Clinical trial NCT05942781: Concurrent Vestibular Activation and Postural Training Using Virtual Reality
Official title: Effects of Concurrent Vestibular Activation and Postural Training on Postural Control Using Virtual Reality
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Vestibular Disorder
Keywords: sensory reweighting
vestibular rehabilitation
vestibular reflex
virtual reality
Lead sponsor: Clarkson University
Sponsor class: OTHER
First posted: 2023-07-12
Enrollment: 24
Sex: ALL
Minimum age (years): 55
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Postural instability is a common symptom of vestibular dysfunction that impacts a person's day-to-day activities. Vestibular rehabilitation is effective in decreasing dizziness, visual symptoms and improving postural control through several mechanisms including sensory reweighting. As part of the sensory reweighting mechanisms, vestibular activation training with headshake activities influence vestibular reflexes. However, combining challenging vestibular and postural tasks to facilitate more effective rehabilitation outcomes is under-utilized. The novel concurrent headshake and weight shift training (Concurrent HS-WST) is purported to train the vestibular system to directly impact the postural control system simultaneously and engage sensory reweighting to improve balance. Healthy older adults will perform the training by donning a virtual reality headset and standing on the floor or foam pad with an overhead harness on and a spotter present to prevent any falls. The investigators propose that this training strategy would show improved outcomes over traditional training methods by improving vestibular-ocular reflex (VOR) gains, eye movement variability, sensory reweighting and promoting postural balance. The findings of this study may guide clinicians to develop rehabilitation methods for vestibular postural control in neurological populations with vestibular and/or sensorimotor control impairment.


Eligibility criteria: Inclusion Criteria:

* Able to stand independently (without an assistive device)

  * This study requires participants to perform postural assessments including reactive balance following mechanical perturbations.
  * Participants will also perform headshake activities and weight shift training in standing for 20 mins will mini breaks.
* Participants must be between the ages of 55-80.

Exclusion Criteria:

* Participants with evidence of:

  * Concussion, vestibular, balance or oculomotor issues for the prior 6 months.
  * Neuropathic conditions, particularly affecting the lower extremities. Participants with this issue will have sensory impairments which can affect their sensory assessment.
  * Current musculoskeletal deficits including significant postural abnormalities (signs of spinal, pelvic and leg length discrepancies).
  * Pain or limitations in neck range of motion.
* Recent (within 6 months) orthopedic surgery that impacts postural training.
* Visual Impairment ○ Participants must be able to see and follow targets in the virtual reality environment. Therefore, subjects must have 20/50 (corrected) vision. Subjects who are blind cannot participate.

Primary outcomes:
measure: Vestibulo-ocular reflex (VOR) gain
timeFrame: Three week study period
measure: Eye movement variability
timeFrame: Three week study period
measure: Electromyography (EMG) amplitude
timeFrame: Three week study period
measure: Electromyography (EMG) time onset
timeFrame: Three week study period
measure: Balance equilibrium and composite scores
timeFrame: Three week study period
measure: Sensory ratios
timeFrame: Three week study period
Secondary outcomes:
Other outcomes:
Locations:
city: Potsdam
country: United States
facility: Clarkson Hall
state: New York
Study officials:
References: