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Peripheral Vestibular Disorders | Game Based Vestibular Exercise for Home Rehabilitation

Peripheral Vestibular Disorders research study

What is the primary objective of this study?

Study Description and Purpose: The vestibular sense organs of the inner ear consist of the semi-circular canals and otolith end organs. These organs contain specialized gravito-inertial sensors that sense angular and linear head acceleration. The input from these sensors is required to stabilize gaze position during head motion, and provide an absolute frame of reference with respect to gravity, thus providing a vertical spatial reference for body orientation and balance. Disease or damage of the vestibular sense organs causes a range of distressing symptoms and functional problems for people that could include loss of balance, gaze instability, disorientation and dizziness. A novel computer based rehabilitation system with therapeutic gaming application has been developed. This method allows different gaze and head movement exercises to be coupled to a wide range of inexpensive, commercial computer games. It can be used in standing and thus graded balance demands using a sponge pad can be incorporated into the program. Study Objective: 1. Test the therapeutic effectiveness of the TRP delivered in the home compared to usual care delivered in an out-patient physical therapy clinic on measures of balance (standing and walking) , gaze control, dizziness, and health related quality of life in individuals with peripheral vestibular disorders. 2. Compare trajectory of change in electronic gaze performance measures obtained during each therapy session of each participant assigned to the home Telerehabilitation. Hypothesis: Investigators believe the Telerehabilitation platform to be a cost-effective delivery of rehabilitation. Additionally motivation to perform tedious home programs can be improved with engaging, fun and interactive computer gaming as part of the rehabilitation process. It is hypothesized the home game-based Telerehabilitation program will result in greater improvements in dynamic balance control, gaze control, and dizziness, in individuals with peripheral vestibular disorders as compared to a typical out-patient physical therapy regimen.

Who is eligible to participate?

Inclusion criteria: 1. Age between 20-60 2. English speaking 3. Diagnosed with unilateral or bilateral peripheral vestibular hypo function based on a detailed neuro-otological and neuro-orthoptic analysis to include binocular electro-oculography with caloric testing; 4. Have a home computer running Windows or Mac OS. 5 Adequate hearing and vision acuity Exclusion Criteria: 1. Those with CNS disorders for example CVA, Multiple Sclerosis, epilepsy, migraines. 2. Recent fractures of the lower extremities or vertebra, advanced hip/knee OA , 3. Cardiac disease .

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

Peripheral Vestibular Disorders

Dizziness

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:Experimental groupExperimental group will receive a game-based exercise program delivered at home. This includes provision of a head-mounted motion mouse. This provides a treatment tool applied to gaze control, and allows incorporation of balance exercises. It also allows many different therapeutic exercises to be coupled to a wide range of inexpensive commercial computer games. Participants will attend 3 clinical sessions during which time the home therapy programs will be established and training in the use of the motion mouse and games will be provided. The treating physiotherapist will attend the participant's home to ensure proper set-up and operation of the computer applications. Participants will be asked to perform their respective home programs four times per week for 20 minutes per session.

Behavioral:Control groupControl group will receive a vestibular exercise program which will include the Herdman gaze stabilization exercises and balance training program. This program is presently a standard of vestibular care. Participants will attend an out-patient physical therapy clinic once a week for 12 weeks. The program also includes a 20 minute home exercise program prescribed 4 times per week.

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.

Experimental GroupExperimental group will receive the assigned intervention which is a game-based rehabilitation program delivered at home.

Control groupControl group will receive a vestibular rehabilitation program which will include the Herdman gaze stabilization exercises and balance training program.

Study Status

Unknown status

Start Date: May 2014

Completed Date: May 2016

Phase: N/A

Type: Interventional

Design:

Primary Outcome: Standing Balance

Secondary Outcome:

Study sponsors, principal investigator, and references

Principal Investigator: Tony Szturm, PT, PhD

Lead Sponsor: University of Manitoba

Collaborator: Canadian Institutes of Health Research (CIHR)

More information:https://clinicaltrials.gov/show/NCT02134444

Szturm T, Betker AL, Moussavi Z, Desai A, Goodman V. Effects of an interactive computer game exercise regimen on balance impairment in frail community-dwelling older adults: a randomized controlled trial. Phys Ther. 2011 Oct;91(10):1449-62. doi: 10.2522/ptj.20090205. Epub 2011 Jul 28.

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