Vestibular Disorder

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.

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.

Researchers are studying the accuracy of a new device called the laryngopharyngeal endoscopic esthesiometer and rangefinder LPEER to measure throat sensitivity in patients suspected of having obstructive sleep apnea OSA. This prospective, double-blinded, randomized crossover trial aims to validate this devices measurements by comparing them to standard sleep study results. The study focuses on understanding sensory differences in patients with mild, moderate, and severe OSA and improving knowledge about OSAs underlying mechanisms. The study involves patients referred for a baseline sleep test who will undergo a sensory test using the LPEER, which delivers air pulses of varying intensity to specific throat areas the velopharynx, hypopharynx, and aryepiglottic folds. Experienced and less experienced pulmonologists or otolaryngologists will perform these tests to assess measurement reliability. The study design includes randomized crossover assignment of raters to evaluate intra- and inter-rater agreement and diagnostic accuracy through detailed statistical analyses. Participants will attend the sleep laboratory where they will receive the sensory test alongside their routine sleep study. Researchers will measure sensory thresholds at three throat sites and collect data related to sleep apnea severity, oxygen levels, and any adverse events. The study will last up to 15 days for each participant, during which safety and test accuracy will be closely monitored. Results will help determine the usefulness of LPEER for future clinical evaluation and monitoring of OSA patients.

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.

Diabetic Peripheral Neuropathy DPN is a common problem in people with type 2 diabetes, causing symptoms like pain, numbness, and balance difficulties. These issues can lead to falls, foot ulcers, and lower quality of life. Current treatments mainly focus on symptom management, so this study aims to evaluate if adding Neural Mobilization NM to balance training can further improve pain, balance, and quality of life in people with DPN. The trial is a randomized controlled study involving 32 patients aged 50 to 75 years. Participants will be randomly assigned to one of two groups for six weeks one group will receive Neural Mobilization combined with balance training plus standard care, while the other group will receive balance training alone along with standard care. Each group will have two 30-minute sessions per week. The NM protocol includes hot packs, TENS, nerve sliding and tensioning techniques, and various balance exercises that increase in difficulty over time. The balance training group receives similar physical therapy without the neural mobilization techniques. Throughout the study, participants will undergo assessments at the beginning and end of the six-week treatment period. Researchers will measure pain levels using the Numeric Pain Rating Scale, balance using the Berg Balance Scale, and quality of life with the Norfolk Quality of Life-Diabetic Neuropathy questionnaire. Data will be analyzed to determine if adding Neural Mobilization offers additional benefits. Ethical approval has been obtained, and participants will provide informed consent before joining.

Diabetes Mellitus, especially type 2, is a widespread condition often leading to Diabetic Peripheral Neuropathy DPN, which affects sensation and muscle control in the feet, legs, hands, and arms. This condition can cause symptoms like pain, numbness, and balance problems, increasing the risk of falls. This research aims to assess whether adding Proprioceptive Neuromuscular Facilitation PNF exercises to the Otago Exercise Program can improve balance, reduce fear of falling, and enhance sensory function in people with DPN. The study compares two groups one follows the Otago Exercise Program alone, which includes 14 strengthening and balance exercises targeting leg muscles and walking skills the other group combines Otago exercises with PNF, a method involving diagonal and spiral movement patterns designed to improve neuromuscular control through progressive resistance. Both interventions are delivered in sessions lasting 40 to 50 minutes, three times a week, over six weeks. Participants will be evaluated using measures such as the Berg Balance Scale, Fall Efficacy Scale, Functional Reach Test, and Semmes Weinstein Monofilament Test at the start and end of the six-week program. Screening includes the Michigan Neuropathy Screening Instrument and Berg Balance Scale to confirm eligibility. The study will document changes in balance, fear of falling, and sensory function to understand the effects of the exercise protocols on fall risk in this population.

This research aims to evaluate the safety and tolerability of a single unilateral administration of one of three dose levels of AAVAnc80-antiVEGF gene therapy in adults with unilateral vestibular schwannoma, a type of tumor affecting the ear. The trial also assesses the performance of the Akouos delivery device designed to safely deliver the gene therapy to the inner ear. This is a Phase 12 interventional trial sponsored by Akouos, Inc.