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NCT Number: NCT07064096

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

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.

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Key information

Age range

20 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Alnasir Hospital Gujar Khan, Gujar Khān, Punjab Province, Pakistan

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About this study

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.

Who can participate

Healthy volunteers accepted: No

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

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

Treatment and study plan

cawthorne cooksey exercise

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

Other names: cawthorne cooksey exercises

Mental Imagery

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.

Primary outcomes

  1. Vertigo Symptom Scale

    Time frame: 8 week

    The Vertigo Symptom Scale (VSS) is a self-report questionnaire designed to assess the severity and frequency of vertigo-related symptoms over the past month

  2. • Dizziness Handicap Inventory

    Time frame: 8 week

    The Dizziness Handicap Inventory (DHI) is a self-reported questionnaire designed to evaluate the impact of dizziness on a person's daily life, emotional well-being, and functional ability. It is widely used in clinical practice for assessing vestibular dysfunction and tracking progress in rehabilitation. Purpose of DHI is to Measures how dizziness affects daily activities.

  3. Mini-BESTest (Mini Balance Evaluation Systems Test)

    Time frame: 8 week

    The Mini-BESTest is a shortened version of the Balance Evaluation Systems Test (BESTest). It is designed to assess dynamic balance and identify impairments in postural control across different systems. This test is particularly useful for evaluating balance deficits in vestibular disorders

Study contacts

Contact information is provided by the study sponsor or research team.

Nadia Azhar, MSNMPT

CONTACT

[email protected]

00923335281431

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Acronym: EMI

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jul 14, 2025
Registry last updated
Jul 14, 2025

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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