Effects Of Mental Imagery Along With Vestibular Rehabilitation On Young Adults With Vestibular Hypofunction

NCT ID: NCT07064096

Last Updated: 2025-07-14

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 44 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-07-01
• Study Completion Date: 2025-12-30

Brief Summary

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.

Detailed Description

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.

Conditions

Vestibular Hypofunction

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Conventional treatment

cawthorne cooksey exercises

Group Type: ACTIVE_COMPARATOR

cawthorne cooksey exercise

Intervention Type: OTHER

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

participatory Group

cawthorne cooksey exercises in addition of mental imagery

Group Type: EXPERIMENTAL

mental imagery

Intervention Type: OTHER

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.

Interventions

cawthorne cooksey exercise

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

Intervention Type: OTHER

mental imagery

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.

Intervention Type: OTHER

Other Intervention Names

cawthorne cooksey exercises

Eligibility Criteria

Inclusion Criteria

• Patients with unilateral vestibular hypofunction
• Head thrust test positive
• Age group 20-40
• DHI score 16 above
• VSS score 11-30

Exclusion Criteria

• With any other associated neurological disorder that effect vestibular rehabilitation
• Having bilateral vestibular hypofunction
• Patients having any other associated disease that affects balance or cause vertigo other that vestibular

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Nadia azhar, MS

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Alnasir Hospital Gujar Khan

Gujar Khān, Punjab Province, Pakistan

Site Status: RECRUITING

Riphah International University

Islamabad, , Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Nadia Azhar, MSNMPT

Role: CONTACT

Nadia.azhar@riphah.edu.pk

00923335281431

Facility Contacts

FAHEEM AHMED

Role: primary

mdawood650@gmail.com

00923044608855

References

Liu KP, Chan CC, Lee TM, Hui-Chan CW. Mental imagery for promoting relearning for people after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2004 Sep;85(9):1403-8. doi: 10.1016/j.apmr.2003.12.035.

Reference Type: BACKGROUND

PMID: 15375808 (View on PubMed)

Ellis AW, Schone CG, Vibert D, Caversaccio MD, Mast FW. Cognitive Rehabilitation in Bilateral Vestibular Patients: A Computational Perspective. Front Neurol. 2018 Apr 27;9:286. doi: 10.3389/fneur.2018.00286. eCollection 2018.

Reference Type: BACKGROUND

PMID: 29755404 (View on PubMed)

van Esch BF, Nobel-Hoff GE, van Benthem PP, van der Zaag-Loonen HJ, Bruintjes TD. Determining vestibular hypofunction: start with the video-head impulse test. Eur Arch Otorhinolaryngol. 2016 Nov;273(11):3733-3739. doi: 10.1007/s00405-016-4055-9. Epub 2016 Apr 25.

Reference Type: BACKGROUND

PMID: 27113255 (View on PubMed)

Other Identifiers

Sulman amjad

Identifier Type: -

Identifier Source: org_study_id