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NCT Number: NCT07608991

Effects of Combined Cervical and Oculomotor Exercises on Dynamic Balance in Elderly

This study focuses on improving balance in elderly individuals (aged 60-80 years) who may experience dizziness or instability while walking or performing daily activities. Poor balance increases the risk of falls, which can lead to serious injuries and loss of independence.

The study compares two types of exercise programs:

One group performs combined cervical (neck) exercises + eye (oculomotor) exercises + Otago balance exercises The other group performs eye (oculomotor) exercises + Otago balance exercises only These exercises are done 3 times per week for 6 weeks, with each session lasting 30-45 minutes.

The goal is to determine whether combining neck and eye exercises improves balance more effectively than eye exercises alone.

This research may help:

Reduce fall risk in elderly people Improve mobility and independence Provide better rehabilitation programs for physiotherapists

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Key information

Conditions

Dynamic Balance Dizziness Neurologic Manifestations Pathological Conditions, Signs and Symptoms Risk of Fall Sensation Disorders Signs and Symptoms

Age range

60 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Foundation University College of Physical Therapy

Islamabad, 44000, Pakistan

About this study

Falls are a major health concern among older adults, frequently leading to serious injuries , and diminished participation in daily activities, which negatively affect overall quality of life. Therefore, designing effective, accessible, and evidence-based strategies to improve balance and prevent falls is essential for promoting healthy aging.because it introduces a novel approach that combines cervical proprioceptive exercises and oculomotor exercises alongside the Otago exercise program. While previous research has demonstrated that both cervical and oculomotor exercises independently enhance balance and reduce fall risk, their combined effects, particularly when integrated into a structured balance program like Otago, remain largely unexplored. By addressing this gap, the present study offers an innovative strategy that targets multiple systems involved in maintaining postural control., the combined intervention is designed to be practical, cost-effective, and easily implemented in various settings, including clinics, community centers, and at home., the study has the potential to guide physiotherapists and rehabilitation professionals toward adopting more holistic balance training protocols. Ultimately, the findings may contribute to reducing fall rates, promoting independence, and enhancing the overall quality of life in the elderly population.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male and female participants aged 60-80 years.
  • DHI-mild score(0-30)
  • Ability to follow instructions and participate in exercises.
  • BBS moderate (21-40)
  • Normal to corrected vision
  • Negative Dix Hallpike

Exclusion criteria

  • Diagnosed vestibular disorders
  • Neurological or musculoskeletal conditions affecting balance.
  • Patients with VBI

Treatment and study plan

occulomotor with otago exercises

Procedure

Smooth pursuit exercises, where the eyes follow a moving target horizontally, vertically, and diagonally while keeping the head still.

Saccadic eye movements, involving quick shifts of gaze between two stationary targets.

Gaze stability (VOR x1 and VOR x2) exercises, involving head movements while maintaining focus on a target, and moving the head and target in opposite directions.

All participants will perform the Otago exercise program, a well-established, evidence-based fall prevention program focusing on lower limb strengthening and dynamic balance. It includes:

  • Strengthening exercises (e.g., knee extensions, hip abduction, calf raises).
  • Static and dynamic balance exercises (e.g., tandem stance, backward walking, sit-to-stand without using hands).
  • A progressive walking plan to improve endurance and confidence during ambulation.

Combined Cervical and Oculomotor Exercises with Otago Exercises

Procedure

Cervical range of motion exercises in flexion, extension, rotation, and side bending (gentle, controlled movements).

Chin tuck exercises in supine or sitting positions to activate deep cervical flexors.

Isometric neck strengthening exercises (flexion, extension, lateral flexion), focusing on controlled, static holds.

Occulomotor Exercises:

Smooth pursuit exercises, where the eyes follow a moving target horizontally, vertically, and diagonally while keeping the head still.

Saccadic eye movements, involving quick shifts of gaze between two stationary targets.

Gaze stability (VOR x1 and VOR x2) exercises, involving head movements while maintaining focus on a target, and moving the head in opposite direction Otago exercises Strengthening exercises (e.g., knee extensions, hip abduction, calf raises). Static and dynamic balance exercises (e.g., tandem stance, backward walking, sit-to-stand without using hands).

A progressive walking plan to improve endurance and confidence during ambulation.

Primary outcomes

  1. Dynamic Balance

    Time frame: 6 weeks

    Berg Balance Scale (BBS) was used Cut-off Values Greater than 45 → Increased risk of falls 21-40 → Moderate balance impairment Outcome Interpretation Higher score = Better balance

  2. Functional Mobility

    Time frame: 6 weeks

    The Timed Up and Go Test (TUG) was used

    Cut-off Values:

    less than 10 seconds → Normal mobility 10-19 seconds → Good mobility 20-29 seconds → Mild impairment

    • 30 seconds → Severe impairment > 13.5 seconds → Increased risk of falls (important clinical cutoff)

    Interpretation:

    Lower time indicates better performance

  3. Dynamic Balance

    Time frame: 6 weeks

    Four Square Step Test was used to evaluate dynamic balance

    Cut-off Values:

    < 15 seconds → Normal performance > 15 seconds → Increased risk of falls

    Interpretation:

    Lower time indicates better balance

  4. Dizziness related disability

    Time frame: 6 weeks

    • Dizziness Handicap was used

    Cut-off Values:

    0-30 → Mild handicap (used in inclusion criteria) 31-60 → Moderate handicap 61-100 → Severe handicap

    Interpretation:

    Higher score indicates greater dizziness-related disability

Sponsors and collaborators

Lead sponsor

Foundation University Islamabad

Other

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
May 27, 2026
Registry last updated
May 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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