The Use of Virtual Reality for the Treatment of Visual Vertigo.

Study Overview
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Brief Summary
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This study investigates the use of virtual environments presented on a head mounted display for the rehabilitation of those suffering with visual vertigo. The control group and treatment groups will be presented with two different sets of environments and be given the same head and eye exercises to complete within the environment. They will also be provided with at home exercises to complete.

Detailed Description
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Visual vertigo occurs after the balance system suffers damage (e.g after a viral infection such as labyrinthitis). This causes an over-reliance on the eyes to maintain balance which causes disorientation in busy environments such as the supermarket. The treatment involves trying to desensitise the individual to visually stimulating situations. Further head and eye exercises are completed alongside the exposure to overcome the damage done to the balance system.

Official Title
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The Use of Virtual Reality for the Treatment of Visual Vertigo.

Conditions
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Treatment of Visual Vertigo

Intervention / Treatment
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* Other: Virtual environment with fast moving objects
* Other: Virtual environment with no movement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Those who have been diagnosed with visual vertigo and have scored a significant level on the Situational Characteristic Questionnaire (over 0.74 as per Pavlou et al., 2006). Exclusion Criteria: Those with or under investigation for epilepsy. Those who have been determined to have no or limited balance function in both ears. Those with reduced visual acuity that will leave them unable to view the 3D effects of the head mounted display. Those with severe mental health disorders e.g. psychosis, paranoid disorders, bipolar disorder or a history of substance abuse. Severe neck pain/ restricted movement. Previous treatment for visual vertigo. Those with an fluctuating vestibular disorder such as Ménière's disease or vestibular migraine. Those with untreated Benign Paroxymal Positional Vertigo (BPPV). Those with a significant brain injury, or head injury that results in a central vestibular disorder. Those with an arrhythmia.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment group<br>Virtual environment with fast moving objects these are graded in intensity from 1-7. Participants complete head and eye exercises within the environment using focus points such as benches and lanterns for a six week treatment program. | Other: Virtual environment with fast moving objects<br>* A beach/park environment with graded moving objects, the individual will complete head and eye exercises.<br>|
| Active Comparator: Control group<br>Virtual environment with no movement graded at grade 0. Participants complete head and eye exercises within the environment using focus points such as benches and lanterns for a six week treatment program. | Other: Virtual environment with no movement<br>* A beach/park environment with static objects, the individual will complete head and eye exercises.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in scoring on the Situational Characteristic Questionnaire | A measure of visual vertigo symptom level | Week 1 and Week 6 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in scoring on the PHQ-9 Questionnaire from week one to six | A measure of depression symptom level | Week 1 and Week 6 | 
| Change in scoring on the GAD-7 Questionnaire from week one to six | A measure of anxiety symptom level | Week 1 and Week 6 |