Trial Outcomes & Findings for Computerized Vestibular Rehabilitation (NCT NCT03589859)

NCT ID: NCT03589859

Last Updated: 2024-11-26

Results Overview

The vestibulo-ocular reflex gain is the relationship between a rotation of the head and the evoked eye movement. The outcome measure is the ratio of the VOR gain after training to that before training. VOR gain is determined by a scaled fit of eye speed to evoking head speed (normal gain is 1). Note that this experiment was not a treatment of impairment but a test of the ability of the vestibular game to elicit motor learning (away from normal) in individuals with intact motor learning. In that context, an increase in the gain to a value greater than unity (faster eye movement relative to the head movement) is "better" with respect to the training goal, but it is not "better" with respect to real-world visual function, for which a gain of one is the goal. There is no threshold value for this type of motor learning experiment. Instead, the question is whether the gain is increased after training, and if so, by what percentage relative to the training goal.

Recruitment status

COMPLETED

Target enrollment

24 participants

Primary outcome timeframe

VOR measurements to determine gain were performed immediately before and after each approximately 30 minute training session. Pre- and post-training gains were then combined in the VOR gain ratio to determine the training effect.

Results posted on

2024-11-26

Participant Flow

Participant milestones

Participant milestones
Measure
Normal Volunteers
Healthy individuals with intact vestibular function VOR Test: Video-oculography is used to record the vestibulo-ocular reflex during active and passive turns of the head. Computer Game: Participants play a custom computer game that is designed to produce motor learning in the vestibulo-ocular reflex
Vestibular Hypofunction
Veterans with peripheral vestibular hypofunction VOR Test: Video-oculography is used to record the vestibulo-ocular reflex during active and passive turns of the head. Computer Game: Participants play a custom computer game that is designed to produce motor learning in the vestibulo-ocular reflex
Overall Study
STARTED
18
6
Overall Study
COMPLETED
18
0
Overall Study
NOT COMPLETED
0
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Normal Volunteers
Healthy individuals with intact vestibular function VOR Test: Video-oculography is used to record the vestibulo-ocular reflex during active and passive turns of the head. Computer Game: Participants play a custom computer game that is designed to produce motor learning in the vestibulo-ocular reflex
Vestibular Hypofunction
Veterans with peripheral vestibular hypofunction VOR Test: Video-oculography is used to record the vestibulo-ocular reflex during active and passive turns of the head. Computer Game: Participants play a custom computer game that is designed to produce motor learning in the vestibulo-ocular reflex
Overall Study
Withdrawal by Subject
0
6

Baseline Characteristics

Assessed only in participants with vestibular dysfunction

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Normal Volunteers
n=18 Participants
Healthy individuals with intact vestibular function VOR Test: Video-oculography is used to record the vestibulo-ocular reflex during active and passive turns of the head. Computer Game: Participants play a custom computer game that is designed to produce motor learning in the vestibulo-ocular reflex
Vestibular Hypofunction
n=6 Participants
Veterans with peripheral vestibular hypofunction VOR Test: Video-oculography is used to record the vestibulo-ocular reflex during active and passive turns of the head. Computer Game: Participants play a custom computer game that is designed to produce motor learning in the vestibulo-ocular reflex
Total
n=24 Participants
Total of all reporting groups
Age, Continuous
35 years
STANDARD_DEVIATION 13 • n=18 Participants
61 years
STANDARD_DEVIATION 15 • n=6 Participants
42 years
STANDARD_DEVIATION 17 • n=24 Participants
Sex: Female, Male
Female
9 Participants
n=18 Participants
0 Participants
n=6 Participants
9 Participants
n=24 Participants
Sex: Female, Male
Male
9 Participants
n=18 Participants
6 Participants
n=6 Participants
15 Participants
n=24 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=18 Participants
0 Participants
n=6 Participants
1 Participants
n=24 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
16 Participants
n=18 Participants
6 Participants
n=6 Participants
22 Participants
n=24 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=18 Participants
0 Participants
n=6 Participants
1 Participants
n=24 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=18 Participants
0 Participants
n=6 Participants
0 Participants
n=24 Participants
Race (NIH/OMB)
Asian
3 Participants
n=18 Participants
0 Participants
n=6 Participants
3 Participants
n=24 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=18 Participants
0 Participants
n=6 Participants
0 Participants
n=24 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=18 Participants
1 Participants
n=6 Participants
1 Participants
n=24 Participants
Race (NIH/OMB)
White
14 Participants
n=18 Participants
5 Participants
n=6 Participants
19 Participants
n=24 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=18 Participants
0 Participants
n=6 Participants
0 Participants
n=24 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=18 Participants
0 Participants
n=6 Participants
1 Participants
n=24 Participants
Region of Enrollment
United States
18 Participants
n=18 Participants
6 Participants
n=6 Participants
24 Participants
n=24 Participants
Dizziness Handicap Inventory
31.6 units on a scale
STANDARD_DEVIATION 16.7 • n=6 Participants • Assessed only in participants with vestibular dysfunction
31.6 units on a scale
STANDARD_DEVIATION 16.7 • n=6 Participants • Assessed only in participants with vestibular dysfunction
Activities-specific Balance Confidence scale
79.5 units on a scale
STANDARD_DEVIATION 14.0 • n=6 Participants • Assessed only in participants with vestibular dysfunction
79.5 units on a scale
STANDARD_DEVIATION 14.0 • n=6 Participants • Assessed only in participants with vestibular dysfunction

PRIMARY outcome

Timeframe: VOR measurements to determine gain were performed immediately before and after each approximately 30 minute training session. Pre- and post-training gains were then combined in the VOR gain ratio to determine the training effect.

Population: This measure applied only to Group 1: healthy individuals with intact vestibular function

The vestibulo-ocular reflex gain is the relationship between a rotation of the head and the evoked eye movement. The outcome measure is the ratio of the VOR gain after training to that before training. VOR gain is determined by a scaled fit of eye speed to evoking head speed (normal gain is 1). Note that this experiment was not a treatment of impairment but a test of the ability of the vestibular game to elicit motor learning (away from normal) in individuals with intact motor learning. In that context, an increase in the gain to a value greater than unity (faster eye movement relative to the head movement) is "better" with respect to the training goal, but it is not "better" with respect to real-world visual function, for which a gain of one is the goal. There is no threshold value for this type of motor learning experiment. Instead, the question is whether the gain is increased after training, and if so, by what percentage relative to the training goal.

Outcome measures

Outcome measures
Measure
Normal Volunteers
n=18 Participants
Healthy individuals with intact vestibular function VOR Test: Video-oculography is used to record the vestibulo-ocular reflex during active and passive turns of the head. Computer Game: Participants play a custom computer game that is designed to produce motor learning in the vestibulo-ocular reflex
Vestibular Hypofunction
Veterans with vestibular hypofunction
Vestibulo-ocular Reflex Gain Ratio
1.15 unitless gain ratio
Interval 1.1 to 1.2

OTHER_PRE_SPECIFIED outcome

Timeframe: Immediately after each 10-minute game block, median value calculated for each participant

Population: This measure applied only to Group 2: participants with vestibular dysfunction. Of the 6 enrolled participants in this group, one chose not to complete the game playing after consenting, and a second was found to have recovery of his vestibular function before game playing. The reported data are from the remaining four participants.

Participants with vestibular hypofunction rated their nausea after each game block on a scale of 1 to 10. For each visit, there were up to 3 game-blocks, each of 10-minutes duration. The number of blocks was determined by the participant. A higher score is a worse outcome (more nausea). The average nausea scale rating was determined for each participant. The final result is the median of these averaged scores.

Outcome measures

Outcome measures
Measure
Normal Volunteers
Healthy individuals with intact vestibular function VOR Test: Video-oculography is used to record the vestibulo-ocular reflex during active and passive turns of the head. Computer Game: Participants play a custom computer game that is designed to produce motor learning in the vestibulo-ocular reflex
Vestibular Hypofunction
n=4 Participants
Veterans with vestibular hypofunction
Nausea Scale
1.2 score on a scale
Interval 0.0 to 4.5

Adverse Events

Normal Volunteers

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Vestibular Hypofunction

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Mark Walker

VA Northeast Ohio Healthcare System

Phone: 216-791-3800

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place