- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03221296
Fall Prevention - Vestibular Rehabilitation
A Feasibility Study on the Effects of Vestibular Training as a Fall Prevention Strategy in the Elderly
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a feasibility study to gather preliminary data on a vestibular rehabilitation program. All participants who visit UHN memory clinic with a diagnosis of mild/moderate cognitive impairment due to Alzheimer's or vascular disease or both and have had falls will be asked to participate. If agree to be contacted they will receive a consent form.
All agreeable participants shall be screened for vestibular impairment through the following tests: Dix-Hall pike test, Head Impulse Test, Head Shake test, test of Dynamic Visual Acuity. In addition, participants will complete the MoCA to assess cognitive functioning. A score lower than 15 will exclude the participant.
After determining the population who is eligible for this study and willing to participate, participants shall move to baseline assessment. At baseline, measurements of balance, gait, and dynamic visual acuity in addition to questionnaires about dizziness felt, confidence in performing activities without falling, depression and quality of life, shall be completed.
Immediately after baseline, participants will begin their treatment arm, depending on if they have been put in the vestibular group or control group. Participants in the vestibular arm will be taught vestibular exercises and asked to perform vestibular exercises for 3 sessions daily, 3-10 minutes/session. Participation in vestibular exercises shall be recorded via a log by their caregiver. During the 12 weeks, these diaries shall be kept with the participant caregiver. Caregivers shall be followed up bi-weekly to ensure that participants are completing the exercises, and logging their participation.
At the end of the 12 weeks, participants will be reassessed with the same measures from baseline in addition to the head impulse test and test of dynamic visual acuity. The investigators shall also administer a final questionnaire (Problematic Experiences of Therapy Scale) to see what may have prevented completion of therapy or caused issues.
Participants that are randomized to standard of care Control group will undergo Baseline and 12-week assessments including vestibular testing and questionnaires.
3-months after final assessments (6 months after start), all participants shall be contacted to see if there were any falls/near fall experiences.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Ontario
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Toronto, Ontario, Canada, M5T 2S8
- Toronto Western Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Elderly people ages 65 and older
- English speaking
- Can log their participation or have a caregiver log on their behalf
- Mild/moderate dementia [(1) Alzheimer's disease, (2) small vessel vascular dementia not related to stroke and (3) mixed dementia of Alzheimer's or small vessel vascular not related to stroke] or mild/moderate cognitive impairment
- Vestibular Impairment
Exclusion Criteria:
- Neurological disease (e.g. seizures, stroke, hemorrhage, central nervous system tumor, multiple sclerosis)
- Being diagnosed with a psychiatric disorder (e.g. Major depression episode, post-traumatic stress disorder, generalized anxiety disorder, schizophrenia, bipolar disorder etc.)
- Those with a current inner ear infection
- Those with severe neck arthritis
- Those with Post-Concussion Syndrome
- Severe cognitive impairment as defined by a MoCA <15
- Following etiologies of dementia: Dementia due to Lewy bodies, Parkinson's disease, Huntington's Disease, Frontotemporal Dementia, Normal Pressure Hydrocephalous
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Vestibular Training (Intervention Group)
For the actual intervention, participants will be asked to commit a total of approximately 20 minutes a day of vestibular exercise, divided into three separate sessions (i.e. three 7 minute sessions). These will include eye movement exercises, walking and balancing. Every 2 weeks, there will be a slight change to the exercises to increase difficulty. (i.e. balancing on one leg or walking with head turns) |
Exercises three times daily, for up to approximately 20 minutes.
Changes in functional status and physical status shall be measured at study onset and follow up.
|
NO_INTERVENTION: Usual Care (Control group)
Patients that are randomized to standard of care Control group will undergo Baseline and 12-week assessments including vestibular testing and questionnaires.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of falls/near fall experiences through the Falls Video Analysis Questionnaire (FVAQ)
Time Frame: 3 months and again 6 months after baseline
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Measured by comparing the test score change from baseline to follow up at 3 months and again at 6 months to determine if the therapy worked
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3 months and again 6 months after baseline
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in levels of dizziness through the Dizziness Handicap Inventory (DHI)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Change in perceived level of confidence through the Activities Specific Balance Confidence Scale (ABC)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Change in quality of life through The Geriatric Depression Scale (GDS)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Cognitive status through the Montreal Cognitive Assessment (MoCA)
Time Frame: 3 months
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Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Change in physical functioning through the head impulse test (HIT)
Time Frame: 3 months
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Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
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Number of patients who can successfully complete Head Impulse Test (HIT)
Time Frame: 3 months
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Shall be measured by proportion of participants completing test (did not need to stop for any reason)
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3 months
|
Number of patients who can successfully complete Head Shake Test (HST)
Time Frame: 3 months
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Shall be measured by proportion of participants completing test (did not need to stop for any reason)
|
3 months
|
Number of patients who can successfully complete Dynamic Gait Index (DGI)
Time Frame: 3 months
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Shall be measured by proportion of participants completing test (did not need to stop for any reason)
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3 months
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Number of patients who can successfully complete the test of dynamic visual acuity (DVA)
Time Frame: 3 months
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Shall be measured by proportion of participants completing test (did not need to stop for any reason)
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3 months
|
Number of patients who can successfully complete the modified clinical test of sensory interaction on balance (mCTSIB)
Time Frame: 3 months
|
Shall be measured by proportion of participants completing test (did not need to stop for any reason)
|
3 months
|
Completeness of questionnaires and which questions were: skipped, missed or difficult to understand for the Dizziness Handicap Inventory (DHI)
Time Frame: 3 months
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Shall be measured by percentage of test items completed
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3 months
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Completeness of questionnaires and which questions were: skipped, missed or difficult to understand for the Montreal Cognitive Assessment (MoCA)
Time Frame: 3 months
|
Shall be measured by percentage of test items completed
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3 months
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Completeness of questionnaires and which questions were: skipped, missed or difficult to understand for the Quality of Life in Alzheimer's Disease (QOL-AD)
Time Frame: 3 months
|
Shall be measured by percentage of test items completed
|
3 months
|
Completeness of questionnaires and which questions were: skipped, missed or difficult to understand for the World Health Organization Quality of Life - BREF (WHOQOL-BREF)
Time Frame: 3 months
|
Shall be measured by percentage of test items completed
|
3 months
|
Completeness of questionnaires and which questions were: skipped, missed or difficult to understand for the Activities Specific Balance Confidence scale (ABC)
Time Frame: 3 months
|
Shall be measured by percentage of test items completed
|
3 months
|
Completeness of questionnaires and which questions were: skipped, missed or difficult to understand for the Geriatric Depression Scale (GDS)
Time Frame: 3 months
|
Shall be measured by percentage of test items completed
|
3 months
|
Number of patients who successfully adhered to the vestibular rehabilitation program through the Problematic Experiences of Therapy scale (PETs)
Time Frame: 3 months
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filled out by both, or either one of, the patient or caregiver
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3 months
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Attrition Rate
Time Frame: 3 months
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Will be measured as the percentage of those who reached follow-up compared to those who completed baseline
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3 months
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Number of patients willing to participate
Time Frame: 3 months
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Determined by the proportion of patients saying yes out of those contacted
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3 months
|
Change in quality of life through The World Health Organization Quality of Life - BREF (WHOQOL-BREF)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Change in quality of life through The Quality of Life in Alzheimer's Disease (QOL-AD)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Change in physical functioning through the head shake test (HST)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Change in physical functioning through the dynamic visual acuity (DVA)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Change in physical functioning through the modified clinical test of sensory interaction on balance (mCTSIB)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Change in physical functioning through the dynamic gait index (DGI)
Time Frame: 3 months
|
Measured by comparing the test score change from baseline to follow up at 3 months
|
3 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Maria C Tartaglia, MD, FRCPC, University Health Network, Toronto
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Neurocognitive Disorders
- Neurodegenerative Diseases
- Tauopathies
- Intracranial Arterial Diseases
- Intracranial Arteriosclerosis
- Leukoencephalopathies
- Dementia
- Alzheimer Disease
- Dementia, Vascular
Other Study ID Numbers
- 17-5055
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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