In this study the investigators propose to apply cognitive training, which has been largely used in the realm of age-related cognitive decline, dementia, and Alzheimer's disease, in a novel clinical context to individuals with vestibular impairment. In prior work the investigators observed that individuals with vestibular loss have evidence of spatial cognitive impairment. The investigators plan to evaluate the preliminary efficacy and feasibility of a cognitive training program in a sample of participants with chronic vestibular impairment who display deficits in spatial ability. The cognitive training program will focus on visuospatial skills and will be used as an adjunct to traditional vestibular physical therapy (VPT).
Patients with chronic vestibular dysfunction with report symptoms of spatial cognitive impairment will be offered cognitive training. The intervention will consist of a well-validated cognitive training protocol that specifically targets spatial navigation skills. The protocol was developed by Willis et al. for the Adult Development and Enrichment Trial (ADEPT) trial, which trains map reading and route-learning skills through mental rotation training tasks over the course of 5 weeks. Patients will be assessed by study staff pre-intervention, immediately post-intervention and at 3 months post-intervention using spatial cognitive outcomes, quality of life measures, and gait and balance outcomes.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
map reading and route-learning skills
Change from baseline in Dizziness Handicap Inventory
Subjective 25-item questionnaire measuring Quality of Life and disability on a scale from 0-100
Time frame: Baseline vs immediately post-training
Change from immediate post-training to 3-months post-training in Dizziness Handicap Inventory
Subjective 25-item questionnaire measuring Quality of Life and disability on a scale from 0-100
Time frame: Immediately post-training to 3 months post-training
Change from baseline in Dynamic Gait Index
Balance challenges during 8 different gait tasks (head turns, speed changes, over/around obstacles) with total score out of 24 points.
Time frame: Baseline vs immediately post-training
Change from immediate post-training to 3-months post-training in Dynamic Gait Index
Balance challenges during 8 different gait tasks (head turns, speed changes, over/around obstacles) with total score out of 24 points.
Time frame: Immediately post-training to 3 months post-training
Change from baseline in Four Square Step Test
Assesses dynamic balance, spatial, \& sequencing skills while stepping forward/back/sideways over a low obstacle (measured in seconds)
Time frame: Baseline vs immediately post-training
Change from immediate post-training to 3-months post-training in Four Square Step Test
Assesses dynamic balance, spatial, \& sequencing skills while stepping forward/back/sideways over a low obstacle (measured in seconds)
Time frame: Immediately post-training to 3 months post-training
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Change from baseline in Money Road Map Test
Assessment of egocentric mental rotation in space by recording total number of errors in right-left discrimination mental rotation tasks.
Time frame: Baseline vs immediately post-training
Change from immediate post-training to 3-months post-training in Money Road Map Test
Assessment of egocentric mental rotation in space by recording total number of errors in right-left discrimination mental rotation tasks.
Time frame: Immediately post-training to 3 months post-training
Change from baseline in Benton Visual Retention Test
visual perception and visual memory assessment by asking participant to reproduce 10 designs following a 10-second exposure and scored 0-10 based on correct drawing reconstruction.
Time frame: Baseline vs immediately post-training
Change from immediate post-training to 3-months post-training in Benton Visual Retention Test
visual perception and visual memory assessment by asking participant to reproduce 10 designs following a 10-second exposure and scored 0-10 based on correct drawing reconstruction.
Time frame: Immediately post-training to 3 months post-training
Change from baseline in modified Clinical Test of Sensory Organization and Balance
Static standing balance during 4 conditions where sensory inputs are altered (eyes open/eyes closed on firm/foam surface) and each condition is timed for max of 30 seconds.
Time frame: Baseline vs immediately post-training
Change from immediate post-training to 3-months post-training in modified Clinical Test of Sensory Organization and Balance
Static standing balance during 4 conditions where sensory inputs are altered (eyes open/eyes closed on firm/foam surface) and each condition is timed for max of 30 seconds.
Time frame: Immediately post-training to 3 months post-training
Change from baseline in Activities-specific Balance Confidence Scale
Subjective questionnaire that determines confidence during daily tasks (scores range 0-100%)
Time frame: Baseline vs immediately post-training
Change from immediate post-training to 3-months post-training in Activities-specific Balance Confidence Scale
Subjective questionnaire that determines confidence during daily tasks (scores range 0-100%)
Time frame: Immediately post-training to 3 months post-training
Change from baseline in Santa Barbara Sense of Direction Scale
15 question related to subjective sense of direction adeptness (ranging 1-7 for each item); cumulative score is divided by number of responses answered to yield a 1-7 total score.
Time frame: Baseline vs immediately post-training
Change from immediate post-training to 3-months post-training in Santa Barbara Sense of Direction Scale
15 question related to subjective sense of direction adeptness (ranging 1-7 for each item); cumulative score is divided by number of responses answered to yield a 1-7 total score.
Time frame: Immediately post-training to 3 months post-training