The objective of the study is to determine the effects of cawthorne cooksey exercises with addition of mental imagery on vertigo,dizziness and balance in young adults with vestibular hypofunctionThe study will be randomized control trial including 2 experimental groups with estimated 22 participants in each group.
The vestibular system detects motion of the head in space and in turn generates reflexes that are crucial for our daily activities, such as stabilizing the visual axis (gaze) and maintaining head and body posture. The vestibular system is comprised of two types of sensors: the two otolith organs (the saccule and utricle), which sense linear acceleration, and the three semicircular canals, which sense angular acceleration in three planes. The receptor cells of the otoliths and semicircular canals send signals through the vestibular nerve fibers to the neural structures that control eye movements, posture, and balance. Vestibular hypofunction i.e. a unilateral or a bilateral vestibulopathy, is a heterogeneous disorder of the peripheral and/or rarely central vestibular system leading typically to disabling symptoms such as dizziness, imbalance, and/or oscillopsia. Mental imagery (MI), also known as motor imagery or cognitive rehearsal, is the mental simulation of physical movement without actual execution. MI activates similar brain regions involved in physical movement and has been shown to improve motor performance, balance, and functional outcomes in various populations. However, its application in conjunction with vestibular rehabilitation for individuals with vestibular hypofunction remains underexplored. This study aims to investigate the combined effect of mental imagery and vestibular rehabilitation exercises on balance, dizziness, and vertigo in young adults diagnosed with vestibular hypofunction. The intervention will involve a structured VR program integrated with guided mental imagery sessions targeting balance and gaze stabilization tasks. Participants will be randomly assigned to two groups: one receiving only vestibular rehabilitation i.e cawthorne-cooksey exercises and the other receiving both VR and mental imagery training. Outcome measures such as the Dizziness Handicap Inventory (DHI), Mini-BESTest (Mini Balance Evaluation Systems Test and Vertigo Symptom Scale will be used to assess changes pre- and post-intervention. This research intends to determine whether the addition of mental imagery enhances the efficacy of vestibular rehabilitation in restoring functional balance and reducing dizziness symptoms. The findings could contribute to developing more comprehensive and accessible rehabilitation strategies for managing vestibular disorders in young adults.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
44
Cawthorne Cooksey exercises -Start with low to moderate intensity. Cawthorne Cooksey exercise Training Phase1-In bed exerercises:- Eye movements: 1)Up and down 2)Side to side 3)Moving finger away from face -Phase2-Sitting: Eye movements as above. Head movements at firsts low, then quick later with eyes closed -bending forward and backward -turning from side to side. --Shoulder shrugging and circling -Bending forward and picking up objects from the ground - Phase 3 - Standing: -Eye, Head, Shoulder movements -Throwing ball from hand to hand, hand under knee -Switch to sitting to standing and turning around in between. -Phase 4 - Walk: with eyes closed and open: -Across room -Slope and Stairs
The mental imagery intervention in this study is a structured, guided cognitive training program designed to enhance the effects of vestibular rehabilitation in young adults with unilateral vestibular hypofunction. Mental imagery (MI) involves the internal visualization and mental rehearsal of physical movements without actual motor output, engaging similar neural pathways as actual execution.
Alnasir Hospital Gujar Khan
Gujar Khān, Punjab Province, Pakistan
RECRUITINGRiphah International University
Islamabad, Pakistan
RECRUITINGVertigo Symptom Scale
The Vertigo Symptom Scale (VSS) is a self-report questionnaire designed to assess the severity and frequency of vertigo-related symptoms over the past month
Time frame: 8 week
• Dizziness Handicap Inventory
The Dizziness Handicap Inventory (DHI) is a self-reported questionnaire designed to evaluate the impact of dizziness on a person's daily life, emotional well-being, and functional ability. It is widely used in clinical practice for assessing vestibular dysfunction and tracking progress in rehabilitation. Purpose of DHI is to Measures how dizziness affects daily activities.
Time frame: 8 week
Mini-BESTest (Mini Balance Evaluation Systems Test)
The Mini-BESTest is a shortened version of the Balance Evaluation Systems Test (BESTest). It is designed to assess dynamic balance and identify impairments in postural control across different systems. This test is particularly useful for evaluating balance deficits in vestibular disorders
Time frame: 8 week
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