Dancing Eyes: The Effect of Rhythmic Auditory Stimulation on VOR Gain Adaptation Among Healthy Adults - A Randomized Clinical Trial

The goal of this study is to learn whether adding rhythmic sound (a metronome beat or music) to eye-head exercises can improve the reflex that keeps vision clear during head movement. This reflex, called the vestibulo-ocular reflex (VOR), helps maintain visual stability during activities such as walking, turning, or bending. This type of training may help people with dizziness or balance problems, but this study focuses on healthy adults.

The main questions addressed are:

Does performing VOR exercises with a steady metronome beat improve the VOR more than performing the same exercises in silence?

Does performing the exercises while listening to self-selected rhythmic music also improve the VOR, and is the effect better or worse than a metronome?

Do the different sound conditions change how difficult the training feels or how dizzy participants feel?

Three conditions will be compared:

Silence: standard VOR training with no sound Metronome: training timed to a simple, steady beat Music: training performed while listening to self-selected music with a clear beat

The study will assess whether adding rhythmic sound leads to greater improvement in VOR gain and whether one type of sound is more effective than another.

Participants are healthy adults. Participants will:

Attend the laboratory for three separate visits, each with a different sound condition (silence, metronome, and music).

Visits will be at least 48 hours apart.

Wear specialized goggles that record eye and head movements (EyeSeeCam).

Perform brief eye-head tests before and after training, consisting of rapid head turns while maintaining fixation on a visual target.

Complete 15 minutes of Incremental VOR adaptation training during each visit, repeating rapid head turns while fixating on a laser projected target (StableEyes). In some sessions movements will be synchronized to a metronome or music.

Rate perceived training difficulty, ease of following the rhythm, and any dizziness or discomfort.

By comparing results across the three conditions within the same participants, the study will determine whether a simple, low-cost rhythmic cue can enhance the effects of standard VOR exercises without increasing discomfort.