Effect of an oculomotor rehabilitation program for subacute brain injury patients with ophthalmoplegia: a case-control study

Abstract

Purpose

Examining the effects of an oculomotor rehabilitation program in subacute brain injury patients presenting with external ophthalmoplegia.

Methods

This case-control study included 33 patients with subacute brain injury accompanied by external ophthalmoplegia (15 cases, 18 controls) from a hospital rehabilitation ward. Participants underwent comprehensive rehabilitation for 8 weeks. The patients participated in an oculomotor rehabilitation program, which involved inducing pursuit, fixation, saccade, and vergence for 20 min daily, 6 days a week for 8 weeks. We assessed improvements in the angle of strabismus; visual function index (VFI), which evaluates inconvenience in daily life; and diplopia after 8 weeks in the two groups using statistical methods.

Results

The program resulted in an immediate strabismus angle improvement (p < 0.001). Strabismus angle change over the 8-week period was significantly higher (p < 0.001) in patients (22.9 ± 12.3°) than in control participants (8.3 ± 7.6°). VFI change was significantly greater (p = 0.003) in patients (7.1 ± 5.1 points) than in control participants (2.7 ± 2.4 points). The patients exhibited significantly higher diplopia improvement rates while looking straight ahead and in the direction of paralysis than did control participants (p = 0.021 and p = 0.037, respectively).

Conclusion

This program improved external ophthalmoplegia without any specialized environmental configurations or personnel, which ensures wide clinical applications.

IMPLICATIONS FOR REHABILITATION

• Our oculomotor rehabilitation program improved external ophthalmoplegia in subacute brain injury patients.

• The program promotes pursuit, fixation, saccades, and vergence. The patients lay in the supine position and it places a little burden on them.

• The program can be completed within 20 min daily, requires no special environmental configurations, and can be performed by anyone.

Keywords:

• Ophthalmoplegia
• rehabilitation
• brain injury
• subacute phase
• case-control study

Acknowledgments

This study was aided by the Showa University Research Grant for Young Researchers. This research received no specific grant from any funding agency in the public, commercial, or not-for profit sectors.

Ethical approval

This study was approved by the ethics committee of Showa University School of Nursing and Rehabilitation Sciences (approval No.: 477).

Author contributions

Watabe T designed the study and wrote the initial draft of the manuscript. Suzuki H, Sako R, Abe M, Aoki K, and Yoda M contributed to the analysis and interpretation of the data and assisted in the preparation of the final version of the manuscript. All other authors critically reviewed the manuscript and approved its final version.

Disclosure statement

The authors have no conflicts of interest that are directly relevant to the content of this article.