Cybersickness, Motion Sickness, Vestibular Diseases
Conditions
Keywords
Gaze Stabilization Exercises, Oculomotor Exercises, Computer Users, Vestibulo-Ocular Reflex, Dynamic Visual Acuity, Physical Therapy
Brief summary
Many people who use computers for long hours experience "cybersickness" (dizziness, nausea, blurred vision) because their eyes see movement on the screen but their body feels still. This study aims to see which type of eye and head exercises works best to fix this. We will compare Gaze Stabilization Exercises (head movements) against Oculomotor Exercises (eye movements). Forty-six computer users will perform these exercises for 4 weeks. We will measure their dizziness, vision, and quality of life before, during, and after the treatment.
Detailed description
This is a single-blinded, randomized clinical trial. Participants (n=46) will be recruited from The University of Faisalabad. Inclusion criteria include screen time \>6 hours/day, computer usage for at least 10 years, and a Simulator Sickness Questionnaire (SSQ) score between 20 and 40. Group A (Intervention): Gaze Stabilization Exercises. Week 1: View X1 exercises. Week 2: View X2 exercises. Week 3: Gaze shift exercises. Week 4: Imaginary Target exercises. (3 sessions/week, 1 minute per exercise, 3 times each). Group B (Active Comparator): Oculomotor Exercises. Week 1: Range exercises. Week 2: Saccadic exercises. Week 3: Pursuit exercises. Week 4: Vergence exercises. (3 sessions/week, 1 minute per exercise, 3 times each). Outcomes: The primary outcome is the change in Dynamic Visual Acuity (LogMAR scale) and Cybersickness (SSQ score). The secondary outcome is Quality of Life (SF-36 questionnaire). Measurements will be taken at baseline, Week 2, and Week 4. Data will be analyzed using SPSS version 20.
Interventions
BEHAVIORALGaze Stabilization Exercises
Week 1 - View X1: Patient sits upright. Target held at eye level 1 meter away. Patient turns head horizontally (left/right) or vertically (up/down) while keeping eyes fixed on target. Speed: slow (1Hz). Duration: 1 minute. Repetitions: 3 times per direction. Week 2 - View X2: Same as View X1 but head movement speed increased to 2Hz. Week 3 - Gaze Shift: Two targets placed 30 cm apart horizontally or vertically. Patient rotates head to face Target 1, then shifts gaze to Target 2 while continuing head rotation toward Target 2. Duration: 1 minute. Repetitions: 3 times. Week 4 - Imaginary Target: Patient fixates on a target (e.g., a sticker on wall). Closes eyes. Rotates head 30-45 degrees away from target. While eyes closed, patient imagines still looking at target. Opens eyes and checks if fixation is accurate. Duration: 1 minute. Repetitions: 3 times per direction. All exercises are performed under supervision for the first 3 sessions, then home-based with weekly follow-up calls.
BEHAVIORALOculomotor Exercises
Week 1 - Range Oculomotor Exercises: Eyes closed. Patient moves eyes slowly in horizontal (left-right), vertical (up-down), diagonal (top-left to bottom-right), and rotational (clockwise/counterclockwise) directions. Duration: 1 minute per direction. Repetitions: 3 times. Week 2 - Saccadic Exercises: Two stationary targets (e.g., two fingers) held 30 cm apart at eye level. Patient rapidly shifts gaze between targets without moving head. Duration: 1 minute. Repetitions: 3 times. Week 3 - Pursuit Exercises: A single target (e.g., pen) is moved slowly horizontally and vertically. Patient follows target smoothly with eyes only (head still). Speed: approx 20 degrees/second. Duration: 1 minute per direction. Repetitions: 3 times. Week 4 - Vergence Exercises: Target (e.g., pen) starts at 50 cm from patient's nose. Patient focuses on target as it is slowly moved toward nose to 5 cm (convergence), then back to 50 cm (divergence). Duration: 1 minute. Repetitions: 3 times under supervision.
Sponsors
University of Faisalabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
The assessor measuring DVA, SSQ, and SF-36 will not know group allocation. Participants and exercise providers cannot be blinded due to the nature of the exercises.
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Screen time \> 6 hours per day * Computer usage history of at least 10 years * Complaints of vertigo, blurred vision, and nausea during computer usage * Positive Romberg's test * Abnormal VOR (4-6 lines lost on LogMAR scale) * SSQ score between 20 and 40
Exclusion criteria
* Diagnosed vestibular disorders (e.g., BPPV, Meniere's) * History of falls in the past 6 months * Pregnancy * Any neurological or neurodegenerative disease * Use of walking aids * Severe visual impairments (worse than 6/12 on Snellen)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Vestibulo-Ocular Reflex (VOR) Function | Baseline (Week 0), Week 2, Week 4 | Measured by Dynamic Visual Acuity (DVA) test using a LogMAR chart. Patient reads smallest line possible while head is stationary (static VA). Then patient rotates head horizontally at 2Hz while reading. Number of lines lost between static and dynamic conditions is recorded. Normal VOR: 1-2 lines lost. Abnormal: 4-6 lines lost. Higher lines lost = worse VOR function. |
| Change in Cybersickness Severity | Baseline (Week 0), Week 2, Week 4 | Measured by the Simulator Sickness Questionnaire (SSQ). Contains 16 symptoms rated 0-3 (0=not at all, 3=severe). Total score range 0-48. Subscales: Nausea (symptoms 1,2,6,7,8,9,14,15), Oculomotor (3,4,5,10,11,12,13), and Disorientation (5,10,11,12,13,14,15). Higher score = worse cybersickness. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Quality of Life | Baseline (Week 0), Week 4 | Measured by the Short Form-36 (SF-36) Health Survey. Contains 36 items measuring 8 domains: Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health. Scores transformed to 0-100 scale per domain. Higher score = better quality of life. |
Countries
Pakistan
Outcome results
None listed