The Effects of Vestibular Rehabilitation Therapy Supported With Virtual Reality on Dizziness and Balance in the Elderly Patients With Dizziness
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Pamukkale University
- Enrollment
- 32
- Locations
- 1
- Primary Endpoint
- Vertigo Symptom Scale (Short form)
Study Overview
Brief Summary
Objective: To investigate the effect of vestibular rehabilitation exercises supported with virtual reality using virtual glasses technology on dizziness, static and dynamic balance, functional mobility, fear of falling, anxiety and depression in the short term (3 weeks) in the elderly with dizziness.
Detailed Description
INTRODUCTION:
Dizziness, is a condition that includes spatial orientation and motion perception disorder symptoms such as swivel illusion or sensation of instability, which can affect gaze stability, posture and walking. This problem is seen in about 30% of the elderly living in society and the prevalence increases with age (1). Patients with history of dizziness have limitations in daily activities, increased fear of falling, increased anxiety and depression, decreased quality of life, and increased risk of falls (2,3).
It has been shown that vestibular rehabilitation programs including postural control and balance exercises as well as recurrent head, eye, and trunk movements have positive effects on dizziness, balance and falling risk in the elderly (4,5).
Exercise programs are often performed in the clinical setting or at home, and participation in the exercise program of real-life environments such as a street, supermarket, park, workplace, where traffic is available can make a difference in patient motivation and exercise effectiveness. Positive effects on walking, postural control, balance and mobility in the elderly have been reported with exercises in the form of interactive games such as "Nintendo Wii", "Balance Rehabilitation Unit", dance video games where virtual reality technologies are used (6-10). There was no study investigating the effects of virtual reality created by virtual glasses and smartphone technology, on balance, functional mobility, falling risk, anxiety and depression in the elderly.
The objective of this study is to investigate the effect of vestibular rehabilitation exercises supported with virtual reality using virtual glasses technology on dizziness, static and dynamic balance, functional mobility, fear of falling, anxiety and depression in the short term (3 weeks) in the elderly with dizziness.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Masking Description
Single blind
Eligibility Criteria
- Ages
- 65 Years to — (Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Living in society
- •Being able to stand up and walk by themselves, without needing a supporting device
- •Consulting an otolaryngologist with the complaint of dizziness.
Exclusion Criteria
- •Presence of cognitive dysfunction
- •Presence of musculoskeletal or systemic disease that prevents exercise.
- •Having an exercise program in the last 6 months,
- •Presence of psychiatric or neurological diseases that affect cooperation and cognitive functions in their history,
- •Presence of neurological disease that affects balance in their history,
- •Positive Dix-Hallpike test,
- •Patients with a Vit D level lower than 30 ng /ml.
Arms & Interventions
Vestibular Rehabilitation
Vestibular Rehabilitation Program Exercises for Eye Movements: Smooth- Pursuit Eye Movements and Saccadic eye movements Exercises for Gaze Stability : Training of Vestibulo-ocular reflex and Cervico-ocular reflex Exercises for Postural Stability: In sitting or standing up position and walking
Duration of treatment: 3 weeks. Number of sessions: 15 Session frequency: 5 times a week. Session duration: 2 sets of 15 minutes, with a 5 minute break between sets, for a total of 35 minutes.
Intervention: Vestibular Rehabilitation supported with Virtual Reality (Other)
Vestibular Rehabilitation supported with Virtual Reality
Patients will perform the exercises in a virtual reality environment using a virtual reality goggle and a smartphone.The virtual environments consist of 2 media provided by the videos taken with a 360 camera . 1) A square with people moving, noise and traffic and 2) A supermarket where the shelves are full. Exercises conducted while sitting and standing on a soft ground will happen in the 1st environment, and the ones on the treadmill will happen in the 2nd environment.
Exercises for Eye Movements: Smooth- Pursuit Eye Movements and Saccadic eye movements Exercises for Gaze Stability : Training of Vestibulo-ocular reflex and Cervico-ocular reflex Exercises for Postural Stability: In sitting or standing up position and walking
Duration of treatment: 3 weeks. Number of sessions: 15 Session frequency: 5 times a week. Session duration: 2 sets of 15 minutes, with a 5 minute break between sets, for a total of 35 minutes.
Intervention: Vestibular Rehabilitation supported with Virtual Reality (Other)
Outcomes
Primary Outcomes
Vertigo Symptom Scale (Short form)
Time Frame: 3 weeks
Vertigo Symptom Scale (Short form) is a questionnaire consisting of 15 items evaluating the frequency of dizziness and / or unbalance and accompanying autonomic and anxiety symptoms within the last 1 month.
Dizziness Handicap Inventory
Time Frame: 3 weeks
The Dizziness Handicap Inventory , developed to measure disability in patients with dizziness and available for follow-up, is a questionnaire consisting of 25 questions about the physical, functional, and emotional state of the patient.
Berg Balance Test
Time Frame: 3 weeks
Berg Balance Test includes activities such as unsupported seating, standing from a seating position, standing without support, picking up an item from the floor, turning 360 degrees, looking back over the shoulder, and transferring from the bed to the chair.
Dynamic Posturography
Time Frame: 3 weeks
Biodex Balance System (Biodex, Inc., Shirley, New York) was used to evaluate the dynamic balance in elderly subjects Postural stability tests and the risk of falls (General Stability Index, Medio-lateral Stability Index, Antero-posterior Stability Index, Falling Risks Index) were calculated.
Secondary Outcomes
- Geriatric Depression Scale(3 weeks)
- Hamilton Anxiety Assessment Scale(3 weeks)
- Timed Up&Go (TUG) test(3 weeks)
- International Falls Efficacy Scale(3 weeks)
Investigators
Oya Topuz
MD, Professor
Pamukkale University