Dynamic visual acuity improvement following vestibular rehabilitation: a proof-of-concept cohort study

Introduction: The vestibular system maintains gaze stability during head movement. Dynamic visual acuity (DVA) measures the vestibulo-ocular reflex, which is often impaired in vestibular dysfunction. Objective evidence regarding DVA changes in routine clinical settings remains limited. Objectives: The objectives of this study were to evaluate the sensitivity of computerized DVA (cDVA) as a functional biomarker for monitoring progress in vestibular rehabilitation. Materials and methods: A proof-of-concept cohort study included 22 adults with vestibular dysfunctions at a tertiary service. DVA was measured using an active head-impulse testing system before and after a five-session rehabilitation program. Paired t-tests were used to determine effect sizes. Results: Mean DVA improved significantly in logarithm of the minimum angle of resolution values, decreasing from 0.517 (standard deviation [SD] 0.328) to 0.406 (SD 0.275) post-intervention (p = 0.0095; Cohen’s d = 0.61). Eye-specific analysis showed a significant reduction for the right eye (p = 0.008; d = 0.62), whereas the left eye showed a non-significant improvement trend (p = 0.082). Conclusions: cDVA captures measurable functional changes over short clinical intervals. These findings support its use as an outcome measure for monitoring gaze stability, providing a valuable complement to physiological vestibular assessments.