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N/A N=30 Randomized Single-blind Treatment

Virtual Environments for Vestibular Rehabilitation

Dizziness Chronic · Vertigo, Peripheral · Fall

Enrolled (actual)
30
Serious AEs
0.0%
Results posted
Dec 2023
Primary outcome: Primary: Visual Vertigo Analog Scale (VVAS) — 43.05; 36.84; 31.28; 21.41 score on a scale — p=0.027

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Balance training (Behavioral); Traditional Vestibular Rehabilitation (Behavioral)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
New York University
Primary completion
Apr 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Visual Vertigo Analog Scale (VVAS)
43.05; 36.84; 31.28; 21.41 0.027 sig
PRIMARY
Functional Gait Analysis (FGA)
20.43; 21.07; 26.35; 27.95 0.0001 sig
PRIMARY
The Dizziness Handicap Inventory (DHI)
53.07; 50.8 0.0002 sig
SECONDARY
The Activities Balance Confidence Scale
71.34; 74.21; 82.89; 79.78 0.028 sig
SECONDARY
Timed-Up and Go
7.97; 7.77; 7.93; 8.03 0.695
SECONDARY
The Four-Step Square Test
11.49; 9.48; 10.29; 9.65 0.469

Summary

The specific aims of this pilot project are: Aim #1: Determine the extent to which sensory integration strategies differ between 28 individuals with unilateral vestibular hypofunction and 28 age-matched peers. Participants' postural sway will be recorded as they experience two levels of moving stars10 and white noise, while standing on the floor or a compliant surface. Our working hypothesis is that patients with vestibular hypofunction utilize substitution strategies such that they will demonstrate greater visual and auditory reliance compared with controls, particularly when somatosensory cues are reduced via the support surface. We will then explore whether these mechanism changes after training. Aim #2: Develop the protocol and establish the feasibility of a randomized controlled trial (RCT) comparing C.S.I. training to standard vestibular rehabilitation. Following the assessment, the 28 patients will be randomized into standard vestibular rehabilitation vs. C.S.I. training. This pilot study will enable us to test the feasibility of our recruitment, randomization procedures, establish attrition rate, and test the training protocol. Aim #3: Generate pilot data for sample size calculation for a properly powered RCT. The follow up RCT will test the effect of C.S.I. training on: Visual Vertigo Analog Scale (VVAS), Functional Gait Analysis (primary); balance confidence, overall disability (descriptive). In our preliminary study, 8 patients met the inclusion criteria for the current proposal. Following the C.S.I. training, they had a large effect size of 1.17 on the VVAS. The current study will allow us to identify the between-group effect size for the VVAS and for a functional gait outcome.

Eligibility Criteria

Inclusion Criteria

  • Adult patients (18 or older)
  • Clinical diagnosis of chronic (3 months and longer) unilateral peripheral vestibular hypofunction
  • Patients will be included based on the presence of a positive head thrust test, head shaking nystagmus, spontaneous nystagmus, and/or canal paresis > 25% if a caloric test is available.
  • Included patients must present with at least two positive items on the VVAS

Exclusion Criteria

Patients will be excluded for prior vestibular rehab, bilateral or unstable vestibular loss or another neurological condition, active benign paroxysmal positional vertigo, acute orthopaedic injuries, peripheral neuropathy, hearing impairment, or visual impairment not corrected with glasses.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04268745). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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