Effects of Vestibular Habituation and Ocular Reflex Exercises on Vertigo

NCT06760975 | Not Yet Recruiting DMC

• 1 other identifier: REC/RCR&AHS/24/0255
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 2

Brief Summary

The aim of this study is to determine the comparative effects of vestibular Habituation and ocular reflex exercises on Gait stability, Dizziness severity, and fear of fall in elderly population with vertigo

Conditions

Vertigo

Keywords

vertigo; Habituation; Ocular reflex; Fear of fall; Gait stability

Outcome Measures

Primary Outcomes (3)

• Dynamic gait index

  The DGI is used for gait assessment and has 8 items. The scoring of DGI is based on 4 point scale ranging from 0-3 while 0 indicates severe impairment and 3 indicates normal ability. DGI proves to be reliable and valid for older people. Total score for best performance is 24 and low score on DGI indicates greater impairment in functional mobility.

  6 weeks

• FES-I Fall efficacy scale international

  FES-I scale is used to access fear of fall and is consist of 16 items questionnaire allows participants to rate their fear of falling during specific activities at the rate of four different intensities ranging from "not at all concerned to vary concerned". Higher scores indicates a more significant fear of falling. score range from 16-19 show low concern of falling. Score ranges from 20-27 shows moderate concern and score ranges from 28-64 show high concern of fall to daily Activities.

  6 weeks

• Dizziness Handicap inventory

  The DHI is used to access dizziness and is consist of 25 items. Each item is answered with No (0) points sometimes (2) points or Yes (4) points. Scoring of DHI ranges from 0 to 100. further divided into physical (28) points , functional (36) points and emotional (36) points. The higher the scores result in perceived handicap. Moreover (DHI) proved to be a reliable instument

  6 weeks

Study Arms (2)

GROUP A Vestibular Habituation Exercises

EXPERIMENTAL

Group A will receive 24 sessions of vestibular habituation exercises, delivered 4 times weekly for six weeks, each session lasting 30 minutes. Effects will be measured at baseline, in the 3rd week, post-intervention, after six weeks, and at a 9th-week follow-up.

Other: Vestibular Habituation Exercises

GROUP B Ocular Reflex exercises

EXPERIMENTAL

Group B will receive ocular reflex exercises. A total of 24 sessions (4x/week for 6 weeks) will be conducted , lasting 50-60 minutes each. The effects will be measured at baseline, in the 3rd week, post intervention, after six weeks, and at a 9th-week follow-up.

Other: Ocular Reflex Excercises

Interventions

Vestibular Habituation Exercises OTHER

The vestibular habituation exercise group follows a structured progression over six weeks. in week 1 participants perform large amplitude, rapid cervical rotations seated, completing 3 sets of five cycles each. By week 2, the exercises increase in complexity , incorporates standing pivots or seated trunk flexion extension. in week 3 the cervical rotations are continued with seated or standing posture. week 4 introduces a busy visual background during the exercise to challenge visual-vestibular integration. In week 5 the exercises are performed standing with the addition complex visual target against a busy background. finally week 6 includes most advance movement including standing pivots 180 degrees and brand-daroff exercises with further visual challenges of near and far targets in busy background. Each exercise session last for 2 minutes and is aimed at progressively enhancing vestibular processing and adaptability.

GROUP A Vestibular Habituation Exercises

Ocular Reflex Excercises OTHER

The Ocular reflex exercises focuses on enhancing visual tracking and reflexes through targeted viewing exercises. In week 1, participants perform horizontal and vertical X1 viewing exercises with a near target, holding each position for 1 minute while seated. In week 2 the duration of the X1 exercises is extended to 2 minutes with the near target still in seated position. Week 3 shift to a far target for the X1 exercises and the participants performs them while standing increasing the challenge. By week 4 the exercise incorporate both near and far target in front of a busy background. extending the duration to 2 minutes while standing. In week 5 horizontal and vertical X2 viewing exercises are added with a plain background, while still using near and far targets in front of a busy background . finally week 6 continues the X1 and X2 exercises with near and far targets in a busy background, performed for 2 minutes while standing. This aims to improve visual tracking.

GROUP B Ocular Reflex exercises

Eligibility Criteria

• Age: 65 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Both male and female patients
• Age 65-75
• patient with vestibular disorder for at least 6 months
• patient with unspecific dizziness sensation for at least 3 months
• Dizziness handicap inventory score \> 16 -

You may not qualify if:

• patient with central nervous system diseases, like stroke, multiple sclerosis, Parkinson's disease.
• orthopedic problems that precluded performance of the exercises
• systemic diseases with no medication control
• if patient were legally blind or had dementia
• patient with no history of epilepsy and other neurological diseases -

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (2)

Rasheed Hospital Lahore

Lahore, Punjab Province, Pakistan

Location

Services Hospital Lahore

Lahore, Punjab Province, Pakistan

Location

Related Publications (6)

• Bayat A, Pourbakht A, Saki N, Zainun Z, Nikakhlagh S, Mirmomeni G. Vestibular rehabilitation outcomes in the elderly with chronic vestibular dysfunction. Iran Red Crescent Med J. 2012 Nov;14(11):705-8. doi: 10.5812/ircmj.3507. Epub 2012 Nov 15.

  PMID: 23396380 BACKGROUND

• Balatsouras DG, Koukoutsis G, Fassolis A, Moukos A, Apris A. Benign paroxysmal positional vertigo in the elderly: current insights. Clin Interv Aging. 2018 Nov 5;13:2251-2266. doi: 10.2147/CIA.S144134. eCollection 2018.

  PMID: 30464434 BACKGROUND

• Cohen HS, Kimball KT. Increased independence and decreased vertigo after vestibular rehabilitation. Otolaryngol Head Neck Surg. 2003 Jan;128(1):60-70. doi: 10.1067/mhn.2003.23.

  PMID: 12574761 BACKGROUND

• Hall CD, Heusel-Gillig L, Tusa RJ, Herdman SJ. Efficacy of gaze stability exercises in older adults with dizziness. J Neurol Phys Ther. 2010 Jun;34(2):64-9. doi: 10.1097/NPT.0b013e3181dde6d8.

  PMID: 20588090 BACKGROUND

• Norre ME, Beckers A. Vestibular habituation training: exercise treatment for vertigo based upon the habituation effect. Otolaryngol Head Neck Surg. 1989 Jul;101(1):14-9. doi: 10.1177/019459988910100104.

  PMID: 2502758 BACKGROUND

• Strupp M, Brandt T. Diagnosis and treatment of vertigo and dizziness. Dtsch Arztebl Int. 2008 Mar;105(10):173-80. doi: 10.3238/arztebl.2008.0173. Epub 2008 Mar 7.

  PMID: 19629221 BACKGROUND

MeSH Terms

Conditions

Vertigo; Substance-Related Disorders

Condition Hierarchy (Ancestors)

Vestibular Diseases; Labyrinth Diseases; Ear Diseases; Otorhinolaryngologic Diseases; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Chemically-Induced Disorders; Mental Disorders

Study Officials

• Hira Jabeen, MS-NMPT

  Riphah International University

  STUDY CHAIR

Central Study Contacts

Hira Jabeen, MS-NMPT

CONTACT

03234116506; hira.jabeen@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The study would be single blinded as Assessor of the study would be kept blind of the treatment groups to which patient will be allocated.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 1, 2025
• First Posted: January 7, 2025
• Study Start: December 31, 2024
• Primary Completion: July 31, 2025
• Study Completion: August 1, 2025
• Last Updated: January 7, 2025

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share

Locations

PA (2)