Flight simulators for pilots offer treatment for chronic dizziness

Vision and motion simulators similar to those used by fighter pilots and astronauts can provide relief from the symptoms of chronic dizziness, researchers at Hammersmith Hospitals NHS Trust and Imperial College London report in the Journal of Neurology*.

Patients with a history of balance problems, including dizziness and vertigo, show up to 50% improvement in the frequency and intensity of dizziness after attending a series of ‘simulator therapy’ sessions. The sessions combine rotating disk, spinning chair and video-based exercises that create the illusion of movement. The treatment strengthens the visual input to the brain, improving balance and reducing dizziness.

“Input from your muscles and joints, your inner ear and your eyes make up the triad of sensory information your body needs to stay balanced,” explains Professor Adolfo Bronstein, lead author and head of the department of neurotology at Charing Cross Hospital in London. “In patients with inner ear damage, we thought that by strengthening the other inputs this would lead to a reduction in dizziness. We are very excited that the results of this trial bear this out, and that these simulator exercises, when combined with physiotherapy, strengthen the sensory input the brain receives which allows correct balance to be maintained.”

Forty patients with chronic inner ear symptoms lasting many years were enrolled into the study. All received standard physiotherapy, with half additionally receiving the visual simulation exercises twice weekly for two months. “We found that the frequency and intensity of dizzy spells was reduced, along with an improvement in balance and coordination in all patients, more so in the half that received the visual simulations,” explains Professor Bronstein. ”These exercises, which are used to train pilots to avoid motion sickness, are simple to set up so we are confident that they will soon become part of the standard treatment programme for chronic dizziness.”

The inner ear, or vestibular system, is a complex arrangement of fluid-filled chambers that acts like a mercury tilt-switch, relaying to the brain information on human balance. When disrupted by a disease such as a cold or flu, or by head injury, the signals become confused resulting in dizziness, vertigo and feelings of nausea. While over a third of the population may experience a vestibular disorder at some point in their lives, chronic dizziness lasting many years has a hugely detrimental effect on quality of life, leaving many patients anxious and depressed. “As well as an improvement in dizziness symptoms and balance, an encouraging finding from this study is that patients’ anxiety and depression was reduced by over a third,” comments Professor Bronstein. “By strengthening visual movement, an often neglected aspect of the balance system, we can make a real difference to these patients’ quality of life.”