Virtual Reality-Based Vestibular Rehabilitation in Vestibular Migraine

NCT07493005 | Completed DMC

• 1 other identifier: 324S720
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Vestibular migraine (VM) is a common neurological condition characterized by recurrent episodes of dizziness, vertigo, and balance problems, often accompanied by migraine symptoms. These symptoms can significantly impair daily functioning and quality of life. Vestibular rehabilitation (VR) is a non-pharmacological treatment approach aimed at improving balance, reducing dizziness, and promoting central compensation mechanisms. This randomized controlled trial aims to evaluate the effectiveness of virtual reality (VR)-based vestibular rehabilitation in patients with vestibular migraine. Participants diagnosed with definite VM will be randomly assigned to two groups: one group will receive a conventional home-based vestibular rehabilitation program, while the other group will receive the same home-based program in addition to a clinic-based virtual reality rehabilitation program. The intervention will last for four weeks. Clinical outcomes will be assessed before and after the intervention using both objective and subjective measures, including functional vestibulo-ocular reflex (VOR) performance, postural control, balance, dizziness severity, psychological status, and quality of life. The study aims to determine whether adding virtual reality-based rehabilitation to conventional home exercises provides additional benefits in improving balance, reducing symptoms, and enhancing functional outcomes in patients with vestibular migraine.

Conditions

Vestibular Migraine

Keywords

Vestibular Migraine; Virtual Reality; Vestibular Rehabilitation; Balance; Dizziness; Functional Outcomes; Randomized Controlled Trial

Outcome Measures

Primary Outcomes (3)

• Change in balance performance measured by Sensory Organization Test (SOT)

  Postural control will be assessed using the Sensory Organization Test (SOT), which evaluates the participant's ability to maintain balance under different sensory conditions by integrating visual, vestibular, and somatosensory inputs.

  Baseline and 4 weeks

• Change in functional vestibulo-ocular reflex performance measured by the Functional Head Impulse Test (fHIT)

  Functional vestibulo-ocular reflex performance will be assessed using the Functional Head Impulse Test (fHIT), which evaluates gaze stabilization during rapid head movements.

  Baseline and 4 weeks

• Change in dynamic balance measured by the Limits of Stability test (LOS)

  Dynamic balance will be assessed using the Limits of Stability (LOS) test, which measures the ability to voluntarily shift the center of gravity within the base of support without losing balance.

  Baseline and 4 weeks

Secondary Outcomes (8)

• Change in dizziness severity measured by the Visual Analog Scale (VAS)

  Baseline and 4 weeks

• Change in balance-related symptom severity measured by the Visual Analog Scale (VAS)

  Baseline and 4 weeks

• Change in dizziness-related disability measured by the Dizziness Handicap Inventory (DHI)

  Baseline and 4 weeks

• Change in activities of daily living measured by the Vestibular Disorders Activities of Daily Living Scale (VADL)

  Baseline and 4 weeks

• Change in functional gait performance measured by the Functional Gait Assessment (FGA)

  Baseline and 4 weeks

Study Arms (2)

Home-Based Vestibular Rehabilitation

ACTIVE COMPARATOR

Participants in this group will receive an individualized home-based vestibular rehabilitation program. The program will include adaptation exercises (vestibulo-ocular reflex training), habituation exercises, substitution strategies, and balance training tailored to the patient's symptoms. Participants will be instructed to perform the exercises daily, three times per day, over a period of four weeks. Compliance will be monitored through regular follow-up and communication.

Behavioral: Home-Based Vestibular Rehabilitation

Virtual Reality-Based Vestibular Rehabilitation + Home-Based Vestibular Rehabilitation

EXPERIMENTAL

Participants in this group will receive the same individualized home-based vestibular rehabilitation program as the control group. In addition, they will undergo clinic-based virtual reality-based vestibular rehabilitation sessions twice per week for four weeks. The virtual reality program will include tasks such as optokinetic stimulation, head-eye coordination, target tracking, limits of stability training, optical flow exposure, spatial navigation, and simulated environments designed to induce controlled sensory conflict and improve balance and postural control.

Behavioral: Virtual Reality-Based Vestibular Rehabilitation

Interventions

Home-Based Vestibular Rehabilitation BEHAVIORAL

Intervention 1 - Home-Based Vestibular Rehabilitation This intervention consists of an individualized home-based vestibular rehabilitation program designed according to each participant's symptom profile. The program includes adaptation exercises (vestibulo-ocular reflex training), habituation exercises targeting motion sensitivity, substitution strategies, and balance training. Participants will be instructed to perform the exercises three times daily, with multiple repetitions, over a four-week period. The program will be explained and demonstrated by a clinician, and participants will be provided with written and visual instructions. Adherence will be monitored through regular follow-up and weekly contact.

Home-Based Vestibular Rehabilitation

Virtual Reality-Based Vestibular Rehabilitation BEHAVIORAL

This intervention consists of a clinic-based virtual reality-based vestibular rehabilitation program administered in addition to the home-based program. Participants will attend supervised sessions twice per week for four weeks, with each session lasting approximately 30 minutes. The virtual reality program includes structured tasks such as optokinetic stimulation, head-eye coordination training, target tracking, limits of stability exercises, optical flow exposure, spatial navigation, and simulated environments. These tasks are designed to induce controlled sensory conflict, enhance vestibular compensation, and improve postural control and functional balance in a safe and interactive environment.

Virtual Reality-Based Vestibular Rehabilitation + Home-Based Vestibular Rehabilitation

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosis of definite vestibular migraine according to the International Classification of Headache Disorders, 3rd edition (ICHD-3)
• Age between 18 and 60 years
• Confirmation of vestibular migraine diagnosis using a validated diagnostic scale
• Not receiving acute pharmacological treatment for vestibular migraine at the time of enrollment
• Ability to perform activities of daily living independently
• No visual impairment or ocular disease that would interfere with assessment or rehabilitation
• Ability to understand and comply with study procedures
• Provision of written informed consent

You may not qualify if:

• Medical contraindications to head movements required for vestibular rehabilitation (e.g., severe cervical disorders)
• Intolerance to virtual reality equipment or conditions preventing its use
• Presence of severe comorbid conditions (e.g., life-threatening disease, severe cognitive impairment, neurological disorder, or severe psychiatric disorder)
• Presence of central nervous system disorders
• Diagnosis of vestibular disorders other than vestibular migraine
• Inability or unwillingness to perform home-based or virtual reality-based vestibular rehabilitation
• Incomplete participation in required assessment procedures
• Physical disability preventing independent walking

Sponsors & Collaborators

• Ege University: lead
• THE SCİENTİFİC AND TECHNOLOGİCAL RESEARCH COUNCİL OF TURKEY (TUBITAK): collaborator

Study Sites (1)

Ege University

Izmir, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Dizziness

Condition Hierarchy (Ancestors)

Sensation Disorders; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Gulce Kirazli, PhD

  Ege University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc.Prof.

Study Record Dates

• First Submitted: March 19, 2026
• First Posted: March 25, 2026
• Study Start: March 1, 2025
• Primary Completion: November 1, 2025
• Study Completion: February 1, 2026
• Last Updated: March 27, 2026

Record last verified: 2026-03

Locations

TU (1)