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Vestibular disorders are disabling conditions that can have a major effect on functioning especially on daily activities and social participation. Latest epidemiological studies estimate that as many as 35% of adults aged 40 years or older had experienced some form of vestibular dysfunction. Non invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS) have been investigated as therapeutic interventions for various neurological disorders like motor deficits and balance disorders after various neurological deficits. The purpose of this study is to compare between rTMs stimulation and galvanic vestibular stimulation in patients with unilateral peripheral vestibular disorders.
A pilot study has been recruited to calculate sample size and determine rTMs protocol that will be utilized during the study were two protocols has been compared and according to pilot study results collaborated with literature review a established protocol has been utilized. The subjects of both genders with age 30 to 60 will be allocated randomly into three equal groups A, B and C. Group A Outcomes measure will include : VNG (videonystagmography), Dizziness handicapped inventory, Berg balance scale, Vestibular disorders activities of daily living scale(VADL). Assessment will be done before and after treatment sessions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A (r TMS group) | Active Comparator | Twenty randomly assigned patients with unilateral peripheral vestibular disorders will undergo 10 Hz rTMS to the dorsolateral prefrontal cortex of their dominant hemisphere; in addition to designed vestibular rehabilitation exercises. |
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| Group B (Galvanic stimulation) | Active Comparator | Twenty randomly assigned patients with unilateral peripheral vestibular disorders will undergo galvanic vestibular stimulation; in addition to designed vestibular rehabilitation exercises. |
|
| Control (Group C) | No Intervention | Twenty randomly assigned patients with unilateral peripheral vestibular disorders will undergo designed vestibular rehabilitation exercises. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| repetitive transcranial magnetic stimulation | Device | high frequency (10 HZ) rTMS pulses are applied to the dorsolateral prefrontal cortex of the dominant hemisphere. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Vestibular canal weakness | Videonystagmography- Scores ranging zero min score and 100 max score | 1 mounth |
| Dizziness handicapped inventory | identify difficulties that you may be experiencing because of your dizziness- 25 items with max score 100 and min score zero | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Postural stability | Computerized dynamic Posturography- Scores ranging zero min score and 100 max score | 1 month |
| Balance | Berg balance scale - 14 items each item scored from zero (min score)-4 (Max score) with total min score zero and max score 56 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Reham A.M. Ahmed, Phd | Contact | 00201285059796 | rihamelsayed_pt@hotmail.com | |
| Hesham M. S. Nafia, M.Sc | Contact | 00201017713483 | drhesham101@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo university | Recruiting | Cairo | Giza Governorate | 12613 | Egypt |
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| ID | Term |
|---|---|
| D050781 | Transcranial Magnetic Stimulation |
| ID | Term |
|---|---|
| D055909 | Magnetic Field Therapy |
| D013812 | Therapeutics |
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| Galvanic stimulation | Device | galvanic stimulation of the vestibular apparatus |
|
| 1 month |
| Vestibular disorders activities of daily living | The Vestibular Disorders Activities of Daily Living (VADL) scale assesses the impact of vestibular impairment on everyday activities. The 28 items are grouped into three dimensions: functional (self-care and intimate activities), ambulation (walking and stair climbing), and instrumental (home management and leisure activities).Each item is rated with zero (min score) to 10 (max score) | 1 month |