Dizziness | Vestibular Rehabilitation and Dizziness

Dizziness research study

What is the primary objective of this study?

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.

Who is eligible to participate?

Inclusion Criteria: - at least 50 years of age - documented balance or mobility problems - normal vestibular function, including otolith function Exclusion Criteria: - 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)

Which medical condition, disease, disorder, syndrome, illness, or injury is researched?


Study Interventions

Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.

Behavioral:standard balance rehabilitationAll subjects will perform balance and gait exercises in addition to the eye movement exercises and will be provided a written home exercise program (HEP) consisting of balance and gait exercises designed to improve postural stability and mobility with progressively more challenging tasks. Balance exercises will include maintaining stability in standing with vision and somatosensory cues altered, dynamic weight shifting and performing ankle, hip and step strategies. Gait activities will include negotiating uneven terrains and obstacles, gait with slow head turns focusing on objects, varied speed (speeding up and slowing down), and unpredictable starts and stops. Walking for endurance will be included in the HEP. Each participant will receive a customized balance and gait HEP based on identified impairments and will be progressed according to ability and level of assistance at home as is standard in PT.

Behavioral:gaze stabilityVestibular adaptation and substitution exercises were designed originally based on the error signals (retinal slip) that induce changes in gain in the vestibular system and 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. Substitution exercises specifically attempt to facilitate use of alternative strategies, rather than teaching the specific strategies. 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.

Behavioral:ControlThe 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.

Study Arms

Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.

gaze stabilitystandard balance rehabilitation plus vestibular-specific exercises

controlstandard balance rehabilitation plus placebo eye exercises

Study Status

Active, not recruiting

Start Date: November 1, 2012

Completed Date: April 2017

Phase: N/A

Type: Interventional


Primary Outcome: symptoms of dizziness

Secondary Outcome: gaze stability

Study sponsors, principal investigator, and references

Principal Investigator: Courtney D Hall, PhD PT

Lead Sponsor: VA Office of Research and Development


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