction was found at 4 months, favoring the intervention for sleep quality (p = 0.03) and insomnia symptoms (p = 0.03), but not fatigue or daytime sleepiness. Conclusions Prenatal sleep psychoeducation did not produce a sustained effect on maternal sleep throughout the postpartum period. There was little evidence of benefits on depressive symptoms. Clinical Trial Registration ACTRN12611000859987

scholarly journals Sport-specific differences in dynamic visual acuity and gaze stabilization in division-I collegiate athletes

2020 ◽  
Vol 30 (4) ◽  
pp. 249-257
Author(s):  
C. Quintana ◽  
N.R. Heebner ◽  
A.D. Olson ◽  
J.P. Abt ◽  
M.C. Hoch
Keyword(s):  
Visual Acuity ◽  
A Priori ◽  
Collegiate Athletes ◽  
Division I ◽  
Normative Values ◽  
Dynamic Visual Acuity ◽  
Gaze Stabilization ◽  
Concussion Management ◽  
Vestibular Ocular Reflex ◽  
Concussion History

BACKGROUND: The vestibular-ocular reflex (VOR) integrates the vestibular and ocular systems to maintain gaze during head motion. This reflex is often negatively affected following sport-related concussion. Objective measures of gaze stability, a function mediated by the VOR, such as the computerized dynamic visual acuity test (DVAT) and gaze stabilization test (GST), may have utility in concussion management. However, normative data specific to sport, sex, or concussion history have not been established in collegiate athletes. OBJECTIVE: The objective of this study was to establish normative values for the DVAT and GST in collegiate athletes and explore the effect of sport, sex, and concussion history on VOR assessments. METHODS: The DVAT and GST were completed by 124 collegiate athletes (72 male, 52 female, mean±SD, age: 19.71±1.74 years, height: 173.99±13.97 cm, weight: 80.06±26.52 kg) recruited from Division-I athletic teams (football, soccer and cheerleading). The DVAT and GST were performed in the rightward and leftward directions during a single session in a standardized environment. Normative values for DVAT and GST measures were expressed as percentiles. Non-parametric statistics were used to compare differences between groups based on sex, sport, and concussion history. Alpha was set a-priori at 0.05. RESULTS: Overall, the median LogMAR unit for 124 athletes completing the DVAT was 0 (IQR = 0.17) for both leftward and rightward. The median velocities achieved on the GST were 145 °/sec and 150 °/sec (IQR = 45 and 40) for the leftward and rightward directions respectively. Significant differences were observed between sports (p = 0.001–0.17) for the GST with cheerleading demonstrating higher velocities than the other sports. However, no significant differences were identified based on sex (p≥0.09) or history of concussion (p≥0.15). CONCLUSIONS: Normative estimates for the DVAT and GST may assist in the clinical interpretation of outcomes when used in post-concussion evaluation for collegiate athletes. Although sex and previous concussion history had no effect on the DVAT or GST, performance on these measures may be influenced by type of sport. Sport-related differences in the GST may reflect VOR adaptations based on individual sport-specific demands.

Correlation of Head Impact Exposures With Vestibulo-Ocular Assessments

2020 ◽  
Vol 29 (3) ◽  
pp. 310-314 ◽  
Author(s):  
Theresa L. Miyashita ◽  
Paul A. Ullucci
Keyword(s):  
Visual Acuity ◽  
Cumulative Effect ◽  
Head Impact ◽  
Division I ◽  
Dynamic Visual Acuity ◽  
Head Impacts ◽  
Ocular Reflex ◽  
Gaze Stability ◽  
Vestibulo Ocular Reflex ◽  
Subconcussive Impacts

Context: Managing a concussion injury should involve the incorporation of a multifaceted approach, including a vision assessment. The frontoparietal circuits and subcortical nuclei are susceptible to trauma from a concussion injury, leading to dysfunction of the vestibulo-ocular system. Research investigating the effect of cumulative subconcussive impacts on neurological function is still in its infancy, but repetitive head impacts may result in vestibular system dysfunction. This dysfunction could create visual deficits, predisposing the individual to further head trauma. Objective: The purpose of this study was to investigate the cumulative effect of subconcussive impacts on minimum perception time, static visual acuity, gaze stability, and dynamic visual acuity scores. Design: Prospective cohort. Setting: Division I university. Patients: Thirty-three Division I men’s lacrosse players (age = 19.52 [1.20] y). Intervention: Competitive lacrosse season. Main Outcome Measures: At the beginning and end of the season, the players completed a vestibulo-ocular reflex assessment, using the InVision™ system by Neurocom® to assess perception, static acuity, gaze stability, and dynamic visual acuity. Score differentials were correlated with the head impact exposure data collected via instrumented helmets. Results: A significant correlation was found between change in perception scores and total number of head impacts (r = .54), and between changes in dynamic visual acuity loss scores on the rightside and maximum rotational acceleration (r = .36). No statistical differences were found between preseason and postseason vestibulo-ocular reflex variables. Conclusions: Cumulative subconcussive impacts may negatively affect vestibulo-ocular reflex scores, resulting in decreased visual performance. This decrease in vestibulo-ocular function may place the athlete at risk of sustaining additional head impacts or other injuries.

scholarly journals The Relationship Between a Baby's Age and Sleepiness in a Sample of Mothers

2021 ◽  
Vol 12 ◽  
Author(s):  
Mar Sánchez-García ◽  
María José Cantero ◽  
Eva Carvajal-Roca
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Daytime Sleepiness ◽  
Positive Relationship ◽  
Sleep Problems ◽  
Initial Period ◽  
Practical Importance ◽  
Sleep Disruption ◽  
Control Group ◽  
The Relationship

One question of great practical importance for the parents, and especially the mother, after the birth of a baby, refers to how long the time during which they have to go with less and more fragmented sleep actually lasts. Most of the studies only explore this issue up to 6 months of the newborn's life, and less is known about the sleep problems the mothers may have after this initial period. The objective of this study is to examine the relationship between the sleep disruption and daytime sleepiness of mothers with infants until 2 years old compared to a group of women currently not at care of babies. To this end, a sample of 113 women, 67 currently bringing up a baby of under 2 years old, and the remainder without a baby at their care under 6 years old, reported sleep duration, sleep interruptions, sleep quality, and responded to questionnaires of sleep quality and daytime sleepiness. The relationship between the age of the children and the comparison between the groups was used to highlight the sleep problems of the mothers taking care of the infant. The results showed that there was a positive relationship between the age of the infant and the duration of the sleep of the mothers and that the duration of sleep for them was similar to those of the women in the control group about 6 months after the infant was born. However, fragmentation of sleep, daytime sleepiness, and sleep problems were still higher than in the control group for mothers with children between 6 and 12 months old.

scholarly journals Sleep quality, REM sleep behavior disorder and daytime sleepiness in adults with and without Parkinson's

2021 ◽  
Vol 26 (2) ◽  
pp. 20-25
Author(s):  
Andrea Díaz Pacheco ◽  
Jesús Moo Estrella
Keyword(s):  
Parkinson’S Disease ◽  
Sleep Quality ◽  
Rem Sleep ◽  
Daytime Sleepiness ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Control Group ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Sleep Behavior

In Parkinson's disease (PD), poor sleep quality and sleep disorders are central part of the non-motor symptoms. The aim was to compare sleep quality (SQ), REM sleep behavior disorder (RBD) and excessive daytime sleepiness (EDS) among adults with and without Parkinson's disease (PD). A second objective was to know the relationship of SQ and RBD with EDS in patients with PD. Method. sixty adults (38 % women,  mean age 66.7 ± 8.11 years), 50 % with PD diagnosis and 50 % healthy controls, Instruments: Epworth Sleepiness Scale, Sleep Quality Pittsburgh Index and REM Behavioral Disorder Sleep Questionnaire, which was designed for this study. Results. Differences were found in SQ (PD = 9.90 ±4.47 vs Control group = 7.23 ±4.71, t = 2.25, p = .028), and the percentage of cases with symptoms of RBD (PD = 30%, control group = 6.7%, ji2 = 5.455, p = .020). No differences were found in EDS (PD = 7.43 ± 5.46 vs Control group = 6.50 ± 5.28, t = .673, p = .504). According to the linear regression analysis, the increase in EDS was not associated with SQ, EDS was only associated with RBD. Conclusion, the PD group presents a poor sleep quality and a higher prevalence of RBD symptoms. EDS did not differ between adults with and without PD. However, RBD was associated with an increase in EDS in the PD group.

Age-Related Vestibular Dysfunction; Vestibulo-Ocular Reflex, Dynamic Visual Acuity, Dizziness and Falls: A Review

2021 ◽  
pp. 279-292
Keyword(s):  
Visual Acuity ◽  
Balance Control ◽  
Vestibular Dysfunction ◽  
Posture Control ◽  
Complex Nature ◽  
Dynamic Visual Acuity ◽  
Ocular Reflex ◽  
Gaze Stability ◽  
Age Related ◽  
Vestibulo Ocular Reflex

Background: Vestibular and vision functions are important contributors to posture control and fall avoidance. This review examines how the vestibulo-ocular reflex can be rehabilitated to help restore postural control. Methods: PubMed searches (7th April 2021) using the terms ‘vestibulo-ocular reflex’, ‘imbalance and vestibular dysfunction’, ‘vestibular dysfunction and dizziness’, ‘dynamic visual acuity’, ‘vestibular dysfunction rehabilitation’, and ‘gaze stabilization exercises’ yielded 4986, 495, 3576,1830, 3312, and 137 potentially useful publications respectively. Selections of those which were found to be the most relevant and representative of a balanced and current account of these topics, as well as selections from the most relevant reports referenced in those publications, were included in this review. Results: Just as there are age-related losses of static visual acuity even when there are no specific visual pathologies diagnosed, patients may also present with age-related loss of vestibular functions in the absence of specific vestibular pathologies. For example, cases of dizziness which are diagnosed as idiopathic might be usefully classified as age-related as the basis for the initiation of rehabilitation exercises. Conclusions: Apart from age-related loss of vestibular functions, cases diagnosed as having a particular form of vestibular pathology may have that condition exacerbated by age-related losses of vestibular functions. The effects of vestibular rehabilitation gaze stability exercises in patients with vestibular dysfunction are well established and include both improved dynamic acuity and postural stability. Improvements in posture control following rehabilitation of the vestibulo-ocular reflex are apparently due to improved peripheral and/or central vestibular balance control which has occurred in conjunction with enhanced gaze stability. The complex nature of increased fall risk suggests that an interdisciplinary approach to rehabilitation that includes vestibulo-ocular reflex rehabilitation appears likely to be associated with optimum outcomes for both pathological and age-related cases.

scholarly journals 091 The Feasibility of At-home Sleep Extension in Adolescents and Young adults: A Meta-Analysis and Systematic Review

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A38-A38
Author(s):  
Xinran Niu ◽  
Shijing Zhou ◽  
Melynda Casement
Keyword(s):  
Young Adults ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Daytime Sleepiness ◽  
Performance Outcomes ◽  
Adolescents And Young Adults ◽  
Negative Consequences ◽  
Sleep Extension ◽  
And Performance ◽  
At Home

Abstract Introduction Insufficient sleep duration has negative consequences for health and performance and is alarmingly common in adolescents and young adults. The primary aim of the meta-analysis and systematic review was to assess whether at-home sleep extension is a feasible means to improve sleep duration and daytime sleepiness without negative consequences for sleep quality or efficiency in adolescents and young adults. An additional aim of the review was to provide a qualitative summary of the health and performance outcomes associated with at-home sleep extension. Methods Peer-reviewed journal articles and doctoral dissertations available in English were searched and screened. Eligible studies had at least five consecutive days of at-home sleep extension, measurement of sleep duration during baseline/habitual sleep and extension of sleep opportunity, and participants 13–30 years of age. Information on primary sleep outcome (i.e., sleep duration), available secondary sleep outcomes (i.e., sleep opportunity, sleep efficiency, sleep quality, daytime sleepiness), and health and performance outcomes were extracted for quantitative synthesis and qualitative review. Results Of the 2254 articles assessed for eligibility, 17 studies (seven in adolescents and ten in young adults) met the eligibility criteria for this review. The average number of days of sleep manipulation was 14.29 (range: 5 to 49 nights). At-home extension of sleep opportunity reliably increased objective (ES = 0.97) and subjective sleep duration (ES = 2.19) and sleep quality (ES = 0.24), and decreased daytime sleepiness (ES = -0.39), when compared to unmanipulated sleep opportunity. Sleep extension was also found to have additional health (e.g., lower psychological stress) and performance benefits (e.g., better athletic performance) across ages and populations. A potential upward publication bias was found based on the distribution of within-subject effect sizes of actigraphic sleep duration. Conclusion The review indicates that at-home sleep extension is feasible in adolescents and young adults to improve sleep duration and daytime sleepiness, and maintain or improve sleep quality. However, the degree of improvement in sleep duration, sleep quality, and daytime sleepiness varied by study population and sleep extension method. Future research should investigate how variations in population and methods of sleep extension impact health and performance outcomes. Support (if any):

scholarly journals The effect of daily walking exercise on sleep quality in healthy young adults

2020 ◽  
Author(s):  
Feifei Wang ◽  
Szilvia Boros
Keyword(s):  
Young Adults ◽  
Sleep Quality ◽  
Repeated Measures ◽  
Intervention Group ◽  
Control Group ◽  
Beneficial Effects ◽  
Walking Intervention ◽  
Walking Exercise ◽  
Group B ◽  
The Impact

Abstract Purpose Walking has beneficial effects on sleep quality in elderly population and patients in clinical settings. However, less is known whether walking improves sleep quality among healthy young adults. This study examined the effectiveness of a 12-week walking intervention on sleep quality among sedentary young adults. Methods Fifty-four healthy adults aged 19 to 36-years old participated a pedometer based aerobic walking intervention, a cross-over randomized control trial. Participants were assigned into two groups (group A and group B) randomly. The 12-week intervention was divided into three sessions equally. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI) before and after session 1 and session 3. Omron HJ-112 pedometer and daily walking diary facilitated the intervention process. Within group and between group comparisons were made for statistical analysis. Results Within group comparison by repeated measures showed that sleep duration (p < 0.01, F-test 22.79), sleep medication (p < 0.05, F-test 5.22), subjective sleep (p < 0.05, F-test 5.51) and global sleep quality (p < 0.01, F-test 12.19) were significantly improved. The comparison between intervention group and control group showed that sleep disturbance was significantly improved (p < 0.05). Conclusion Daily walking exercise has a significant effect on facilitating sleep quality and sleep components among young adults. Further studies are suggested to examine the impact of walking intensity on sleep quality.

‘Gaze shift dynamic visual acuity: A functional test of gaze stability that distinguishes unilateral vestibular hypofunction

2020 ◽  
pp. 1-10
Author(s):  
Po-Yin Chen ◽  
Ying-Chun Jheng ◽  
Shih-En Huang ◽  
Lieber Po-Hung Li ◽  
Shun-Hwa Wei ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Head Rotation ◽  
Measurement Unit ◽  
Healthy Controls ◽  
Dynamic Visual Acuity ◽  
Gaze Shifts ◽  
Gaze Shift ◽  
Gaze Stability ◽  
Vestibular Hypofunction ◽  
Field Of Vision

BACKGROUND: Embedded within most rapid head rotations are gaze shifts, which is an initial eye rotation to a target of interest, followed by a head rotation towards the same target. Gaze shifts are used to acquire an image that initially is outside of the participant’s current field of vision. Currently, there are no tools available that evaluate the functional relevance of a gaze shift. OBJECTIVE: The purpose of our study was to measure dynamic visual acuity (DVA) while performing a gaze shift. METHODS: Seventy-one healthy participants (42.79±16.89 years) and 34 participants with unilateral vestibular hypofunction (UVH) (54.59±20.14 years) were tested while wearing an inertial measurement unit (IMU) sensor on the head and walking on a treadmill surrounded by three monitors. We measured visual acuity during three subcomponent tests: standing (static visual acuity), while performing an active head rotation gaze shift, and an active head rotation gaze shift while walking (gsDVAw). RESULTS: While doing gsDVAw, patients with Left UVH (n = 21) had scores worse (p = 0.023) for leftward (0.0446±0.0943 LogMAR) head rotation compared with the healthy controls (–0.0075±0.0410 LogMAR). Similarly, patients with right UVH (N = 13) had worse (p = 0.025) gsDVAw for rightward head motion (0.0307±0.0481 LogMAR) compared with healthy controls (–0.0047±0.0433 LogMAR). As a whole, gsDVAw scores were worse in UVH compared to the healthy controls when we included the ipsilesional head rotation on both sides gsDVAw (0.0061±0.0421 LogMAR healthy vs. 0.03926±0.0822 LogMAR UVH, p = 0.003). Controlling for age had no effect, the gsDVAw scores of the patients were always worse (p <  0.01). CONCLUSION: The gaze shift DVA test can distinguish gaze stability in patients with UVH from healthy controls. This test may be a useful measure of compensation for patients undergoing various therapies for their vestibular hypofunction.

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