Visual Vestibular Habituation as an Effective Treatment for Motion Sickness

Background: Motion sickness is a common problem experienced by much the population. Clinical treatments at this time are primarily pharmacological. Currently it is known that multiple exposures to motion sickness triggers can, over time, result in habituation and the patient can become free of symptoms. This repeated recurrence of sickness is not desirable or practical to daily living. Limited evidence is available for visual-vestibular habituation training that does not provoke the undesirable symptoms and can last for upwards of a year. Method: An exhaustive search of available medical literature was conducted using Medline-OVID, CINAHL, VISIONCITE, EBMR Multifile and Web of Science using the keywords: motion sickness, visual vestibular and habituation. All articles published prior to 2000, non-English language and non-human trials were excluded by the search. Relevant articles were assessed for quality using GRADE. Results: Three studies met inclusion criteria and were included in this systematic review. A pilot study consisting of 29 subjects demonstrated visual-vestibular habituation and reduction of motion sickness symptom scores in susceptible individuals from 13.0 ± 4.4 to 1.5 ± 3.1 eighteen weeks after habituation. A randomized controlled, double blind, trial with 20 subjects demonstrated an overall reduction in the peak velocity and in time constant of 17.2% and 22.7% respectively (p<0.05) with vestibular training. A pilot study demonstrated figure skaters, due to their habituation, were less susceptible to motion sickness than were controls (2.8 ± 2.8 vs. 16.2 ± 13.7; <0.01). Conclusion: Since the overall GRADE of evidence is low, more research is needed before a strong recommendation for visual-vestibular habituation can be given. Current evidence, although limited, does show promising results for this non-pharmacological treatment for motion sickness. Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Annjanette Sommers MS, PA-C Second Advisor Mary E. Von, DHEd, PA-C, DFAAPA