NCT01729039

Brief Summary

The purpose of this study is to determine whether vestibular exercises provide added benefit to balance rehabilitation in older adults with dizziness and normal vestibular function.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
49

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Nov 2012

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

November 1, 2012

Completed
12 days until next milestone

First Submitted

Initial submission to the registry

November 13, 2012

Completed
7 days until next milestone

First Posted

Study publicly available on registry

November 20, 2012

Completed
3.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 30, 2016

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 28, 2017

Completed
1.5 years until next milestone

Results Posted

Study results publicly available

August 22, 2018

Completed
Last Updated

August 22, 2018

Status Verified

August 1, 2018

Enrollment Period

3.9 years

First QC Date

November 13, 2012

Results QC Date

October 17, 2017

Last Update Submit

August 20, 2018

Conditions

Keywords

rehabilitationagedaged, 80 and overvestibular diseases

Outcome Measures

Primary Outcomes (2)

  • Visual Analog Scale - Head Movement

    This scale was used to measure perceived level of dizziness after one minute of horizontal head movement at 1 hertz (Hz). This technique uses a 10-cm line with one end being no symptoms (score = 0) and the other representing the worse possible symptoms (score = 10) and is commonly used to assess perception of pain. The subject is asked to place a mark on the 10-cm line at a point which indicates the intensity of his/her perception of symptoms of dizziness and the distance along that line is measured. Scores range from 0 to 10 with higher scores indicating worse perceived dizziness.

    6 weeks

  • Visual Analog Scale - Disequilibrium

    This scale was used to measure perceived level of unsteadiness while walking. This technique uses a 10-cm line with one end being no symptoms (score = 0) and the other representing the worse possible symptoms (score = 10) and is commonly used to assess perception of pain. The subject is asked to place a mark on the 10-cm line at a point which indicates the intensity of his/her perception of symptoms of unsteadiness and the distance along that line is measured. Scores range from 0 to 10 with higher scores indicating worse perceived unsteadiness.

    6 weeks

Secondary Outcomes (3)

  • Dynamic Gait Index

    6 weeks

  • Activities-specific Balance Confidence Scale

    6 weeks

  • 10 Meter Walk Test

    6 weeks

Study Arms (2)

gaze stability

EXPERIMENTAL

standard balance rehabilitation plus vestibular-specific exercises

Behavioral: standard balance rehabilitationBehavioral: gaze stability

control

PLACEBO COMPARATOR

standard balance rehabilitation plus placebo eye exercises

Behavioral: standard balance rehabilitationBehavioral: Control

Interventions

All subjects perform balance and gait exercises in addition to eye exercises and receive a written home exercise program (HEP) of balance and gait exercises to improve postural stability and mobility with progressively challenging tasks. Balance exercises include maintaining stability with vision and somatosensory cues altered, dynamic weight shifts and performing ankle, hip and step strategies. Gait activities include negotiating uneven terrains and obstacles, gait with head turns, varied speed, and unpredictable starts and stops. Walking for endurance is included in the HEP. Each participant receives a customized balance and gait HEP based on identified impairments and is progressed according to ability and level of assistance at home.

controlgaze stability
gaze stabilityBEHAVIORAL

Vestibular adaptation and substitution exercises will be performed by the experimental group (GS). Adaptation exercises involve head movement while maintaining focus on a target, which may be stationary or moving. Typical progression of adaptation exercises involve increased velocity of head movement, movement of both target and head, target placed in a distracting visual pattern and maintenance of a challenging posture. During active eye-head exercise, a large eye movement to a target is made prior to the head moving to face the target, potentially facilitating use of preprogrammed eye movements.

gaze stability
ControlBEHAVIORAL

The placebo exercises will consist of saccadic eye movements while the head is stationary and will be performed by the control group. These eye movements will be performed against a plain background in order to eliminate retinal slip and, therefore, eliminate the error signal for vestibular adaptation.

control

Eligibility Criteria

Age50 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • at least 50 years of age
  • documented balance or mobility problems
  • normal vestibular function, including otolith function

You may not qualify if:

  • cognitive impairment
  • progressive medical issues that would impact mobility (e.g., Parkinson's disease, cerebellar atrophy)
  • dizziness due to orthostatic hypotension or Benign Paroxysmal Positional Vertigo (BPPV)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Atlanta VA Medical and Rehab Center, Decatur, GA

Decatur, Georgia, 30033, United States

Location

Mountain Home VA Medical Center James H. Quillen VA Medical Center, Mountain Home, TN

Mountain Home, Tennessee, 37684, United States

Location

MeSH Terms

Conditions

DizzinessVestibular Diseases

Condition Hierarchy (Ancestors)

Sensation DisordersNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsLabyrinth DiseasesEar DiseasesOtorhinolaryngologic Diseases

Limitations and Caveats

High dropout rate; small sample size

Results Point of Contact

Title
Dr. Courtney Hall
Organization
James H Quillen VAMC

Study Officials

  • Courtney D Hall, PhD PT

    Mountain Home VA Medical Center James H. Quillen VA Medical Center, Mountain Home, TN

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 13, 2012

First Posted

November 20, 2012

Study Start

November 1, 2012

Primary Completion

September 30, 2016

Study Completion

February 28, 2017

Last Updated

August 22, 2018

Results First Posted

August 22, 2018

Record last verified: 2018-08

Data Sharing

IPD Sharing
Will not share

Locations