Dizziness, Nystagmus
Conditions
Keywords
Oculomotor Exercise, Dynamic Balance, Dynamic Leap and Balance Test, Benign Paroxysmal Positional Vertigo, Cervical Exercises
Brief summary
Benign paroxysmal positional vertigo (BPPV) is the most common type of dizziness disorder in the community.Its cardinal symptoms include vertigo which is induced by change in position of head, turning over in bed, looking up, lying down in bed or any sudden change in the position of head. This study compares the effectiveness of occulomotor exercises alone and combined cervical and occulomotor exercises which take 6 weeks to implement and recruit results and each session lasting 10-20 minute Assessment will be performed at baseline.
Detailed description
Benign Paroxysmal Positional Vertigo (BPPV) is the most prevalent peripheral vestibular disorder, significantly affecting patients' daily activities and quality of life. While vestibular maneuvers are widely used for treatment, evidence on the added benefits of combining these maneuvers with therapeutic exercises remains limited. This study aims to fill that gap by evaluating the effectiveness of an integrated approach, potentially enhancing symptom relief and supporting evidence-based clinical decisions. The combination may offer a more holistic strategy for managing BPPV, guiding healthcare professionals toward improved treatment protocols. Additionally, the research emphasizes a quick, accessible intervention suitable for clinical and emergency settings. By reducing dizziness more effectively, the study aspires to improve functional outcomes for patients. Overall, it highlights the value of innovative, combined therapies in vestibular care.
Interventions
PROCEDUREOcculomotor exercises
Oculomotor exercises are used to treat BPPV and involve repeated head movements to habituate the brain to vertigo triggers. Saccadic Eye Movement Exercises: Moving the eyes quickly between two stationary targets while keeping the head still. Smooth Pursuit Exercises: Tracking a moving target with the eyes while keeping the head stationary. Adaptation X1 Exercises: Moving the head horizontally while maintaining focus on a stationary target. Adaptation X2 Exercises: Simultaneously moving the head and target in opposite directions horizontally, requiring the eyes to track the moving target.
PROCEDURECervical Exercises
Cervical exercise include Deep Neck flexor strengthening starts with the patient lie supine with knees bent. Perform chin tuck and lift head \~2-3 cm off the surface. Hold for 5- 10 seconds. 10 repetitions, 2 sets daily. DNF activate stabilizing neck muscles and reduce Cervicogenic Input \& provides quick, non-invasive relief from BPPV.
Sponsors
Foundation University Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed Patients of Benign Paroxysmal Vertigo (BPPV) * Age between 18-35 years * Male \& Female Patients * Positive Dix-Hall pike Test * Normal Cognitive Function: Able to follow instructions and provide informed consent. * Normal or Corrected-to-normal Vision * DHI Scale: Moderate (0-100)
Exclusion criteria
* Patients with visual impairment * Pregnancy * Patients with a history of severe heart disease * Patients with a pacemaker or implantable cardioverter-defibrillator (ICD) * No other vestibular disorders or conditions that may affect balance * Pre-Existing Neurological or Musculoskeletal Conditions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nystagmus | 6 weeks | Dynamic leap and balance test Moderate Impairment: Noticeable instability, excessive sway, needs extra steps to regain balance, and slower performance. Severe Impairment: Unable to maintain balance after landing, requires assistance, or is unable to complete the task safely. |
| benign paroxysmal positional vertigo | 6 weeks | Dix-Hall pike Test (DHT) is considered the gold standard assessment for the diagnosis of the vestibular disorder benign paroxysmal positional vertigo (BPPV). The patient starts in a sitting position and their head is turned 45° towards the side to be tested. The assessor then assists them to lie down quickly and extends their neck 20° over the end of the plinth, maintaining 45° rotation. The assessor should be able to see the patient's eyes and should observe for nystagmus. A positive response is elicited if rotational nystagmus is noted. The nystagmus will have a delayed onset of approximately 1-2 seconds following movement and it should subside after 10-20 seconds |
| Dizziiness | 6 weeks | The Dizziness Handicap Inventory (DHI) is a widely used tool to assess the impact of dizziness on an individual's daily life.The total score ranges from 0 to 100, with higher scores indicating a greater impact of dizziness. |
Countries
Pakistan
Outcome results
None listed