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Multicenter Study
. 2020 Jul 14;10(7):e037138.
doi: 10.1136/bmjopen-2020-037138.

2BALANCE: a cognitive-motor dual-task protocol for individuals with vestibular dysfunction

Maya Danneels  1 , Ruth Van Hecke  2 , Laura Leyssens  2 , Sofie Degeest  2 , Dirk Cambier  2 , Raymond van de Berg  3   4 , Vincent Van Rompaey  5   6 , Leen Maes  2   7
Affiliations
Multicenter Study

2BALANCE: a cognitive-motor dual-task protocol for individuals with vestibular dysfunction

Maya Danneels et al. BMJ Open. .

Abstract

Introduction: Aside from primary vestibular symptoms such as vertigo and dizziness, persons with vestibular dysfunction frequently express cognitive and motor problems. These symptoms have mainly been assessed in single-task setting, which might not represent activities of daily living accurately. Therefore, a dual-task protocol, consisting of the simultaneous performance of cognitive and motor tasks, was developed. This protocol assesses cognitive and motor performance in general, as well as cognitive-motor interference in specific.

Methods and analysis: The motor component of the 2BALANCE protocol consists of a static and dynamic postural task. These motor tasks are combined with different cognitive tasks assessing visuospatial cognition, processing speed, working memory and response inhibition. First, test-retest reliability will be assessed with an interval of 2 weeks in a group of young adults. Second, the 2BALANCE protocol will be validated in persons with bilateral vestibulopathy. Finally, the protocol will be implemented in persons with unilateral vestibular loss.

Discussion and conclusions: The 2BALANCE project aims to elucidate the impact of vestibular dysfunction on cognitive and motor performance in dual-task setting. This protocol represents everyday situations better than single-task protocols, as dual-tasks such as reading street signs while walking are often encountered during daily activities. Ultimately, this project could enable individualised and holistic clinical care in these patients, taking into account single as well as dual-task performance.

Ethics and dissemination: The current study was approved by the ethics committee of Ghent University Hospital on 5 July 2019 with registration number B670201940465. All research findings will be disseminated in peer-reviewed journals and presented at vestibular as well as multidisciplinary international conferences and meetings.

Trials registration number: NCT04126798, pre-results phase.

Keywords: adult neurology; adult otolaryngology; audiology; neurotology; protocols & guidelines.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Set-up and timeline of the 2BALANCE project: (1) assessment of test–retest reliability (TR), (2) validation in persons with bilateral vestibulopathy and (3) implementation of 2BALANCE protocol in persons with unilateral vestibular loss and various vestibular disorders. HC, healthy controls.
Figure 2
Figure 2
Primary and secondary outcome measures. cVEMP, cervical vestibular evoked myogenic potentials; DVA, dynamic visual acuity; MOCA, Montreal cognitive assessment; oVEMP, ocular vestibular evoked myogenic potentials; SVA, static visual acuity; vHIT, video head impulse test.
Figure 3
Figure 3
2BALANCE protocol consisting of five different cognitive tasks in combination with a static and dynamic postural task.
Figure 4
Figure 4
Example of Corsi block stimuli and raster for indicating responses.
Figure 5
Figure 5
Example of the mental rotation task.
Figure 6
Figure 6
Symbols and their respective numerical digit for the coding task; coding set 1.
Figure 7
Figure 7
Visual Analogue Scale for strenuousness.
See this image and copyright information in PMC

References

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