Motion Sickness and Progressive Gaze Stability Exercises: Impact on Engagement in Meaningful Activities

BACKGROUND AND PURPOSE: Twenty percent of the general population is affected by a vestibular disorder. For some, symptoms of motion sickness are so severe that they limit participation in valued activities. Onset may be provoked by movements such as rotary, vertical, and low frequency motions often experienced during travel, recreational activities, and use of screen-based media. Common symptoms include nausea, headache, vomiting, stomach sensitivity, cold sweats, and dizziness, with symptoms lasting hours as chronic episodic spells. As a result, symptomatic episodes may limit participation in leisure activities, social interactions, and driving and community mobility (Cohen et al., 2006). Gaze stability exercises consisting of 3 min of horizontal head movement with eyes fixed on a target, followed by 1 min of rest after each minute of head movement, may minimize the impact of motion sickness by improving tolerance to motion sensitivity (Alyahya et al., 2016).

This collaborative project with physical therapy aimed to reduce motion sickness symptoms to promote participation in meaningful activities. The purpose of this study was to explore the impact of progressive gaze stability exercises on participants’ engagement in meaningful activities. The related research question was, Does participation in a 6-wk progressive gaze stability exercise program versus a 6-wk saccadic eye movement exercise program reduce symptoms of motion sickness and facilitate engagement in meaningful activities?

METHOD: This study had a retrospective qualitative design using focus groups with semistructured interview questions. Participants were 41 healthy adults of both genders aged 20–40 with chronic motion sensitivity who were randomly assigned to a 6-wk progressive gaze stability exercise program (experimental group) or a 6-wk saccadic eye movement exercise program (control group).

After completing the program, 14 participants from the experimental group and nine participants from the control group participated in focus groups, each lasting 20–25 min. Focus groups were semistructured and guided by nine open-ended questions related to the impact of motion sickness on daily activities and any noted changes in participation after completion of the 6-wk program. Audio recordings were transcribed verbatim and analyzed through a process of first-cycle and second-cycle coding. A codebook was created to organize and compare key categories and identify patterns to formulate corresponding themes.

RESULTS: Participants reported difficulties engaging in meaningful activities of daily living in both childhood and adulthood as a result of their motion sickness. The three themes that emerged from this analysis were driving and community mobility, leisure and social participation, and health management. The majority of experimental participants reported that they had noted some improvement in their motion sickness symptoms.

CONCLUSION: On the basis of the qualitative data obtained, it appears that progressive gaze stability exercises were more effective in reducing symptoms of motion sickness than saccadic eye movement exercises. Motion sickness limits clients’ participation in valued activities. This study supports the role of occupational therapy in the emerging area of vestibular rehabilitation. In collaboration with other health professionals, occupational therapy practitioners are well positioned to address barriers to participation caused by motion sickness and facilitate engagement in valued activities.

References

Alyahya, D., Johnson, E. G., Daher, N. S., Gaikwad, S. B., Deshpande, S., Cordett, T. K., & Zidek, L. (2016). Effect of vestibular adaptation exercises on chronic motion sensitivity: A randomized controlled trial. Physical Therapy and Rehabilitation, 3(1). https://doi.org/10.7243/2055-2386-3-1

Cohen, H. S., Burkardt, A., Cronin, G. W., & McGuire, M. (2006). Specialized knowledge and skills in adult vestibular rehabilitation for occupational therapy practice. American Journal of Occupational Therapy, 60, 669–678. https://doi.org/10.5014/ajot.60.6.669

Hall, C., Heusel-Gillig, L., Tusa, R., & Herdman, S. (2010). Efficacy of gaze stability exercises in older adults with dizziness. Journal of Neurologic Physical Therapy, 34, 64–69. https://doi.org/10.1097/NPT.0b013e3181dde6d8