Vertigo

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.

Researchers are evaluating the safety, tolerability, and effectiveness of the gene therapy SENS-501 in children aged 6 to 31 months who have severe to profound hearing loss caused by mutations in the Otoferlin gene. This open-label Phase I/II study focuses on children with pre-lingual hearing loss due to these genetic mutations, aiming to better understand how this treatment works in this young population. The study involves administering SENS-501 directly into one ear using a special injection system. It includes a dose-escalation phase where children receive either a low or high dose, followed by a dose expansion phase where the dose recommended from earlier phases is given. The treatment is given as a single unilateral intracochlear injection, and the administration system's safety, performance, and usability are also evaluated. Participants will be followed for up to 5 years to monitor safety and tolerability and to assess hearing improvement using auditory brainstem response (ABR) and pure tone audiometry (PTA). Additional evaluations include clinical checks of the administration system shortly after treatment. Throughout the study, children will undergo hearing tests and medical assessments to measure outcomes and track any side effects or complications from the treatment and procedure.

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.

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.

Stroke is a leading cause of disability, often resulting in difficulties with walking and balance that reduce quality of life. This research investigates the additional effects of combining functional muscle training with turning-based specific training on turning ability, balance, and quality of life in patients who have experienced a subacute or chronic stroke. The study is designed as a randomized controlled trial to provide new treatment protocols targeting turning during gait rehabilitation. Participants are divided into two groups: one receiving both functional muscle training and turning-based specific training, and the other receiving only turning-based specific training. The functional muscle training focuses on strengthening lower body muscles such as hip abductors, adductors, flexors, extensors, plantarflexors, dorsiflexors, and rotators using exercises with progressive resistance bands over six weeks. Turning-based training progresses through various exercises involving 90-degree turns, figure-of-eight walking, step across body, braiding, and obstacle avoidance. Participants will be assessed at the start and after six weeks of intervention using tests for turning performance like the Standing Turn Test and Figure of 8 Test, as well as balance measures including the Berg Balance Scale, Timed Up and Go Test, and Modified 4 Square Step Test. The study aims to evaluate improvements in turning, balance, and quality of life, with data analyzed using recognized statistical software. This involvement offers participants structured rehabilitation aiming to address turning difficulties after stroke and reduce fall risk.

This research aims to explore how the vestibular system influences motor and cognitive development in school-aged children. It focuses on children with typical development, those with vestibular impairments, and children diagnosed with neurodevelopmental disorders such as Autism Spectrum Disorder, ADHD, or Developmental Coordination Disorder. The goal is to better understand how vestibular dysfunctions at birth or early life stages affect various developmental areas including balance, cognition, motor skills, and psychosocial performance. Participants undergo the Balanced Growth Protocol, a comprehensive behavioral assessment including audiovestibular testing, cognitive tasks, and motor evaluations. The study groups include typically developing children, vestibular-impaired children recently diagnosed with vestibular dysfunction, and children with neurodevelopmental disorders. Each group completes the same testing protocol designed to detect vestibular, cognitive, and motor dysfunctions and investigate their interrelations. During the study, children attend two main test moments involving assessments such as video Head Impulse Test, Rotatory chair, caloric tests, vestibular evoked myogenic potentials, and various motor and cognitive tests. These evaluations measure vestibular function, motor skills, and cognitive abilities, including attention and executive function. Parents complete questionnaires about executive function as well. All tests are conducted once during the scheduled visits, with total testing times varying between 5 to 20 minutes per assessment. The study tracks detailed performance outcomes to understand vestibular involvement in child development.

Vestibular neuritis is a severe and ongoing dizzying condition caused by inflammation of the nerve connected to the inner ear's balance canals. It causes sudden, intense vertigo with balance problems, nausea, and vomiting, but without hearing loss or other neurological symptoms. This condition is the second most common cause of peripheral vertigo and accounts for about 7% of vertigo cases. The study aims to determine if wearing Boarding Ring glasses can help speed up recovery of balance in people with vestibular neuritis. Participants are randomly assigned to one of three groups: wearing Boarding Ring glasses, wearing placebo glasses, or not wearing any glasses. Each group undergoes several tests including caloric tests, measurement of eye movement speed (nystagmus), angle of deviation in the Fukuda test, Alexander's degree of nystagmus, and completes questionnaires assessing balance disorder impact and anxiety. These evaluations occur at the start and over the course of one year to monitor changes. During the study, participants will perform balance-related tests such as walking in place and have eye movements recorded with special helmets. Questionnaires will assess the impact of vertigo on daily life and anxiety levels. The main outcome is the change in angle of deviation in the Fukuda test from day 0 to day 7. Secondary outcomes include eye movement speed, degree of nystagmus, hospitalization duration if applicable, and questionnaire scores over one year. The study monitors participants closely to understand how Boarding Ring glasses affect recovery from vestibular neuritis.

Stroke often leads to difficulties with movement, balance, and thinking skills, affecting daily life and independence. This research compares two types of body weight-supported gait training: one using virtual reality with dual-task activities and the other using forward and backward walking training. The goal is to find better rehabilitation methods to improve walking, balance, and cognitive function in people who have had a stroke. Participants will receive conventional rehabilitation therapies like physiotherapy, occupational therapy, and speech therapy for six weeks, five days per week. Along with this, they will undergo one of three training programs: virtual reality-assisted forward walking, backward walking, or forward walking with 30% body weight support. Each gait training session lasts 30 minutes daily for six weeks. During the study, researchers will assess walking ability using tests like the 10-Meter Walk Test and 6-Minute Walk Test at the start and after six weeks. They will also measure balance, motor function, cognitive status, psychological health, and gait details such as step length and speed. These evaluations help understand how different training methods affect recovery and mobility after stroke.