Vestibular Rehabilitation Incorporated With Optokinetic Stimulation in Peripheral Vestibular Dysfunction Patients - Trial NCT05002374

Timeline & Enrollment

Primary Outcome

Subjective visual vertical test,Subjective visual vertical test,Subjective visual vertical test,Subjective visual vertical test,Postural stability,Postural stability,Postural stability,Postural stability

Summary

Background Patients with peripheral vestibular dysfunction often complain of dizziness,
 blurred vision, imbalance and etc. Vestibular rehabilitation although has been proved to be
 an efficient method to improve the symptoms, the optimal treatment type, intensity and
 frequency is still unclear. Base on the mechanisms of vestibular rehabilitation, vestibular
 adaptation, substitution, and habituation, repeated practice and exposure to symptom-provoked
 movement could improve the symptoms. However, the symptom-provoked movement generated by only
 head and eye movement might not create sufficient threshold to induce vestibulo-ocular reflex
 adaptation. Practicing vestibular exercises in the same environment might be difficult for
 the patients to transfer learned ability to the real world environment. Therefore,
 optokinetic stimulation could potentially provide stronger visual-vestibular mismatch, and
 when combining with a virtual reality system could also simulate real world environment.
 Furthermore, an intensive training protocol on a daily basis might possibly promote the
 mechanisms of vestibular rehabilitation to enhance recovery from peripheral vestibular
 lesions. The purpose of this study is to investigate the efficacy of an intense vestibular
 rehabilitation programme incorporated with optokinetic stimulation in virtual reality
 environment on both subjective and objective symptoms in patients with peripheral vestibular
 dysfunction in the short and long term.
 
 Methods This study will be an assessor-blind randomised controlled trial. Patients diagnosed
 as peripheral vestibular dysfunction aged between 20-80 years will be recruited and randomly
 allocated into two groups: vestibular rehabilitation incorporated with optokinetic
 stimulation in virtual reality (Group OKN) and vestibular rehabilitation only (Group C).
 Group C will receive customised vestibular rehabilitation, while Group OKN will receive the
 same exercise programme as Group C plus optokinetic stimulation provided in virtual
 environment. Both groups will receive vestibular rehabilitation intensively for five
 consecutive days with a trained physiotherapist, following with daily home exercise for two
 months. Self-perceived symptoms, spatial orientation, postural control and gait performance
 will be assessed prior to treatment (baseline), at the end of the five-day treatment, at four
 and eight weeks following the five-day training.

ICD-10 Classifications