Training the vestibulo-ocular reflex - improving movement, balance and proprioception.

(photo credit Casey Horner)

“Consciousness is a controlled hallucination generated by your brain, based on scraps of sensory data”. (The neuroscientists)

What is it?

The vestibulo-ocular reflex helps us maintain balance and stability by coordinating the movements of our eyes and head. It consists of the vestibular system, which is responsible for detecting changes in head position and movement, and the ocular system, which controls eye movements.

The vestibular system, located in the inner ear, consists of three semicircular canals and two otolith organs. These structures contain specialised sensory cells that detect changes in the position and movement of the head. When we move our head, the fluid in these structures moves, stimulating the sensory cells and sending signals to the brain about the head's movement and position.

The ocular system, which includes the muscles that control eye movement, works in conjunction with the vestibular system to stabilise our gaze and allow us to maintain clear vision while moving. When the vestibular system detects movement or changes in head position, it sends signals to the ocular system to adjust the position of the eyes, ensuring that they remain fixed on a target and providing a stable visual image.

This reflex is important for several reasons. Firstly, it helps us maintain balance and stability, allowing us to walk, run, and perform other motor activities without falling or losing our balance. Feed forward mechanisms mean the body gets ready to move where the eyes look. Secondly, it plays a crucial role in coordinating our eye movements, which is essential for visual perception, reading, and many other daily tasks. Finally, it contributes to our ability to maintain a stable visual image, even when our head is in motion, helping us navigate and interact with our environment effectively.

Who might benefit from assessing and improving this?

Balance and stability are paramount for keeping us moving efficiently and safely, living well, and as Louis Gifford would say, “with thoughtless effortless movement”. The ocular and vestibular systems working well together play a significant role in ensuring our overall well-being. This intricate sensory reflex not only helps us maintain physical equilibrium but also holds immense potential in rehab and in optimising performance in sport. So what can it help with?

Achieving Optimal Balance and Stability:

It is instrumental in maintaining balance and stability, making it a crucial component of any rehabilitation program. By integrating the coordination of eye movements and head position, we enhance postural control, reducing the risk of falls, improving overall stability and reducing risk of injury.

Enhancing Motor Skills and Coordination:

Rehabilitation often focuses on restoring motor skills and coordination, which are essential for daily activities and functional independence. The vestibulo-ocular reflex holds the key to improving these skills by facilitating the synchronization of eye movements with body movements. Incorporating this into training can help people regain motor control, improve coordination, and enhance their overall physical performance.

Optimising Visual Perception and Cognitive Function:

Any impairment in this system can impact one's ability to process visual information effectively so including vestibulo-ocular reflex exercises during rehabilitation can optimise visual perception, leading to improved cognitive function and better overall sensory integration. This can be especially beneficial for anyone recovering from neurological conditions or traumatic brain injuries helping facilitate activities of daily living.

It can benefit a wide range of people who may be experiencing difficulties with balance, coordination, visual perception, or cognitive function. Here are some specific groups of people who can benefit from vestibulo-ocular reflex training:

Balance Disorders: Those who have balance disorders, such as vertigo, dizziness, or unsteadiness. By improving the coordination between the vestibular and ocular systems, this training can help reduce symptoms and enhance balance control.

Neurological Conditions: Individuals recovering from neurological conditions, such as stroke, traumatic brain injury, or multiple sclerosis, often experience impairments in balance, coordination, and visual perception. Training can be beneficial in rehabilitating these individuals and improving their overall functional abilities.

Athletes and Sports Enthusiasts: Athletes and sports enthusiasts who rely heavily on balance and coordination, such as gymnasts, dancers, or athletes participating in dynamic sports (such as runners, mountain bikers, or tennis players), can benefit. It can help enhance proprioception, spatial awareness, and overall performance.

Older Adults: As we age, our balance and coordination abilities may decline, increasing the risk of falls and injuries. Training can be particularly beneficial for older adults in improving their balance, reducing the risk of falls, and maintaining their functional independence.

Visual Processing Issues: Those who have difficulties with visual processing, such as tracking moving objects, focusing, or reading, can benefit. By improving the coordination between eye movements and visual perception, this training can enhance visual processing abilities and overall cognitive function.

Vestibular Disorders: People with vestibular disorders, such as Meniere's disease or vestibular migraines, often experience symptoms like vertigo, dizziness, and visual disturbances. Training can help reduce these symptoms, improve balance control, and enhance quality of life.

Enhancing proprioception and interoception. It can also be beneficial for individuals who have poor proprioception, or interoception, such as those with hypermobility disorders or persistent pain. Improving the integration of sensory information from the visual, vestibular, and somatosensory systems and incorporating exercises that challenge the coordination between eye and body movements can assist people with poor proprioception by improving body awareness and enhancing their ability to perceive and control their movements, so increasing confidence.

Enhancing General Mobility- by targeting the coordination between eye, head and body movements and practicing specific exercises that involve tracking moving objects, focusing on different visual targets, and coordinating eye-head-body movements, overall mobility and movement efficiency can be enhanced.

De-Threatening Movements - by gently challenging habitual movement patterns that may have become guarded or restricted due to prediction of pain or avoidance of exacerbating symptoms. Improving the information being sent to the brain and gradually challenging prediction errors can help reduce perception of threat and lead to positive changes such as greater range, more confident movement or reduction in pain.

The ocular and vestibular system's importance cannot be overstated. By addressing these sensory systems, individuals can improve their balance, stability, motor skills, coordination, visual perception, cognitive function. If you are seeking rehabilitation, to maximise sporting gains or just to improve general everyday function and mobility, considering the benefits of ocular and vestibular training can be a game-changer in your journey towards your goals.

It's important to note that the suitability of training may vary depending on individual circumstances.