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 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.

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.

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.

Benign paroxysmal positional vertigo BPPV is a common inner ear disorder that causes brief episodes of dizziness triggered by head movements. This research aims to explore the link between BPPV and vitamin D deficiency, a condition that may affect the stability of calcium crystals in the inner ear and contribute to vertigo. The study is conducted at Sohag University Hospital in Egypt, where vitamin D deficiency is common and BPPV is frequently seen in patients. The study is a hospital-based case-control design enrolling 80 adults with BPPV and 80 matched controls without vertigo symptoms. All participants will undergo diagnostic testing including the Dix-Hallpike maneuver to confirm or exclude BPPV. Blood samples will be collected to measure serum levels of vitamin D using enzyme-linked immunosorbent assay ELISA. The research compares vitamin D levels between those with and without BPPV to investigate any association. Participants will provide demographic and medical history information and receive a full ear, nose, and throat exam. Researchers will record vitamin D levels and analyze their relationship with BPPV presence and recurrence. Data collection occurs over five months from April to September 2026, with analysis in October 2026. The primary outcome is the vitamin D level measured from enrollment up to one month after testing. The study maintains confidentiality and informed consent is obtained from all participants.

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 ears 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, Alexanders 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.

Researchers are collecting data from patients aged 4 to 99 years who experience various headache types, vertigo, and chronic pain conditions like fibromyalgia. This observational study aims to investigate the biological markers, imaging features, heart-lung right-to-left shunts, genetic traits, treatments, and outcomes related to these headache and vertigo disorders. Long-term follow-up is planned to better understand these conditions over time. Participants include groups with migraine including vestibular migraine, other primary headache disorders such as tension-type and cluster headaches, other vertigo disorders, secondary headache disorders, and a control group without headache or vertigo. The study gathers real-world treatment data and evaluates multiple clinical and biological characteristics to support comprehensive analysis. During the study, participants will undergo various assessments including biomarker collection, imaging, genetic analysis, and detailed clinical evaluations. Researchers will track outcomes such as migraine and headache days, vertigo attacks, headache severity, medication use, patient quality of life, and safety measures over periods ranging from six months to as long as 30 years. Data accuracy and participant privacy are closely maintained throughout the study.

This research aims to understand how cognitive load affects balance and the bodys ability to recover from sudden disturbances in young adults aged 18 to 30. The study looks at how doing mental tasks while trying to maintain balance impacts postural stability and the ability to prevent falls. It also compares these effects between male and female participants to fill gaps in knowledge about the connection between thinking processes and physical balance. Participants will undergo several assessments involving standing on force plates to measure static balance and balance recovery after being physically disturbed. They will perform tasks involving cognitive load, such as backward counting with subtraction and a color-naming test, during these assessments. The study uses devices to monitor heart rate variability and skin response to understand the cognitive loads impact on balance mechanisms. Different experimental conditions include balance testing alone, balance with cognitive tasks, and perturbation with or without cognitive tasks. Throughout the study, participants will be evaluated using various measures, including center of pressure, postural sway, balance recovery, heart rate variability, galvanic skin response, and a NASA Task Load Index to assess mental workload. These measurements occur at baseline and during interventions to see how cognitive tasks affect balance control. The study involves randomized group assignments and triple masking to ensure unbiased results. The total study duration and follow-up details are based on these assessments during the experimental sessions.