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CompletedNCT05333198Updated Apr 18, 2022

Oculomotor and Vestibular Ocular Reflex Exercises in Patients With Benign Paroxysmal Positional Vertigo

An interventional study of Traditional physical therapy using Epley's maneuver and Oculomotor and Vestibular Ocular Reflex (VOR) exercises in Benign Paroxysmal Positional Vertigo (Disorder), sponsored by Riphah International University. Completed at 1 site in Pakistan. Open to participants aged 30 Years to 60 Years. Per ClinicalTrials.gov, last updated 2022-04-18.

Sponsored by Riphah International University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 11 months after the study started (first participant enrolled Feb 2021, registered Jan 2022).
Phase
Not applicable
Study type
Interventional
Enrollment
32
Allocation
Randomized
Ages
30 Years to 60 Years
Sex
All
01

Study summary

The aim of this research is to assess effects of Oculomotor and VOR exercises on vertigo, dizziness and balance in patients with BPPV. Randomized controlled trial was conducted at Hameed Latif Hospital, Lahore. The sample size 32 participants which were divided into two groups, 16 participants in traditional physical therapy group and 16 in oculomotor and vestibular ocular reflex exercises group. Study duration was of 6 months. Sampling technique applied was non-probability consecutive sampling technique. Only 30-70 years individuals with Benign Paroxysmal Positional Vertigo (BPPV) were included. Tools used in the study are vertigo handicap questionnaire, visual vertigo analogue scale, dizziness handicap inventory, berg balance scale and dynamic gait index. The data was analyzed using SPSS.

Read the detailed description

Randomized controlled trial was conducted at Hameed Latif Hospital, Lahore. The sample size 32 participants which were divided into two groups, 16 participants in traditional physical therapy group and 16 in oculomotor and vestibular ocular reflex exercises group. Study duration was of 6 months. Sampling technique applied was non-probability consecutive sampling technique. Only 30-70 years individuals with Benign Paroxysmal Positional Vertigo (BPPV) were included. Tools used in the study are vertigo handicap questionnaire, visual vertigo analogue scale, dizziness handicap inventory, berg balance scale and dynamic gait index. The data was analyzed using SPSS.

02

Conditions studied

  • Benign Paroxysmal Positional Vertigo (Disorder)

Keywords

  • Benign Paroxysmal Positional Vertigo
  • Oculomotor exercises
  • Vestibular Ocular Reflex (VOR) exercises
03

In context

Vertigo

248 studies on the registry are indexed under Vertigo; 39 are open to participants now.

This study's enrollment of 32 is below the median of 57 across 186 interventional studies indexed under Vertigo.

Browse Vertigo studies →

Lead sponsor

Riphah International University is the lead sponsor of 2,133 studies on the registry; 633 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
30 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients who have vertigo with posterior canal involvement during Dix-Hallpike test with or without accompanying nystagmus (objective or subjective BPPV).
  • Ability to walk at least 3 meters by itself with or without assistive device
  • Normal vision with or without correction by spectacles or contact lenses

Exclusion criteria

Exclusion Criteria:

  • Patients with other neurologic conditions, orthopedic problems, and uncontrolled metabolic diseases to eliminate confounding factors affecting balance performance
  • Unable to understand and answer a simple verbal command.
  • Previously underwent oculomotor and vestibular ocular exercises.
  • Other vestibular disorders like Meniere disease
  • Long-term use of benzodiazepines (more than 20 years).
  • Patients who are already performing structured physical activities such as muscle strengthening exercises, Pilates, yoga or high intensity aerobic exercises
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
32 participants (actual)

Study arms

  • Other
    Traditional physical therapy using Epley's maneuver

    Epley's maneuver was performed once a week for three weeks. The maneuver was performed by patient in sitting position, head was rotated towards involved side and then extended to 30 degrees, it was then rotated to 180 degrees followed by patient rolling onto opposite side. Each position was maintained for 1-2 minutes.

    Other: Traditional physical therapy using Epley's maneuver

  • Active comparator
    Oculomotor and Vestibular Ocular Reflex (VOR) exercises

    oculomotor and VOR exercises after Epley's maneuver. The exercises were performed for approximately 5 minutes daily or 1 to 2 minutes, 3 to 4 times a day, in sitting position. The exercises were continued for three weeks. The maneuver was performed by patient in sitting position, head was rotated towards involved side and then extended to 30 degrees, it was then rotated to 180 degrees followed by patient rolling onto opposite side. Each position was maintained for 1-2 minutes. Saccadic exercises were performed by moving eyes between two stationary targets. Smooth pursuit exercises were performed by tracking a moving target while keeping head still and VOR exercises were performed by moving head left to right while maintaining eyes on stationary target

    Other: Oculomotor and Vestibular Ocular Reflex (VOR) exercises

Interventions

  • OtherTraditional physical therapy using Epley's maneuver

    Epley's maneuver was performed once a week for three weeks. The maneuver was performed by patient in sitting position, head was rotated towards involved side and then extended to 30 degrees, it was then rotated to 180 degrees followed by patient rolling onto opposite side. Each position was maintained for 1-2 minutes.

  • OtherOculomotor and Vestibular Ocular Reflex (VOR) exercises

    oculomotor and VOR exercises after Epley's maneuver. The exercises were performed for approximately 5 minutes daily or 1 to 2 minutes, 3 to 4 times a day, in sitting position. The exercises were continued for three weeks. The maneuver was performed by patient in sitting position, head was rotated towards involved side and then extended to 30 degrees, it was then rotated to 180 degrees followed by patient rolling onto opposite side. Each position was maintained for 1-2 minutes. Saccadic exercises were performed by moving eyes between two stationary targets. Smooth pursuit exercises were performed by tracking a moving target while keeping head still and VOR exercises were performed by moving head left to right while maintaining eyes on stationary target

06

What researchers measure

Primary outcomes

  1. Vertigo Handicap Questionnaire

    It assess effect of vertigo on disability, handicap and benefits following therapeutic intervention both physically and psychologically.

    Time frame: First reading at 0 day

  2. Vertigo Handicap Questionnaire

    It assess effect of vertigo on disability, handicap and benefits following therapeutic intervention both physically and psychologically.

    Time frame: second reading after 3 weeks

  3. Visual Vertigo Analogue Scale

    Intensity of visual vertigo in nine challenging situations of visual motions that typically provoke dizziness

    Time frame: First reading at 0 day

  4. Visual Vertigo Analogue Scale

    Intensity of visual vertigo in nine challenging situations of visual motions that typically provoke dizziness

    Time frame: second reading after 3 weeks

  5. Dizziness Handicap Inventory

    Self-perceived handicapping effects imposed by dizziness.

    Time frame: First reading at 0 day

  6. Dizziness Handicap Inventory

    Self-perceived handicapping effects imposed by dizziness.

    Time frame: second reading after 3 weeks

  7. Berg Balance Scale

    Objectively determine a patient's ability (or inability) to safely balance during a series of predetermined tasks

    Time frame: First reading at 0 day

  8. Berg Balance Scale

    Objectively determine a patient's ability (or inability) to safely balance during a series of predetermined tasks

    Time frame: First reading at 3 week

  9. Dynamic Gait Index

    The clinical tool to assess gait, balance and fall risk. It evaluates not only usual steady-state walking, but also walking during more challenging tasks.

    Time frame: first reading after 0 day

  10. Dynamic Gait Index

    The clinical tool to assess gait, balance and fall risk. It evaluates not only usual steady-state walking, but also walking during more challenging tasks.

    Time frame: second reading after 3 weeks

07

Study locations

1 site
  • Binash Afzal
    Lahore, Punjab 54000, Pakistan
08

References and documents

Publications

  • Kim HJ, Lee JO, Choi JY, Kim JS. Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea. J Neurol. 2020 Aug;267(8):2252-2259. doi: 10.1007/s00415-020-09831-2. Epub 2020 Apr 16. PubMed 32300888 ↗
  • Scocco DH, Garcia IE, Barreiro MA. Sitting Up Vertigo. Proposed Variant of Posterior Canal Benign Paroxysmal Positional Vertigo. Otol Neurotol. 2019 Apr;40(4):497-503. doi: 10.1097/MAO.0000000000002157. PubMed 30870365 ↗
  • Dunlap PM, Holmberg JM, Whitney SL. Vestibular rehabilitation: advances in peripheral and central vestibular disorders. Curr Opin Neurol. 2019 Feb;32(1):137-144. doi: 10.1097/WCO.0000000000000632. PubMed 30461465 ↗
  • Wu P, Cao W, Hu Y, Li H. Effects of vestibular rehabilitation, with or without betahistine, on managing residual dizziness after successful repositioning manoeuvres in patients with benign paroxysmal positional vertigo: a protocol for a randomised controlled trial. BMJ Open. 2019 Jun 18;9(6):e026711. doi: 10.1136/bmjopen-2018-026711. PubMed 31217316 ↗
  • Kane AW, Diaz DS, Moore C. Physical Therapy Management of Adults with Mild Traumatic Brain Injury. Semin Speech Lang. 2019 Feb;40(1):36-47. doi: 10.1055/s-0038-1676652. Epub 2019 Jan 7. PubMed 30616293 ↗
  • Hillier S, McDonnell M. Is vestibular rehabilitation effective in improving dizziness and function after unilateral peripheral vestibular hypofunction? An abridged version of a Cochrane Review. Eur J Phys Rehabil Med. 2016 Aug;52(4):541-56. Epub 2016 Jul 12. PubMed 27406654 ↗
  • Arnold SA, Stewart AM, Moor HM, Karl RC, Reneker JC. The Effectiveness of Vestibular Rehabilitation Interventions in Treating Unilateral Peripheral Vestibular Disorders: A Systematic Review. Physiother Res Int. 2017 Jul;22(3). doi: 10.1002/pri.1635. Epub 2015 Jun 25. PubMed 26111348 ↗
  • Meldrum D, Burrows L, Cakrt O, Kerkeni H, Lopez C, Tjernstrom F, Vereeck L, Zur O, Jahn K. Vestibular rehabilitation in Europe: a survey of clinical and research practice. J Neurol. 2020 Dec;267(Suppl 1):24-35. doi: 10.1007/s00415-020-10228-4. Epub 2020 Oct 13. PubMed 33048219 ↗
  • Mempouo E, Lau K, Green F, Bowes C, Ray J. Customised vestibular rehabilitation with the addition of virtual reality based therapy in the management of persistent postural-perceptual dizziness. J Laryngol Otol. 2021 Oct;135(10):887-891. doi: 10.1017/S0022215121002127. Epub 2021 Aug 10. PubMed 34372958 ↗
  • Lin SI, Tsai YJ, Lee PY. Balance performance when responding to visual stimuli in patients with Benign Paroxysmal Positional Vertigo (BPPV). J Vestib Res. 2020;30(4):267-274. doi: 10.3233/VES-200709. PubMed 32925126 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 18, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05333198
Lead sponsor
Riphah International University
Responsible party
Sponsor
First posted
Apr 18, 2022
Start date
Feb 15, 2021
Primary completion
Oct 15, 2021
Completion
Dec 15, 2021
Last update
Apr 18, 2022

Study contacts

Binash Afzal, PhD*
principal investigator · Riphah International University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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