Dizziness

Researchers are investigating the relationship between functional measures of balance and gait and objective kinetic and kinematic parameters in people with Multiple Sclerosis (MS). This cross-sectional observational study aims to understand how biomechanical gait and balance data collected through the Vicon motion analysis system relate to clinical assessments of balance, gait, and physical performance. The study seeks to identify which biomechanical factors are most closely linked to functional abilities and mobility challenges in MS. Participants will attend a single laboratory session where they will undergo biomechanical analysis of balance and gait using the Vicon motion capture system. They will also complete standardized functional tests including the Mini Balance Evaluation Systems Test, Functional Gait Assessment, Short Physical Performance Battery, and a 2-Minute Walk Test. Additionally, they will fill out questionnaires assessing fear of falling and fatigue and have their lower-limb spasticity evaluated with the modified Ashworth Scale. During the session, which takes about 40 minutes for the primary kinetic and kinematic analysis and additional time for functional assessments, researchers will collect detailed movement data alongside clinical measures. This data will be analyzed to explore correlations between biomechanical parameters and functional outcomes. The study includes assessments of postural control, gait performance, physical endurance, fatigue, and spasticity. The findings aim to improve understanding of movement impairments in MS and support better clinical assessments and rehabilitation approaches.

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 d'Hebron 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 intervention’s 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 whether an experimental vestibular implant system can improve balance in adults with bilateral vestibulopathy who have normal to severe hearing loss. The implant system includes a vestibular implant surgically placed behind the ear in the mastoid bone, combined with a cochlear implant sound processor and programming software, designed to preserve hearing in the implanted ear. The study aims to assess safety and performance in restoring balance in this population. Participants will receive the vestibular implant device, which stimulates the vestibular nerve via an electrode. The sound processor worn behind the ear powers the implant. The study includes a baseline pre-surgery phase and a six-month post-implantation follow-up period to evaluate changes in balance and hearing function. The intervention is implanted surgically and assessed over time. During the study, participants will undergo various tests to evaluate balance and hearing, including the Dynamic Gait Index, Functional Gait Assessment, posturography sensory tests, and questionnaires on dizziness, fall risk, and quality of life. Hearing thresholds will also be monitored. Assessments occur from baseline up to six months after activation of the implant. Safety and device-related adverse events will be closely monitored throughout the study.

Researchers are evaluating a combined therapy called Acceptance and Commitment Therapy Integrated Vestibular Rehabilitation (ACTIVE) for individuals aged 18 to 49 who have vestibular symptoms related to mild traumatic brain injury (mTBI). This trial compares ACTIVE with usual care vestibular rehabilitation (VESTIB CONTROL) to see which approach better reduces symptoms and improves recovery. The study focuses on military service members and civilians who experience ongoing dizziness and related impairments after mTBI. Participants in the ACTIVE group will receive four weekly 90-minute sessions combining Acceptance and Commitment Therapy (ACT) and targeted vestibular rehabilitation exercises, along with daily at-home activities over four weeks. The ACT component focuses on psychological flexibility and mindfulness. The comparison group will receive usual care vestibular rehabilitation and other supportive treatments excluding ACT, also delivered weekly over four weeks. Both groups will have individualized care based on their needs. Participants will be assessed before treatment and at 4 weeks, 3 months, and 6 months after treatment ends. Assessments include dizziness severity, anxiety levels, vestibular function tests, symptom questionnaires, and activity monitoring using Fitbit devices. Researchers will monitor symptoms, functional improvements, and return to activity status. The total participation period covers about six months, allowing for evaluation of both short- and longer-term outcomes.

Researchers are studying the immediate effects of fibular repositioning taping on balance, jumping, and sprint performance in healthy young women aged 18 to 30. This randomized controlled trial aims to find out if this taping method changes physical performance compared to sham taping or no taping. The study focuses on short-term changes in selected performance measures among healthy participants to understand the taping's impact. Participants are randomly assigned to one of three groups: fibular repositioning taping applied to the dominant ankle, sham taping that looks similar but lacks therapeutic repositioning, or a control group with no taping. Baseline assessments are done before the intervention, and outcome measurements are repeated 30 minutes after the taping or waiting period. The intervention uses a rigid taping technique intended to support fibular positioning. During the study, participants undergo tests including the Y Balance Test, horizontal and vertical jump tests, and a 10-meter sprint test at baseline and 30 minutes after intervention or waiting. Researchers measure these functional outcomes to assess any changes in physical performance. The study is conducted under controlled conditions with single masking and random group allocation, and participation lasts only for the duration of the testing session.

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.