Scholars@Duke
Richard Alan Clendaniel

Richard Alan Clendaniel

Assistant Professor in Orthopaedic Surgery
Orthopaedic Surgery, Physical Therapy
richard.clendaniel@duke.edu
DUMC 104002, Durham, NC 27710
311 Trent Drive, Durham, NC 27710

Selected Publications

Remote assessment and management of patients with dizziness: development, validation, and feasibility of a gamified vestibular rehabilitation therapy platform.

Journal Article Front Neurol · 2024 INTRODUCTION: Dizziness is a growing public health concern with as many as 95 million adults in Europe and the United States experiencing vestibular hypofunction, which is associated with reduced quality of life, poorer health, and falls. Vestibular rehabi ... Full text Link to item Cite

The minimal clinically important difference for gait speed in significant unilateral vestibular hypofunction after vestibular rehabilitation.

Journal Article J Otol · January 2023 Gait speed is a valid measure of both physical function and vestibular health. Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction, yet there is little data to indicate how changes in gait speed reflect chang ... Full text Link to item Cite

Self-Reported Measures Have a Stronger Association With Dizziness-Related Handicap Compared With Physical Tests in Persons With Persistent Dizziness

Journal Article Frontiers in Neurology · July 15, 2022 Background: Associations between dizziness-related handicap and a variety of self-reported measures have been reported. However, research regarding associations between dizziness-related handicap and aspects of functioning that includes both physical tests ... Full text Cite

Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association.

Journal Article J Neurol Phys Ther · April 1, 2022 BACKGROUND: Uncompensated vestibular hypofunction can result in symptoms of dizziness, imbalance, and/or oscillopsia, gaze and gait instability, and impaired navigation and spatial orientation; thus, may negatively impact an individual's quality of life, a ... Full text Link to item Cite

Coronavirus Disease 2019 Return to Work Guidance and Recommendations for Vestibular Clinicians.

Journal Article Ear Hear · 2020 As states begin issuing progressive deconfinement guidelines, hospitals and institutions are starting to reopen for elective procedures and consultations. Vestibular clinicians are opening their practices to evaluate, test, or treat patients with dizziness ... Full text Link to item Cite

Efficacy of intergrating vestibular rehabilitation and cognitive behaviour therapy in persons with persistent dizziness in primary care- a study protocol for a randomised controlled trial.

Journal Article Trials · October 7, 2019 BACKGROUND: Dizziness is a common complaint, and the symptom often persists, together with additional complaints. A treatment combining Vestibular Rehabilitation (VR) and Cognitive Behaviour Therapy (CBT) is suggested. However, further research is necessar ... Full text Link to item Cite

The Necessity for Post-Maneuver Restrictions in the Treatment of Benign Paroxysmal Positional Vertigo: An Updated Meta-Analysis of the Literature.

Journal Article Otol Neurotol · July 2018 OBJECTIVE: Many studies have published conflicting results regarding the necessity of post-maneuver postural restrictions following treatment of benign paroxysmal positional vertigo (BPPV). The purpose of this meta-analysis is to complete an updated, compr ... Full text Link to item Cite

How to diagnose cervicogenic dizziness.

Journal Article Arch Physiother · 2017 Cervicogenic dizziness (CGD) is a clinical syndrome characterized by the presence of dizziness and associated neck pain. There are no definitive clinical or laboratory tests for CGD and therefore CGD is a diagnosis of exclusion. It can be difficult for hea ... Full text Open Access Link to item Cite

Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION.

Journal Article J Neurol Phys Ther · April 2016 BACKGROUND: Uncompensated vestibular hypofunction results in postural instability, visual blurring with head movement, and subjective complaints of dizziness and/or imbalance. We sought to answer the question, "Is vestibular exercise effective at enhancing ... Full text Link to item Cite

Nonmedical Management of Positional Vertigo

Chapter · December 31, 2014 New topics addressed in this edition include: Development of the vestibular systemCentral compensation following peripheral vestibular system impairmentVideo head impulse test (vHIT)Biomechanics and physiology of balanceElectrocochleography ... ... Cite

Vestibular Rehabilitation

Book · July 24, 2014 Recognized as two of the world's leading authorities on the subject, Susan Herdman and Richard Clendaniel, joined by a team of expert contributors, deliver the 4th Edition of the field's definitive text on the management of vestibular ... ... Cite

Differential diagnosis: BPPV versus central positional nystagmus and vertigo

Chapter · July 24, 2014 Recognized as two of the world's leading authorities on the subject, Susan Herdman and Richard Clendaniel, joined by a team of expert contributors, deliver the 4th Edition of the field's definitive text on the management of vestibular ... ... Cite

Physical Therapy management of cervicogenic dizziness

Chapter · July 24, 2014 Recognized as two of the world's leading authorities on the subject, Susan Herdman and Richard Clendaniel, joined by a team of expert contributors, deliver the 4th Edition of the field's definitive text on the management of vestibular ... ... Cite

Physical Therapy management of bilateral vestibular hypofunction and loss

Chapter · July 24, 2014 Recognized as two of the world's leading authorities on the subject, Susan Herdman and Richard Clendaniel, joined by a team of expert contributors, deliver the 4th Edition of the field's definitive text on the management of vestibular ... ... Cite

An Interprofessional Course in Disaster Preparedness

Conference JOURNAL OF INTERPROFESSIONAL CARE · March 1, 2013 Link to item Cite

Balance and Dizziness

Chapter · 2013 Cite

The effects of habituation and gaze stability exercises in the treatment of unilateral vestibular hypofunction: a preliminary results.

Journal Article J Neurol Phys Ther · June 2010 Featured Publication BACKGROUND AND PURPOSE: The efficacy of both habituation and adaptation exercise interventions in the treatment of unilateral vestibular hypofunction has been demonstrated by previous studies. The purpose of this article is to describe the preliminary resu ... Full text Link to item Cite

Retention of VOR gain following short-term VOR adaptation.

Journal Article Exp Brain Res · May 2008 Featured Publication Motor learning in the vestibular system can be differentially obtained depending upon the context for which the vestibulo-ocular reflex (VOR) has been exposed. Manipulating head orientation relative to gravity is an example of a contextual cue that can eli ... Full text Link to item Cite

Mechanism of dynamic visual acuity recovery with vestibular rehabilitation.

Journal Article Arch Phys Med Rehabil · March 2008 Featured Publication OBJECTIVE: To determine why dynamic visual acuity (DVA) improves after vestibular rehabilitation in people with vestibular hypofunction. DESIGN: Combined descriptive and intervention study. SETTING: Outpatient department in an academic medical institution. ... Full text Link to item Cite

Non-vestibular diagnosis and imbalance: cervicogenic dizziness

Chapter · April 3, 2007 Recognized as one of the world’s leading authorities on the subject, Susan Herdman delivers the most current information available about the management of patients with vestibular disorders in her updated 3rd edition text. ... Cite

Assessment and interventions for the patient with complete vestibular loss

Chapter · April 3, 2007 Recognized as one of the world’s leading authorities on the subject, Susan Herdman delivers the most current information available about the management of patients with vestibular disorders in her updated 3rd edition text. ... Cite

Balance and Dizziness

Chapter · 2007 Cite

Axis of eye rotation changes with head-pitch orientation during head impulses about earth-vertical.

Journal Article J Assoc Res Otolaryngol · June 2006 Featured Publication The goal of this study was to assess how the axis of head rotation, Listing's law, and eye position influence the axis of eye rotation during brief, rapid head rotations. We specifically asked how the axis of eye rotation during the initial angular vestibu ... Full text Link to item Cite

Context-specific adaptation of saccade gain is enhanced with rest intervals between changes in context state.

Journal Article Ann N Y Acad Sci · April 2005 Dual-state adaptation of motor responses has been known for some time. A more recent development is a form of dual-state adaptation known as "context-specific adaptation," which was explored through the use of saccade gain adaptation. In this model, two di ... Full text Link to item Cite

The three-dimensional vestibulo-ocular reflex evoked by high-acceleration rotations in the squirrel monkey.

Journal Article Exp Brain Res · December 2004 Featured Publication The aim of this study was to determine if the angular vestibulo-ocular reflex (VOR) in response to pitch, roll, left anterior-right posterior (LARP), and right anterior-left posterior (RALP) head rotations exhibited the same linear and nonlinear characteri ... Full text Link to item Cite

Acquisition of context-specific adaptation is enhanced with rest intervals between changes in context state, suggesting a new form of motor consolidation.

Journal Article Neurosci Lett · October 14, 2004 Featured Publication We previously showed that the saccadic system could be adapted in a context-specific manner: two different adapted gains could be associated with two different context cues, with the gain state switched when the context state was switched. This was accompl ... Full text Link to item Cite

Vergence-dependent adaptation of the vestibulo-ocular reflex.

Journal Article Exp Brain Res · October 2003 Featured Publication The gain of the vestibulo-ocular reflex (VOR) normally depends on the distance between the subject and the visual target, but it remains uncertain whether vergence angle can be linked to changes in VOR gain through a process of context-dependent adaptation ... Full text Link to item Cite

Differential adaptation of the linear and nonlinear components of the horizontal vestibuloocular reflex in squirrel monkeys.

Journal Article J Neurophysiol · December 2002 Featured Publication Previous work in squirrel monkeys has demonstrated the presence of linear and nonlinear components to the horizontal vestibuloocular reflex (VOR) evoked by high-acceleration rotations. The nonlinear component is seen as a rise in gain with increasing veloc ... Full text Link to item Cite

Sensory, motor, and combined contexts for context-specific adaptation of saccade gain in humans.

Journal Article Neurosci Lett · November 8, 2002 Featured Publication Saccadic eye movements can be adapted in a context-specific manner such that their gain can be made to depend on the state of a prevailing context cue. We asked whether context cues are more effective if their nature is primarily sensory, motor, or a combi ... Full text Link to item Cite

Context-specific adaptation of saccade gain.

Journal Article Exp Brain Res · October 2002 Featured Publication Previous studies established that vestibular reflexes can have two adapted states (e.g., gain) simultaneously, and that a context cue (e.g., vertical eye position) can switch between the two states. The present study examined this phenomenon of context-spe ... Full text Link to item Cite

Context-specific adaptation of saccade gain in parabolic flight.

Journal Article J Vestib Res · 2002 Featured Publication Previous studies established that vestibular reflexes can have two adapted states (e.g., gains) simultaneously, and that a context cue (e.g., vertical eye position) can switch between the two states. Our earlier work demonstrated this phenomenon of context ... Link to item Cite

Horizontal vestibuloocular reflex evoked by high-acceleration rotations in the squirrel monkey. IV. Responses after spectacle-induced adaptation.

Journal Article J Neurophysiol · October 2001 Featured Publication The horizontal angular vestibuloocular reflex (VOR) evoked by sinusoidal rotations from 0.5 to 15 Hz and acceleration steps up to 3,000 degrees /s(2) to 150 degrees /s was studied in six squirrel monkeys following adaptation with x2.2 magnifying and x0.45 ... Full text Link to item Cite

Outcome measures for assessment of treatment of the dizzy and balance disorder patient.

Journal Article Otolaryngol Clin North Am · June 2000 Featured Publication There are a variety of measurement tools available for assessing the treatment outcomes for patients with dizziness and imbalance. Some of these tools, however, may not be appropriate or valid for the patients in question. In this article, the various outc ... Full text Link to item Cite

The effect of the canalith repositioning maneuver on resolving postural instability in patients with benign paroxysmal positional vertigo.

Journal Article Am J Otol · May 2000 Featured Publication OBJECTIVE: Patients with benign paroxysmal positional vertigo (BPPV) often experience postural instability as well as brief episodes of vertigo. The purpose of this study was to determine whether successful resolution of the episodic vertigo, through use o ... Full text Link to item Cite

Cervical vertigo

Chapter · 1999 Cite

Context specific adaptation of saccade gain

Conference Society for Neuroscience Abstracts · 1999 Cite

Vestibular rehabilitation strategies in Meniere's disease.

Journal Article Otolaryngol Clin North Am · December 1997 Featured Publication Once the episodic spells of vertigo associated with Meniere's disease have abated, vestibular rehabilitation exercises play an important role in promoting adaptation to the decreased vestibular input. Outlines of different treatment approaches for three ty ... Link to item Cite

Effect of VOR gain changes on balance

Conference Society for Neuroscience Abstracts · 1997 Cite

Vestibular adaptation exercises and recovery: acute stage after acoustic neuroma resection.

Journal Article Otolaryngol Head Neck Surg · July 1995 Featured Publication The use of exercises in the treatment of patients with vestibular deficits has become increasingly popular, and evidence exists that these exercises are beneficial in patients with chronic vestibular deficits. The question as to whether patients with acute ... Full text Link to item Cite

Behavior of identified Edinger-Westphal neurons during ocular accommodation.

Journal Article J Neurophysiol · November 1994 Featured Publication 1. The present study used single-unit recording and antidromic activation techniques in alert rhesus monkeys to examine the static and dynamic behavior of 21 parasympathetic, preganglionic neurons of the Edinger-Westphal nucleus (EW) during ocular accommod ... Full text Link to item Cite

Characteristics of antidromically identified oculomotor internuclear neurons during vergence and versional eye movements.

Journal Article J Neurophysiol · March 1994 Featured Publication 1. Previous studies have shown that midbrain near response cells that increase their activity during convergent eye movements project to medial rectus motoneurons, which also increase their activity during convergence. Most neurons in the abducens nucleus ... Full text Link to item Cite

Vergence dependent adaptation of the vestibulo-ocular reflex (VOR)

Conference Society for Neuroscience Abstracts · 1994 Cite

Eye movement signs in vertical canal benign paroxysmal positional vertigo

Conference CONTEMPORARY OCULAR MOTOR AND VESTIBULAR RESEARCH: A TRIBUTE TO DAVID A. ROBINSON · January 1, 1994 Link to item Cite

Oculomotor internuclear neurons: Their role in horizontal eye movements.

Conference Society for Neuroscience Abstracts · 1991 Cite

Manual Techniques

Chapter · 1989 Cite

HAMSTRINGS MUSCLE LENGTH IN COLLEGE BASEBALL PLAYERS

Journal Article PHYSICAL THERAPY · May 1, 1986 Link to item Cite

HAMSTRING MUSCLE LENGTH IN MEN AND WOMEN - NORMATIVE DATA

Conference PHYSICAL THERAPY · January 1, 1984 Link to item Cite

EXERCISE AND ACUTELY INDUCED STRESS

Conference PHYSICAL THERAPY · January 1, 1983 Link to item Cite