Dizziness

Researchers are investigating how balance and walking abilities relate to detailed movement measurements in people with Multiple Sclerosis MS. This observational study focuses on understanding the connection between clinical tests of function and objective biomechanical data. The goal is to identify which movement characteristics best reflect balance, gait, and physical performance challenges faced by individuals with MS. Participants will attend a single laboratory session where they undergo biomechanical analysis using the Vicon motion capture system. They will complete functional assessments of balance, gait, and physical performance, as well as questionnaires about fear of falling and fatigue. Spasticity in the lower limbs will also be assessed during this visit. During the session, participants will perform tests such as the mini-BESTest for balance, Functional Gait Assessment, Short Physical Performance Battery, and a 2-minute walk test. Questionnaires like the Fall Efficacy Scale and Fatigue Severity Scale will be completed. Researchers will analyze these collected data to explore how biomechanical and functional measures relate, aiming to improve assessment tools for MS rehabilitation.

Researchers are evaluating a low-cost augmented reality platform for balance training in patients with balance disorders caused by degenerative injuries or cerebrovascular diseases. The study aims to determine if the system is usable, acceptable, safe, and if it improves balance. The trial is a usability study conducted by the Hospital Universitari Vall dHebron Research Institute. The intervention has two phases the first phase lasts four weeks with supervised balance training sessions at the hospital, conducted for 60 minutes, three times a week. If patients meet inclusion criteria, the intervention continues for two additional weeks at home with a family member trained to assist as a training partner. The platform uses different exercise protocols accessed through RGSweb, including balance and sit-to-stand exercises with visual targets and movement tracking. Participants undergo three assessments before treatment Day 0, after the hospital phase Week 4, and after the home phase Week 6. Evaluations include usability scales, adherence measures, balance tests like the Berg Balance Scale, postural sway, sit-to-stand tests, balance confidence, and quality of life questionnaires. Safety is monitored throughout, and adherence is tracked during both hospital and home interventions.

Researchers are evaluating a new approach to care for patients experiencing dizziness in the emergency department ED. This multi-site feasibility trial compares placing a physical therapist directly in the ED to start care immediately versus the usual care where patients might wait for outpatient therapy. The study aims to assess the ability to enroll patients, deliver the intervention properly, and collect patient outcome data over time. The trial will take place at two hospital EDs, each randomly assigned to either the embedded physical therapy intervention or usual care. The intervention involves a physical therapist providing standard exercises, maneuvers, and coaching directly in the ED during patient visits from 8am to 8pm. Usual care consists of typical ED tests and treatments without physical therapy involvement. A third hospital will contribute baseline data but will not enroll participants. The active intervention phase lasts 9 months, followed by 12 months of ongoing data collection. Participants will be adults 18 years or older who visit the ED with dizziness during the specified hours and speak English or Spanish. Researchers will collect surveys from participants over 12 months to measure dizziness impact and retention rates, along with electronic health record data on therapy adoption, care fidelity, and healthcare use. Clinician feedback on the interventions acceptability and feasibility will also be gathered before and after the study period. The total study duration for each participant includes the 9-month intervention and 12-month follow-up.

About 20% of adults experience recurrent fainting, leading to significant symptoms, difficulties with work and driving, injuries, and reduced quality of life. Because few treatments have been proven effective in randomized trials, researchers are conducting a phase 2, randomized, double-blind study to test if blocking serotonin 5HT3 receptors with ondansetron can prevent fainting or near fainting caused by tilt-induced vasovagal syncope VVS. This study aims to provide preliminary data for future larger trials. Participants will be randomly assigned to receive either two doses of ondansetron 8 mg by mouth one the evening before and one the morning of the study or matching placebo doses on separate days. After dosing, participants undergo a tilt table test where their heart rhythm, blood pressure, and blood samples will be monitored continuously for up to 60 minutes or until fainting occurs. Additional measurements include bioelectrical impedance to assess fluid shifts in the body during posture changes and questionnaires to evaluate quality of life, anxiety, and depression. During the study, participants will have ECG electrodes and a blood pressure cuff applied, along with an intravenous line for blood sampling. Blood samples will be collected at baseline and during the tilt test to measure catecholamine levels. Participants will also complete online surveys assessing health-related quality of life and mood symptoms. The main outcome is the time until fainting or near fainting within one hour. Secondary outcomes include stroke volume, cardiac output, vascular resistance, and psychological measures monitored during the study and within 12 months. The study lasts about one day for the tilt test and includes follow-up assessments up to one year.

Researchers are evaluating auricular transcutaneous vagus nerve stimulation aTVNS as a treatment for chronic dizziness, including Persistent Postural-Perceptual Dizziness PPPD. The study aims to measure changes in dizziness using the Dizziness Handicap Inventory DHI score after a 4-week treatment period. This is a randomized, double-blind trial sponsored by Mayo Clinic that compares active aTVNS with a sham control device. Participants are randomly assigned to one of two groups. The active treatment group will perform two daily sessions of aTVNS, each about 30 minutes, totaling 1 hour per day for 8 weeks. The sham control group will perform two daily sessions using a device that mimics stimulation without electrical current for 4 weeks, then switch to the active treatment for the remaining 4 weeks. The aTVNS device delivers mild electrical pulses to the ear to stimulate the vagus nerve. During the study, participants will complete assessments at baseline, 4 weeks, and 8 weeks. Researchers will measure dizziness changes using the DHI score, anxiety levels, postural sway, and frequency of dizzy days. The study includes monitoring of symptoms and safety throughout the approximately 8-week period. The goal is to understand the effects of aTVNS on dizziness and related symptoms in adults with PPPD.

Researchers are evaluating an experimental vestibular implant system designed to improve balance in adults with bilateral vestibulopathy, a condition causing balance deficits and hearing loss. The implant is combined with a cochlear implant sound processor and programming software, aiming to preserve hearing in the implanted ear. This study focuses on adults with normal to severe hearing loss in the inner ear who have not benefited from conventional rehabilitation. The vestibular implant is surgically placed under the skin behind the ear in the mastoid bone and includes an electrode that stimulates the vestibular nerve. A sound processor worn behind the ear powers the implant via a coil. Participants will receive this implant and undergo a personalized rehabilitation program. The study evaluates changes in balance and hearing over time after implantation. Participants will be assessed before surgery and followed for six months after activation of the implant. Assessments include balance performance tests like the Dynamic Gait Index and Functional Gait Assessment, posturography tests, hearing threshold measurements, and questionnaires on dizziness, fall risk, and quality of life. Device or procedure-related adverse events will also be monitored throughout the study period.

This research focuses on adapting and implementing the Action Falls programme, originally designed to prevent falls in care home residents, for older adults receiving domiciliary home care. The programme aims to identify reasons for falls and suggest preventive actions such as medication reviews and encouraging physical activity. The study particularly targets older people supported by home care services in rural and coastal areas of Nottinghamshire and Lincolnshire. The project involves observing home care visits and interviewing older adults, their relatives, care workers, and decision makers to understand how to adjust the programme materials and delivery for home settings. This includes co-design workshops to tailor training, manuals, and checklists to better suit domiciliary care needs. The adapted programme will then be prepared for future evaluation of its effectiveness in preventing falls within home care contexts. Participants will be observed and interviewed to inform the adaptation process, with data collected on programme changes using an implementation research framework over 18 months. The study will monitor how the programme is shaped for home care delivery, involving various stakeholders such as older adults, their families, care workers, and social care leaders. The total study period runs from July 2026 to June 2028, with future studies planned to evaluate the adapted programmes impact.

Researchers are conducting a study called Acutelines, a large data and biobank project at the University Medical Center Groningen in the Netherlands. It focuses on patients with a wide range of acute medical conditions who present to the Emergency Department. The goal is to improve how acute diseases are recognized and treated, understand their outcomes, and support personalized medicine by collecting detailed clinical data, imaging, and biomaterials over time. Participants have their medical information, including demographics, health status, medical history, vital signs, diagnostic tests, and treatments, systematically collected. Biomaterials such as blood, urine, feces, and hair are gathered from patients who meet certain severity criteria. Data collection occurs during hospital admission, including continuous monitoring, and continues with follow-ups at 3 months, 1 year, 2 years, and 5 years after the initial emergency visit. Throughout the study, various assessments are performed, such as quality of life, physical functioning, mental health, symptoms, and hospital length of stay. Researchers collect data on mortality and other health outcomes for up to 50 years. The study uses digital tools to automate data capture and integrates information from multiple healthcare sources. Participants will be monitored closely during hospitalization and at scheduled intervals afterward to help improve understanding and treatment of acute diseases.

Researchers are evaluating the Home Hazard Removal Program HARP, adapted for people with disabilities PwD, to prevent falls by identifying and removing hazards in the home. This pilot randomized controlled trial RCT will test how well the adapted HARP works and how it can be implemented for community-dwelling PwD. The study uses frameworks like RE-AIM and PRISM to guide adaptation, design, and evaluation, aiming for broad usefulness and dissemination of findings. Participants will be randomized into two groups one receiving the adapted HARP intervention and the other placed on a waitlist control receiving virtual social visits. The adapted HARP involves two to three in-home visits by an occupational therapist over about five weeks to identify fall hazards and collaboratively create solutions. Additional visits and a contractor, if needed, help implement home modifications, all provided at no cost. Booster visits occur 3 to 6 months later to check and support ongoing home safety. Participants will be followed for 12 months, with monthly tracking of falls, fall-related injuries, and home modifications. Fear of falling is assessed at the start and end of the study. Researchers will collect quantitative and qualitative data, including interviews and focus groups, to evaluate hazard types, costs, adherence to modifications, and barriers to adoption. The total study duration includes the intervention and follow-up to monitor safety and effectiveness in everyday home settings.

Benign Paroxysmal Positional Vertigo BPPV is a common cause of recurrent vertigo that affects about 2.4% of people during their lifetime, especially older adults. It causes brief episodes of vertigo, dizziness, and imbalance that can reduce quality of life. Although maneuvers to reposition the inner ear crystals are effective, BPPV often recurs, so this study is evaluating if adding Brandt-Daroff exercises to the GANS Maneuver can further reduce dizziness and improve quality of life in patients with BPPV. Participants will be randomly assigned to one of two groups one group will receive the GANS Maneuver alone, while the other will receive the GANS Maneuver combined with Brandt-Daroff exercises. The intervention lasts six weeks, with supervised GANS Maneuver sessions held twice weekly, each including three repetitions. Those in the combined group will also perform Brandt-Daroff exercises at home twice daily. The total supervised GANS sessions will be 12, and the Brandt-Daroff exercises will be done 36 times at home during the study. During the study, dizziness and quality of life will be assessed using the Dizziness Handicap Inventory Scale DHI and the Vestibular Activities and Participation VAP Scale at the start and after six weeks of treatment. Participants will attend regular supervised sessions for assessment and treatment. Data will be analyzed to see if adding Brandt-Daroff exercises improves outcomes compared to GANS Maneuver alone. The study is conducted over one year with ethical approval and careful monitoring of participants.