Epidemiology and antimicrobial resistance patterns of bacterial meningitis among hospitalized patients at a tertiary care hospital in Saudi Arabia: a six-year retrospective study.

INTRODUCTION: Bacterial meningitis poses significant medical challenges due to its acute inflammatory nature and potential for severe neurological complications, emphasizing the need for prompt diagnosis and treatment. Limited data exists on its epidemiology and antimicrobial resistance trends among hospitalized patients in Saudi Arabia. This study aimed to investigate these factors at a tertiary care hospital over six years. METHODS: A retrospective analysis was conducted on cerebrospinal fluid samples results from 222 bacterial meningitis cases among hospitalized patients between 2018 and 2023. Demographic, clinical, microbiological data, and antibiotic susceptibility patterns were collected and analyzed. RESULTS: Pseudomonas aeruginosa (43%) was the predominant pathogen isolated. Neonates (16%) and children (47%) were most affected population. Nosocomial meningitis accounted for 92% of cases, mainly in the intensive care settings (50.45%). Extended-spectrum beta-lactamase was the leading resistance pattern (12.2%). Seasonal variation was observed, with a peak incidence in October-November. CONCLUSION: The study highlights the substantial burden of bacterial meningitis among hospitalized patients, especially among high-risk groups. Emerging antimicrobial resistance emphasizes the need for optimized surveillance and stewardship. Future prospective research employing molecular techniques across multiple centers in the country is warranted to enhance understanding and guide public health strategies in Saudi Arabia.

Role of telerehabilitation in the rehabilitation of children with cerebral palsy during COVID-19: A review.

Individuals with cerebral palsy (CP) have limited mobility and are unable to actively participate in tasks that are part of their daily living. Thus, continuous therapeutic sessions are required to keep such individuals active and engaged in the environment. Due to the coronavirus disease of 2019 (COVID-19) lockdowns, rehabilitation for children with CP was inhibited which consequently put them at risk of losing their functional gains which were obtained through previous in-person therapies. In order to avoid this, an alternate to conventional therapy was required and this rendered it necessary to review the role of telerehabilitation (TR) and its various modes for the rehabilitation of children with CP. This study aimed to explore the effectiveness of TR for children with CP during COVID-19 through the present literature and to determine if TR is an alternate to conventional physical therapy in children with CP during the coronavirus outbreak. This scoping review was conducted by searching different databases such as PubMed, Cochrane Collaboration, Medline, and Google Scholar on the basis of inclusion criteria. Screening was performed from January 2019 to June 2022 and the initial screening attempt returned 469 studies. After applying the aforementioned criteria, all impertinent studies were excluded which resulted in 28 studies being included for this review as they contained information about the effectiveness of TR on children with CP during COVID-19. These 28 articles included randomised controlled trials, surveys, reviews, clinical trials, case reports, prospective studies, editorials, and longitudinal studies. Three out of the 7 randomised controlled trial studies revealed that action observation treatment can be a useful approach for TR in child with CP during similar pandemics. The other 3 studies supported the use of computer-based games, robots, nonimmersive virtual reality, and wearable haptic devices as a significant means of TR in child with CP as an alternate to routine therapy during COVID-19. TR is an affable mode of rehabilitation specifically for the pediatric population. In the future, it can be an alternate to routine therapy for those who are unlikely to get daily access to in-person therapeutic sessions due to various reasons or circumstances.

Arabic version of the Extended Nordic Musculoskeletal Questionnaire, cross-cultural adaptation and psychometric testing.

BACKGROUND: The Extended Nordic Musculoskeletal Questionnaire (NMQ-E) had never been adapted into Arabic. We culturally adapted the NMQ-E to Arabic in five stages and investigated its psychometric properties. METHODS: After translating and cross-culturally adapting the NMQ-E into Arabic, through forward translation, translation synthesis, backward translation, expert committee review, and pilot testing, the psychometric properties were investigated. The construct validity was assessed by having the participants completing the Arabic version of the NMQ-E with four Arabic scales that measured musculoskeletal pain in all regions covered in the NMQ-E. Participants' baseline records were also used to evaluate internal consistency (Cronbach's α). Seven days later, participants completed the Arabic NMQ-E again to evaluate its test-retest reliability employing intraclass correlation coefficient (ICC) and standard error of measurement (SEM) for the age questions, and Cohen's kappa coefficient (κ), the proportion of observed agreement (Po), the proportion of positive agreement (Ppos), and the proportion of negative agreement (Pneg) for the dichotomous items. RESULTS: A total of 127 participants, 70 males and 57 females with mean age 32.5 ± 12.2 years, were included. Significant differences were found between participants with and without musculoskeletal pain in the corresponding scales, signifying the content validity of the questionnaire. Cronbach's α for both the prevalence and consequences pain sections combined ranged from 0.30 to 1.00. The test-retest reliability of the age questions was excellent, with ICC values ranging between 0.995 and 1.00. The SEM was 0.77 for the neck region and 0 for the rest of the regions. The prevalence questions demonstrated almost perfect agreement, with κ values ranging between 0.82 and 1.00, the Po between 0.94 and 1.00, the Ppos between 0.80 and 1.00, and the Pneg between 0.93 and 1.00. The consequences of pain questions showed moderate-to-perfect agreement, with κ values ranging between 0.57 and 1.00, between 0.83 and 1.00 for the Po, between 0.50 and 1.00 for the Ppos, and between 0.86 and 1.00 for the Pneg. CONCLUSIONS: The results suggest that the Arabic NMQ-E is a valid and reliable tool that can be used to screen Arab adults for the prevalence and consequences of musculoskeletal pain.

Translation and cross-cultural adaptation of the functional mobility scale in children with cerebral palsy into Arabic.

Introduction: Cerebral palsy (CP) is a lifelong disorder of posture and movement which often leads to a myriad of limitations in functional mobility. The Functional Mobility Scale (FMS) is a parent-report measure of functional mobility for children with CP at three different distances (5 m, 50 m, and 500 m). This is a cross-sectional study which sought to translate and culturally adapt the FMS into Arabic and to validate the translated version. Functional mobility for children and adolescents with CP in Saudi Arabia was examined. Methods: The translation methodology complied with the World Health Organization Disability Assessment Schedule 2.0 translation package. A total of 154 children with CP were recruited (mean age 8.16 ± 3.32 years). Parents were interviewed to rate the usual walking ability of their children on the Arabic FMS. The re-test assessment was done with 34 families. The mean time interval between the first and second sessions was 14.3 days (SD = 8.5), with a range of 6-37 days. Results: Concurrent validity was explored using Spearman's rank correlation coefficient between scores of the Arabic FMS with their corresponding score on the Gross Motor Function Classification System (GMFCS). Spearman's r values ranged between (-0.895 and -0.779), indicating strong to very strong correlations. The Test-retest reliability was examined using Cohen's weighted kappa, which showed almost perfect agreements. There was greater limitation for functional mobility at longer distances as 55.2% of children could not complete 500 meters (FMS score N). Overall, there was limited use of wheelchairs for all distances (ranging from 9.1% to 14.3%). Levels IV and V on the GMFCS had less variation in FMS scores and most of the children in these levels either did not complete the distances (no functional mobility at all distances) or used a wheelchair for mobility. Discussion: The Arabic FMS was shown to be a reliable and valid measure of functional mobility for children with CP in their environment based on the parental reports. Functional mobility varied at different distances and within each GMFCS level. The use of both the GMFCS and FMS when assessing children with CP is recommended.

Dizziness in Saudi Arabia: An epidemiologic study.

Introduction: Dizziness is one of the most common and recurring complaints in adults presenting at the clinic. However, its prevalence in the population of the Kingdom of Saudi Arabia remains unclear. We aimed to examine the prevalence and correlates of dizziness in a large sample of the Saudi population. Methods: In this is cross-sectional study, we used an electronic survey, which was completed by 1.478 respondents, with a response rate of 84% across five regions of Saudi Arabia. The online survey was launched on the Qualtrics website and distributed via social media channels to obtain heterogeneous responses. The study included adults aged ≥18 years who resided in Saudi Arabia during data collection. We used t-test and chi-square test for descriptive analysis and multiple logistic regression model to assess prevalence and predictors of dizziness. Results: More than half of the participants were aged between 26 years and 45 years (58.66%). Of the participants, 42.97% reported having dizziness at the time of taking the survey. Women were less likely than men to report dizziness (OR = 0.65; CI, 0.49, 0.87; p = 0.003). A description of the type of dizziness by age revealed that vertigo slightly decreased with age. Unclear vision with movement or blurry vision was common in young adults, whereas imbalance was common in older adults. A multiple regression model adjusted for demographic characteristics revealed a statistically significant association between dizziness and age group. Participants in the age group of 46-55 years were 1.83 times more likely to report dizziness compared to those aged >65 years (odds ratio = 1.83; confidence interval, 0.62, 5.41; p = 0.0009). Discussion: Dizziness is a common complaint in Saudi Arabia. Future studies should elucidate the risk factors for and mechanisms of dizziness to help prevent falls and reduced quality of life.

Cross-Cultural Adaptation and Psychometric Properties of the Arabic Version of the Fall Risk Questionnaire.

A simple, valid, and reliable self-assessment fall-risk questionnaire in Arabic is needed to significantly promote awareness and develop fall-prevention programs. This study translated and adapted the Fall Risk Questionnaire (FRQ) into Arabic and determined its validity and reliability among Saudi Arabian older adults in two phases: (1) cross-culturally adapting the FRQ into Arabic and (2) assessing the adapted questionnaire's psychometric properties in two sessions with 110 Arabic-speaking participants aged ≥65 years. Pearson's r showed that the Arabic FRQ had a significant moderate negative relationship with the Berg Balance Scale and fair-to-moderate positive correlations with Five Time Sit to Stand and Time Up and Go. The receiver operating characteristic curve indicated a significant area under the curve = 0.81. The cut-off score was 7.5 and associated with 73.7% sensitivity and 73.6% specificity. Internal consistency was estimated as good, with Cronbach's α = 0.77. Deletion of item 1 slightly increased Cronbach's α to 0.78. The Arabic FRQ demonstrated excellent test-retest reliability, with an intraclass correlation coefficient = 0.95 (95% CI: 0.92-0.97). It is highly valid and reliable in providing valuable data for evaluating fall risk in adults aged ≥65 years and for consulting a specialist for further investigation if necessary.

Isolation of Staphylococcus aureus Urinary Tract Infections at a Community-Based Healthcare Center in Riyadh.

Background The aim of this study was to assess the clinical presentation, risk factors, and comorbidities of the patients with Staphylococcus aureus bacteriuria, and to analyze the antimicrobial susceptibility data of S. aureus isolated from their urine samples. Methods A total of 90 isolates of S. aureus were collected from patients with urinary tract infections (UTIs). Urinalysis was performed manually, including macroscopic examination of color and appearance, and microscopic examination for the presence of urinary WBCs, RBCs, and bacteria. Full identification and susceptibility testing of S. aureus were performed by the VITEK 2 system (BioMérieux, Marcy-l'Étoile, France) using standard criteria. Results The majority of the patients were female (62%), with a mean age of 32.9 years. Most of the patients were outpatients (85%), and 52% were previously healthy with no underlying disease. Seventy positive urine cultures were associated with UTI symptoms, and the most common symptom was dysuria (40%). Out of 77 urinalyses performed, 58 were positive for UTI. Of the S. aureus isolated, 24% were methicillin-resistant S. aureus (MRSA). Susceptibility to vancomycin, teicoplanin, and linezolid was 100%, while susceptibility to erythromycin, clindamycin, gentamicin, trimethoprim-sulfamethoxazole, fusidic acid, and tetracycline, was 86%, 93%, 97%, 91%, 68%, and 87%, respectively. Conclusion Although S. aureus UTI is known to be associated with other risk factors such as urinary catheterization, long hospital stay, or complicated UTI, our results show the community-acquired presentation of UTI. Trimethoprim-sulfamethoxazole may be used as an effective treatment for UTI caused by S. aureus. S. aureus UTI could be an alarming sign of more invasive infections such as S. aureus bacteremia, though clinical evaluation and finding the source of S. aureus are crucial for effective treatment and prevention of further complications.

Evaluation of Minimal Optimal Dose of Intravenous Ferric Carboxymaltose for Treatment of Iron Deficiency Anemia and Risk of Transient Hyperferritinemia.

Background: Iron supplementation is administered orally or intravenously to treat iron-deficiency anemia (IDA). Ferric Carboxymaltose (FCM) "Ferinject®" is an intravenous (IV) iron preparation that has emerged as a safe therapeutic option for treating IDA in the past decade. Aim: This study aimed to evaluate safety and efficacy of carboxymaltose in a cohort of patients with IDA not responding to oral therapy. Methods: This 12-month retrospective study included 106 patients with IDA, with-or without bariatric surgery, who received (single or multiple doses) of Carboxymaltose 500mg/10mL. Data points included patients' demographics, baseline data for Hb, platelet, ferritin, and MCV pre-and at 1, 2, and 3 months following different doses of IV-Carboxymaltose. Changes in Hb, MCV, platelets, and ferritin levels were recorded in response to Carboxymaltose to assess the optimal dose, risk of hyperferritinemia, and hypophosphatemia. Results: At three months (95 days) follow-up, the median change pre-and post-therapy in hemoglobin was from 9.5 to 11.9g/dL (p < 0.01), MCV 73.6-80.5fL (p < 0.01), and ferritin 5.3-93.8ng/mL. A significant difference was observed between platelet count of patients who underwent bariatric surgery and those who did not. An optimal ferritin response (>30ng/mL) was observed in 87.8% of patients who received first dose, and none of the full three doses showed no response. 37% of patients who received two doses developed hyperferritinemia. Serum phosphate levels were assessed in 28 cases, and hypophosphatemia was observed in 25% of these patients. Conclusion: Carboxymaltose is a reliable option for IDA. IV-FCM therapy helps achieve significant improvement in hemoglobin concentration and MCV from the first dose carrying a low reversible risk of hyperferritinemia following multiple doses. An interesting finding of this study is the discovery of a population of IDA patients requiring periodic assessment for iron reinfusion to sustain normal levels, mostly post-bariatric surgery. Changes in serum phosphate levels reported to occur consecutively with FCM treatment should be further studied.

Correlation between anxiety and chronic motion sensitivity.

BACKGROUND: Chronic motion sensitivity (CMS) is a combination of autonomic symptoms provoked by exposure to motion. The correlation between anxiety and CMS is not yet well understood. OBJECTIVES: 1) To compare median anxiety levels between young adults with and without CMS. 2) To examine the effect of anxiety on postural stability with immersion virtual reality. 3) To compare anxiety levels between sexes. METHODS: Participants included 60 adults (20-40 years), with and without CMS. After determining their current and general anxiety levels, postural stability was measured. RESULTS: There were significant differences in median (minimum, maximum) state- and trait-anxiety scores between participants with and without CMS, but no significant differences in median state- and trait-anxiety scores between males and females with CMS. There was a significant inverse relationship between state- and trait-anxiety scores and postural stability (ρ= -0.28, p = 0.03, and ρ= -0.32, p = 0.01, respectively). The stepwise regression analysis showed the Motion Sickness Susceptibility Questionnaire-Short Form score to be the only variable contributing significantly to postural stability (R2 = 26.2%; t = -4.5, p < 0.001). CONCLUSIONS: Young adults with CMS are more anxious, although anxiety does not contribute to postural stability in this group. Anxiety levels do not appear to differ between young adult males and females with CMS.

Nonalcoholic fatty liver disease in lean and obese patients in Saudi patients from a single center.

BACKGROUND: Fatty liver is a disease caused by the accumulation of fat in the liver. It is one of the major risk factors for developing cirrhosis and hepatocellular carcinoma. Saudi Arabia is one of the most prevalent countries in diabetes and obesity; the overall prevalence of diabetes is 23.7% and obesity is 35.6%. AIM: To study the correlation between fatty liver finding on abdominal ultrasound (US) and their clinical and biochemical profile including BMI, blood glucose level, lipid profile, liver function tests, and blood pressure in both group lean and obese patients. METHODS: Cross-sectional study of 346 fatty liver ultrasound-proven patients were enrolled in the study from January to May 2016 in King Saud Hospital- Qassim, Saudi Arabia. RESULTS: Mean age of the participants was 50.3 years. Female participants were 55% of the cohort. Participants were divided based on their BMI: BMI <25 (lean), BMI of 25-30 (overweight and mild obesity), and BMI >30 (morbid obesity). We found that cholesterol (P = 0.007) and low-density lipoprotein (LDL) (P = 0.015) were higher in lean compared to others (5 and 3.1), respectively. Gamma-glutamyl transferase (GGT) was higher in mildly obese patients (113.2) and ALT, which was higher in lean patients (60.4). In addition, 34.5% of the overall patients had Diabetes Mellitus (DM). We found that HbA1c was lower in lean (7.3) compared to morbidly obese patients (7.6). Platelets counts were higher in morbidly obese patients (278) compared to other groups. CONCLUSION: High cholesterol and LDL strongly correlated with lean fatty liver patients. There was a significant relationship between the female gender and the risk of development of fatty liver. However, liver enzymes were within the normal range, except GGT, which was higher in all the groups, with the highest value in mildly obese patients. Therefore, they are not sensitive for diagnosing fatty liver patients.

Level of Adherence to COVID-19 Preventive Measures Among Health Care Workers in Saudi Arabia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a pandemic caused by a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Health-care workers (HCWs) are at a high risk of contracting SARS-CoV-2 infection. Thus, different infection control strategies have been used to reduce SARS-CoV-2 transmission. Our study aims to assess the level of adherence of HCWs to the preventive measures against COVID-19 in Saudi Arabia. METHODS: An observational study was carried out using data collected by a self-administrated dual-language (Arabic and English) online questionnaire directed to HCWs in Saudi Arabia to measure the level of adherence to COVID-19 preventive measures. All HCWs involved in patient care in Saudi Arabia were included in this study. RESULTS: A total of 214 HCWs were included in the study (median age = 30 years; 62% male). Among all the participants, 65% of HCWs were in direct contact with COVID-19 patients, and 18% were diagnosed with COVID-19. The level of overall adherence to mask use was 82%. HCWs were committed to wearing gloves, gowns, and goggles with a percent of 95%, 85%, and 68%, respectively. CONCLUSION: Our findings demonstrated that HCWs in Saudi Arabia have an acceptable level of adherence to COVID-19 preventive measures during the pandemic. Larger studies are required to evaluate the effectiveness of these preventive measures in reducing the transmission of respiratory microbes between HCWs and patients.

Variations in length of stay of inpatients with COVID-19: A nationwide test of the new model of care under vision 2030 in Saudi Arabia.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) has impacted the Kingdom of Saudi Arabia (KSA) as it has other nations. However, length of stay (LOS), as a healthcare quality indicator, has not been examined across the healthcare regions in the KSA. Therefore, this study aimed to examine factors associated with LOS to better understand the Saudi Health System's performance in response to the COVID-19 pandemic in the newly suggested five Saudi regional business units (BUs). METHODS: A retrospective study was conducted using Ministry of Health (MOH) data on hospital LOS during the period from March to mid-July 2020. Participants were adult inpatients (18 years or older) with confirmed COVID-19 (n = 1743 patients). The 13 regions of the KSA were united into the defined five regional BUs during the reorganization of the health system. Covariates included demographics such as age and sex, comorbidities, and complications of COVID-19. A multiple linear regression with stepwise forward selection was used to model LOS for other explanatory variables associated with LOS, including demographic, comorbidities, and complications. RESULTS: The mean LOS was 11.85 days which differed significantly across the BUs, ranging from 9.3 days to 13.3 days (p value < 0.001). BUs differed significantly in LOS for transferred patients but not for patients in the intensive care unit (ICU) or those who died in-hospital. The multiple regression analysis revealed that the LOS for inpatients admitted in the Eastern and Southern BUs was significantly shorter than for those in the Central BU. (p value < 0.001). Admission to the ICU was associated with lengthier stays (p value < 0.0001). Factors significantly associated with shorter stays (compared to the reference), were being Saudi, death during admission, and patients referred to another hospital (p value < 0.05). CONCLUSION: The LOS for patients with COVID-19 differed across the proposed regional healthcare BUs, suggesting regional differences in quality of care under the reorganization of the national health system. Since patient and disease characteristics did not explain these findings, differences in staffing and other resources need to be examined to develop interventions.

Regional differences in COVID-19 ICU admission rates in the Kingdom of Saudi Arabia: A simulation of the new model of care under vision 2030.

OBJECTIVE: Saudi Arabia has succeeded in having one of the lowest rates of COVID-19 worldwide due to the government's initiatives in taking swift action to control both the spread and severity of the virus. However, Covid-19 can serve as a test case of the expected response of the new healthcare system under Vision 2030. This study used data from the thirteen present administrative regions of KSA to simulate the variations in ICU admission as a quality indicator in the five business units proposed by a new Model of Care. METHODS: We determined the rates of ICU admission for patients with confirmed SARS-CoV-2 (COVID-19) from March to mid-July 2020. The final sample included 1743 inpatients with moderate to severe COVID-19. Patient characteristics, including demographics, pre-existing chronic conditions, and COVID-19 complications, were collected. Business units (BUs) were compared with respect to the relative odds of ICU admission by using multiple logistic regression. RESULTS: After keeping patient and clinical characteristics constant, clear BU differences were observed in the relative odds of ICU admission of COVID-19 patients. Inpatient admission to ICU in our total sample was almost 50%. Compared to the Central BU, the Northern and Western BUs showed significantly higher odds of ICU admission while the Eastern & Southern BUs had significantly lower odds. CONCLUSION: ICU use for COVID-19 patients differed significantly in KSA healthcare BUs, consistent with variations in care for other non-COVID-19-related conditions. These differences cannot be explained by patient or clinical characteristics, suggesting quality-of-care differences. We believe that privatization and the shift to fewer administrative BUs will help lessen or eliminate altogether the present variations in healthcare service provision.

Effects of head motion on postural stability in healthy young adults with chronic motion sensitivity.

BACKGROUND: Motion sensitivity, or motion sickness, is common in modern vehicular and visually stimulating environments. Several studies have shown a relationship between motion sensitivity and decreased postural stability. We aimed to evaluate the effects of head motion (horizontal and vertical) on postural stability in healthy adults with and without chronic motion sensitivity (CMS). METHODS: Sixty healthy adult men and women (age, 20-40 years) with CMS (CMS group, n = 30) and without CMS (non-CMS group, n = 30) participated in the study. Postural stability was assessed during three conditions (static, horizontal head motion, and vertical head motion) using computerized dynamic posturography. Group and condition-related differences in equilibrium scores were evaluated. RESULTS: There was no significant group x condition interaction (F2,114 = 0.9, partial ƞ2 = 0.04, p = 0.35). However, significant condition-related differences in equilibrium scores were observed (F2,114 = 26.4, partial ƞ2 = 0.31, p < 0.001). Equilibrium scores were significantly worse in the horizontal and vertical head motion conditions compared to those in the static condition (p < 0.001), but were comparable in vertical and horizontal head motion conditions (p = 0.27). CONCLUSIONS: Postural stability was lower in the horizontal and vertical conditions compared to the static condition. However, horizontal and vertical head motions had comparable effects on postural stability in both CMS and non-CMS groups, contrary to our expectations.

Effect of Gaze Stability Exercises on Chronic Motion Sensitivity: A Randomized Controlled Trial.

BACKGROUND AND PURPOSE: Motion sensitivity is a common condition among the general population and may be accompanied by postural instability and anxiety. Preliminary studies suggest that minimal dosage of gaze stability exercises improves postural stability in young adults with chronic motion sensitivity. The aim of this study was to investigate the effect of progressive gaze stability exercises on postural stability, motion sensitivity, and anxiety in healthy young adults with chronic motion sensitivity. METHODS: We conducted a single-blind randomized controlled trial to assess the effect of gaze stability exercises on chronic motion sensitivity. Forty-one participants of both genders ages 20 to 40 years with chronic motion sensitivity were randomly assigned to 2 groups. The intervention group performed gaze stability exercises while the sham group performed saccadic eye movement exercises for 6 weeks. Computerized Dynamic Posturography with Immersion Virtual Reality (CDP-IVR)-condition 1 (C1) and condition 2 (C2)-Motion Sensitivity Quotient (MSQ), Motion Sickness Sensitivity Susceptibility Questionnaire Short Form (MSSQ-Short: MSA, MSB), and State-Trait Anxiety Inventory for Adults (STAI Form Y-2) were the outcome measures used. RESULTS: There was no significant group × time interaction for MSA, MSB, MSSQ percentile, STAI, MSQ, C1 mean, or C2 mean. However, posttreatment a significant difference in the mean CDP-IVR score of C2 was identified between the 2 groups. For C2, the intervention group demonstrated a 117% increase in the mean CDP-IVR score compared with a 35.2% increase in the sham group. MSQ reduced significantly from baseline to 6 weeks postintervention in the intervention group (4.0 ± 1.2 vs 1.9 ± 0.9). Anxiety was significantly reduced in the sham group only (38.2 ± 1.9 vs 35.8 ± 2.2). DISCUSSION AND CONCLUSIONS: Based on the results of this study, progressive gaze stability exercises appear to have value for managing chronic motion sensitivity in healthy young adults. Further research with larger sample size and broader age range is needed to generalize these findings.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A203).

Effect of visual input on postural stability in young adults with chronic motion sensitivity: A controlled cross-sectional study.

BACKGROUND: Chronic motion sensitivity (CMS) has been defined as a feeling of un-wellness elicited by either actual or perceived motion. CMS is a common condition and is more prevalent in females than in males. In addition to a variety of symptoms, young adults with CMS have less postural stability than those without CMS. OBJECTIVE: To determine whether dependence on visual cues for postural stability is different between young adults with and without CMS, and whether it differs by gender within each group. METHODS: Sixty young adults (30 females and 30 males) were assigned to one of two groups (CMS or non-CMS) using the Motion Sickness Susceptibility Questionnaire-Short Form. Postural stability was measured for all participants using the Bertec Balance Advantage-Computerized Dynamic Posturography with Immersion Virtual Reality. RESULTS: A significant difference was found in mean postural stability scores during immersion virtual reality between the CMS and non-CMS groups (p < 0.001); however, no significant difference was shown in mean postural stability between males and females within the CMS and non-CMS groups (p = 0.10 and p = 0.97, respectively). CONCLUSION: The results suggest that young adults with CMS are over-reliant on visual cues for postural stability, and that visual dependence is not influenced by gender.