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This study will investigate two different techniques used for eliciting sternocleidomastoid (SCM) muscle contraction. Sustained contraction of the SCM muscle is necessary for accurate recording of cervical vestibular evoked myogenic potentials (cVEMPs). These responses are used clinically to assess the function of structures within the vestibular system.
The British Society of Audiology (BSA) guidelines recommend the head turn and head raise techniques as effective methods for eliciting SCM contraction. However, they do not recommend which technique to employ, leaving that to the discretion of the clinician. The purpose of this study is to determine which activation technique to recommend in the local standard operating procedure on cVEMP testing developed by the Audiology and Vestibular Function Testing service based at the Royal Liverpool University Hospital.
Healthy volunteers will be recruited to the study. The study will be conducted at the Royal Liverpool University Hospital, Liverpool, UK.
The participants will each be invited to attend one appointment in which they will undergo cVEMP testing, performed using each activation technique in turn. After testing the participants will be asked to complete a questionnaire in which they will comment on their experience of performing each technique and assign each a tolerability rating.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Raise-Turn Sequence | Experimental | Participant performs cVEMP twice using the head raise activation technique followed by the head turn activation technique. |
|
| Turn-Raise Sequence | Experimental | Participant performs cVEMP twice using the head turn activation technique followed by the head raise activation technique. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Head Turn Activation Technique | Diagnostic Test | Participant sat upright with head turned to the side through 45 degrees. They are presented with an auditory stimulus delivered using insert earphones and their cVEMP response is recorded using skin electrodes. |
| Measure | Description | Time Frame |
|---|---|---|
| cVEMP signal quality | Ratio of cVEMP signal power to background noise power | During single 1.5 hour appointment |
| Measure | Description | Time Frame |
|---|---|---|
| cVEMP signal amplitude | P1-N1 amplitude measured from the P1 to N1 peaks | During single 1.5 hour appointment |
| Activation technique tolerability rating | Participant reported tolerability will be scored on a four-point LIKERT scale ranging from 1 (highly intolerable) to 4 (highly tolerable) |
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Inclusion Criteria:
Exclusion Criteria:
Exclusion criteria to cVEMP procedure :
Exclusion criteria to tympanometry procedure :
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Liverpool University Hospitals NHS Foundation Trust | Liverpool | L7 8XP | United Kingdom |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Feb 14, 2024 | |
| Reset | Jul 31, 2024 | |
| Release | Jul 1, 2025 | |
| Reset | Jul 17, 2025 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Feb 14, 2024 | Jul 31, 2024 | |||
| Jul 1, 2025 |
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| Head Raise Activation Technique | Diagnostic Test | Participant assumes caloric test position (30 degrees from horizontal) with head raised. Participant is presented with an auditory stimulus delivered using insert earphones and their cVEMP response is recorded using skin electrodes. |
|
| During single 1.5 hour appointment |
| Activation technique tolerability subjective feedback | Participant reported concerns shared through a post-test questionnaire | During single 1.5 hour appointment |
| Jul 17, 2025 |