A study investigating the possibility and practicality of assessing and treating dizziness after traumatic brain injury
Dizziness is very common after a head injury. In many cases, it is caused by benign paroxysmal positional vertigo (BPPV), a treatable condition where tiny crystals inside the inner ear become dislodged. Even though BPPV is common, it is often missed or left untreated while people recover in hospital. This study looks at whether training hospital ward staff to test for and treat BPPV directly at the bedside is practical and effective. Adult hospital patients with a head injury who have this type of dizziness will take part in gentle balance tests. They will then receive one of three simple care approaches: head repositioning movements, home-style balance exercises, or helpful advice. Participants are followed up at 4 and 12 weeks to see how their dizziness improves.
At a glance
What is this study about?
Experiencing dizziness or spinning sensations after a head injury can be unsettling and make recovery harder. In up to half of these cases, the cause is a condition called benign paroxysmal positional vertigo, or BPPV. BPPV happens when tiny natural crystals in the inner ear get knocked out of place, sending confusing signals to the brain that you are moving when you are standing or sitting still.
While doctors and nurses in major trauma wards are experts at treating urgent physical injuries, dizziness can sometimes be overlooked. Patients may wait until after they leave the hospital to get help for balance problems. This study aims to change that by training regular ward staff to recognise, test for, and treat BPPV as soon as possible during a hospital stay.
By testing whether bedside treatment is practical in everyday NHS hospital wards, the researchers hope to make early dizziness care routine. Finding out which simple treatment works best on the ward could help future patients recover their balance faster, feel safer on their feet, and return to normal life sooner.
Key takeaways
- Tests whether hospital ward staff can easily diagnose and treat inner-ear dizziness (BPPV) after a head injury.
- Open to adult hospital inpatients recovering from a head injury confirmed by a CT scan.
- Compares three standard care options: gentle head repositioning movements, balance exercises, or practical advice.
- Involves bedside assessments and two follow-up visits over a 12-week period.
- Participation is voluntary, and you can stop tests at any time if you feel dizzy or unwell.
Who may be eligible?
This study is open to adults aged 18 and older who are currently staying in hospital because of a closed head injury (confirmed by a CT scan) and who are experiencing dizziness caused by BPPV. Ward staff involved in their care may also take part in interviews.
To ensure safety, the study is not suitable for everyone. People cannot take part if they are pregnant, have unstable neck or spine injuries, or have severe confusion or reduced consciousness. It also excludes individuals taking a medicine called phenytoin, those with active severe mental health conditions, or people with a history of substance abuse.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- I am aged 18 or older.
- I am currently staying in hospital after a head injury.
- A CT scan has confirmed my head injury.
- I am experiencing dizziness or spinning feelings when moving my head.
- I do not have an unstable neck injury and I am not pregnant.
What does participation involve?
If you take part, ward staff will first ask you some questions about your symptoms and carry out a few gentle, non-invasive balance checks at your bedside. If BPPV is confirmed, you will be randomly placed into one of three standard treatment groups: a simple set of guided head movements (called repositioning manoeuvres) to help shift inner-ear crystals back into place, a set of gentle balance exercises (Brandt-Daroff exercises), or practical advice on managing your symptoms.
After you leave hospital, you will have two follow-up visits: one at 4 weeks and another at 12 weeks. These visits will check whether your dizziness has cleared up and how your recovery is progressing. The total time you will be involved in the study is about 3 months, and you will be reimbursed for your travel and time for the follow-up visits.
Potential risks and benefits
Locations (3)
- St. Mary's HospitalApproximateLondon, England
- King's College HospitalApproximateLondon, England
- St George's HospitalApproximateLondon, England
Common questions
What is BPPV?
BPPV stands for benign paroxysmal positional vertigo. It is a common inner-ear problem where tiny calcium crystals become loose and float into areas where they should not be, causing short bursts of dizziness when you move your head.
Do the balance tests hurt?
No, the tests are completely non-invasive and do not involve needles or painful procedures. They only involve moving your head and body into specific positions while staff watch your eye movements.
What happens if I feel sick during the tests?
Moving your head can sometimes bring on brief dizziness or nausea. You are always in control, and the staff member will stop the movement or test immediately if you ask them to.
Will taking part cost me anything?
No. The hospital assessments are part of the study, and you will receive financial reimbursement to cover your travel and time for the follow-up appointments at 4 and 12 weeks.
Can I leave the study if I change my mind?
Yes. You can leave the study at any point without giving a reason. Your standard hospital care and treatment will continue as normal.
How to find out more
Rebecca Smith
Always speak to your GP or specialist before deciding to take part in a study.
Discussion
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