The Cardiac Autonomic Control System Response to Vestibular Stimulation in Subjects With and Without BPPV

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

36 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-04-28

Study Completion Date

2020-09-01

Brief Summary

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The vestibular system in the inner year is an important system in the body which is responsible for balance. In addition, there is evidence that the vestibular system plays a role in maintaining blood pressure while changing body position, such as moving from lying down in bed to sitting. Dysfunction of the vestibular system may affect the ability to maintain blood pressure, therefore the aim of this study is to assess if a specific problem in the vestibular system (Benign Paroxysmal Positional Vertigo- BPPV) may cause changes in the interaction between the vestibular system and the cardiovascular system. We assume that patients with this medical condition (BPPV) will have different heart rate parameters in comparison with healthy patients.

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Detailed Description

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This is a case-control study, that will consist of one routine assessment by a vestibular physiotherapist in an outpatient clinic in Tel Aviv ("Clalit Health Services"). The session will last approximately 90 minutes, and will include 40-60 participants.

Two groups of patients (30-70 years old) will be assigned to this study:

1. Patients with Benign Paroxysmal Positional Vertigo (BPPV).
2. Healthy patients (Control Group).

Both groups will undergo routine physical assessment which is done to diagnose if the patient has BPPV or not. The physical assessment includes quick changes in body and head position.

In addition to the routine physical assessment, heart rate variability parameters will be monitored during the whole session in patients in both groups (using Polar watch RS800CX). Furthermore, all patients will be asked to test their grip strength (using a hand-held dynamometer), moving from sitting to standing 5 times in a row and to fill two questionnaires.

The patients that were diagnosed with BPPV will be treated with the routine vestibular physiotherapy, performed by the same physiotherapist who did the physical assessment.

Statistical analysis of the data will be performed in IBM SPSS Statistics software (version 24), and a statistical significance level of a p-value \< 0.05 will be considered significant. Normality distribution will be tested with the Kolmagorov-Smirnov test.

Parametric tests suitable for the analysis of the data in this study are:

1. Paired and unpaired t-tests.
2. Repeated Measures Analysis of Variance (ANOVA).

Non-parametric tests suitable for the analysis of the data in this study are:

1. Mann-Whitney.
2. Wilcoxon.

Spearman coefficient will be used to examine correlations.

Conditions

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Benign Paroxysmal Positional Vertigo Vertigo Autonomic Nervous System

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Subjects with BPPV

Patients diagnosed with BPPV, who meet the following criteria:

1. Main complain of spinning sensation (Vertigo) when changes are made in head position relative to gravity.
2. Positive Dix-Hallpike / Supine Roll Test, confirmed by presence of nystagmus.

Heart rate variability parameters monitoring

Intervention Type DIAGNOSTIC_TEST

No intervention- only additional monitoring of heart rate, physical tests and filling of questionnaires:

Heart rate variability parameters monitoring- by wearing a Polar watch (RS800CX).

Isometric grip test- by using a Jamar Hand Held Dynamometer.

Questionnaires:

1. Dizziness Handicap Inventory (DHI) - hebrew version.
2. Stait-Trait Anxiety Inventory (STAI)

Subjects without BPPV (Control group)

Patients who do not suffer from dizziness / spinning sensation (Vertigo), and do not meet the exclusion criteria in the study.

Heart rate variability parameters monitoring

Intervention Type DIAGNOSTIC_TEST

No intervention- only additional monitoring of heart rate, physical tests and filling of questionnaires:

Heart rate variability parameters monitoring- by wearing a Polar watch (RS800CX).

Isometric grip test- by using a Jamar Hand Held Dynamometer.

Questionnaires:

1. Dizziness Handicap Inventory (DHI) - hebrew version.
2. Stait-Trait Anxiety Inventory (STAI)

Interventions

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Heart rate variability parameters monitoring

No intervention- only additional monitoring of heart rate, physical tests and filling of questionnaires:

Heart rate variability parameters monitoring- by wearing a Polar watch (RS800CX).

Isometric grip test- by using a Jamar Hand Held Dynamometer.

Questionnaires:

1. Dizziness Handicap Inventory (DHI) - hebrew version.
2. Stait-Trait Anxiety Inventory (STAI)

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Isometric grip test Five times sit to stand Questionnaires

Eligibility Criteria

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Inclusion Criteria

Subjects with BPPV- Patients diagnosed with BPPV, who meet the following criteria:

1. Main complain of spinning sensation (Vertigo) when changes are made in head position relative to gravity (such as when moving from sitting to lying down or rolling in bed, bending over etc.)
2. Positive Dix-Hallpike / Supine Roll Test, confirmed by presence of nystagmus.

Subjects without BPPV (Control group):

Subjects who do not suffer from dizziness / spinning sensation (Vertigo).

Exclusion Criteria

* Suffering from pain in the day of assessment.
* Postural Hypotension.
* Familial Dysautonomia.
* Diabetic Neuropathy.
* History of Whiplash or Traumatic Brain Injury (TBI) in the last year.
* History of Stroke (CVA), Multiple Sclerosis (MS) or Central Positional Vertigo.
* Coronary Heart Disease (CHD), Cardiac Heart Failure (CHF), Cardiac arrhythmias, Vertebrobasilar Insufficiency (VBI).
* Under treatment of Beta- Blockers.
* Anxiety Disorders.
* Vestibular Migraine, Vestibular Neuritis, Menier's Disease, Perilymphatic Fistula, Superior Canal Dehiscence Syndrome.
* Medical conditions with high risk of subluxation / dislocation of the Atlanto-axial joint.
* Health professionals who are specialized to treat Vestibular disorders (such as Vestibular physiotherapists)

Minimum Eligible Age

30 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes