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Oculomotor neurorehabilitation for reading in mild traumatic brain injury (mTBI) : an integrative approach

THIAGARAJAN P; CIUFFREDA KJ; CAPO APONTE JE; LUDLAM DP; KAPOOR N
NEUROREHABILITATION , 2014, vol. 34, n° 1, p. 129-146
Doc n°: 169579
Localisation : Centre de Réadaptation de Lay St Christophe

D.O.I. : http://dx.doi.org/DOI:10.3233/NRE-131025
Descripteurs : AL - NEUROREEDUCATION, AF3 - TRAUMATISME CRANIEN

Considering the extensive neural network of the oculomotor
subsystems, traumatic brain injury (TBI) could affect oculomotor control and related reading dysfunction. OBJECTIVE: To evaluate comprehensively the effect of
oculomotor-based vision rehabilitation (OBVR) in individuals with mTBI. METHODS:
Twelve subjects with mTBI participated in a cross-over, interventional study
involving oculomotor training (OMT) and sham training (ST). Each training was
performed for 6 weeks, 2 sessions a week. During each training session, all three
oculomotor subsystems (vergence/accommodation/version) were trained in a
randomized order across sessions. All laboratory and clinical parameters were
determined before and after OMT and ST. In addition, nearvision-related symptoms
using the Convergence Insufficiency Symptom Survey (CISS) scale and subjective
visual attention using the Visual Search and Attention Test (VSAT) were assessed.
RESULTS: Following the OMT, over 80% of the abnormal parameters significantly
improved. Reading rate, along with the amplitudes of vergence and accommodation,
improved markedly. Saccadic eye movements demonstrated enhanced rhythmicity and
accuracy. The improved reading-related oculomotor behavior was reflected in
reduced symptoms and increased visual attention. None of the parameters changed
with ST. CONCLUSIONS: OBVR had a strong positive effect on oculomotor control,
reading rate, and overall reading ability. This oculomotor learning effect
suggests considerable residual neuroplasticity following mTBI.

Langue : ANGLAIS

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