Gaze Stabilization vs Oculomotor Exercises on Cybersickness in Computer Users (GAZE-CS)

Kísérleti: Gaze Stabilization Exercises

Participants in this arm will receive Gaze Stabilization Exercises (GSE) for 4 weeks, 3 sessions per week. The protocol includes View X1, View X2, Gaze Shift, and Imaginary Target exercises. Each exercise is performed for 1 minute, repeated 3 times per session. Exercises target the vestibulo-ocular reflex (VOR) by coordinating head and eye movements to reduce sensory conflict.

Viselkedési: Gaze Stabilization Exercises

Week 1 - View X1: Patient sits upright. Target held at eye level 1 meter away. Patient turns head horizontally (left/right) or vertically (up/down) while keeping eyes fixed on target. Speed: slow (1Hz). Duration: 1 minute. Repetitions: 3 times per direction. Week 2 - View X2: Same as View X1 but head movement speed increased to 2Hz. Week 3 - Gaze Shift: Two targets placed 30 cm apart horizontally or vertically. Patient rotates head to face Target 1, then shifts gaze to Target 2 while continuing head rotation toward Target 2. Duration: 1 minute. Repetitions: 3 times. Week 4 - Imaginary Target: Patient fixates on a target (e.g., a sticker on wall). Closes eyes. Rotates head 30-45 degrees away from target. While eyes closed, patient imagines still looking at target. Opens eyes and checks if fixation is accurate. Duration: 1 minute. Repetitions: 3 times per direction. All exercises are performed under supervision for the first 3 sessions, then home-based with weekly follow-up calls.

Aktív összehasonlító: Oculomotor Exercises Group

Participants in this arm will receive Oculomotor Exercises for 4 weeks, 3 sessions per week. The protocol includes Range, Saccadic, Pursuit, and Vergence exercises. Each exercise is performed for 1 minute, repeated 3 times per session. Exercises target isolated eye movements without head motion to improve oculomotor control and reduce visual strain.

Viselkedési: Oculomotor Exercises

Week 1 - Range Oculomotor Exercises: Eyes closed. Patient moves eyes slowly in horizontal (left-right), vertical (up-down), diagonal (top-left to bottom-right), and rotational (clockwise/counterclockwise) directions. Duration: 1 minute per direction. Repetitions: 3 times. Week 2 - Saccadic Exercises: Two stationary targets (e.g., two fingers) held 30 cm apart at eye level. Patient rapidly shifts gaze between targets without moving head. Duration: 1 minute. Repetitions: 3 times. Week 3 - Pursuit Exercises: A single target (e.g., pen) is moved slowly horizontally and vertically. Patient follows target smoothly with eyes only (head still). Speed: approx 20 degrees/second. Duration: 1 minute per direction. Repetitions: 3 times. Week 4 - Vergence Exercises: Target (e.g., pen) starts at 50 cm from patient's nose. Patient focuses on target as it is slowly moved toward nose to 5 cm (convergence), then back to 50 cm (divergence). Duration: 1 minute. Repetitions: 3 times under supervision.

Change in Vestibulo-Ocular Reflex (VOR) Function

Measured by Dynamic Visual Acuity (DVA) test using a LogMAR chart. Patient reads smallest line possible while head is stationary (static VA). Then patient rotates head horizontally at 2Hz while reading. Number of lines lost between static and dynamic conditions is recorded. Normal VOR: 1-2 lines lost. Abnormal: 4-6 lines lost. Higher lines lost = worse VOR function.

Change in Cybersickness Severity

Measured by the Simulator Sickness Questionnaire (SSQ). Contains 16 symptoms rated 0-3 (0=not at all, 3=severe). Total score range 0-48. Subscales: Nausea (symptoms 1,2,6,7,8,9,14,15), Oculomotor (3,4,5,10,11,12,13), and Disorientation (5,10,11,12,13,14,15). Higher score = worse cybersickness.

Change in Quality of Life

Measured by the Short Form-36 (SF-36) Health Survey. Contains 36 items measuring 8 domains: Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health. Scores transformed to 0-100 scale per domain. Higher score = better quality of life.