‘Much designed to investigate whether the visual

‘Much of the
motion sickness goes unrecognized’, the point is that unless nausea and
vomiting are elicited, decrements in performance may not even be recognized as
being indicative of motion sickness.39 Peter J. Gianaros, Eric R.
Muth suggested that motion sickness may be more appropriately viewed as
a multidimensional construct. This multidimensional syndrome consists of
various symptoms which affect the travellers which further affects their
journey. They are

·      
The nausea syndrome  comprised of at least three dimensions:

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Ø  gastrointestinal
distress (sick, queasy, ill, stomach awareness/discomfort, vomiting),

Ø  somatic
distress (shaky, lightheaded, sweaty, tired/fatigued, weak, warmth), and

Ø  emotional
distress (upset, worried, hopeless, panicked, nervous, scared/afraid).

§  Sopite-related
symptoms include drowsiness, yawning, and disengagement from the environment

The present
study was designed to investigate whether the visual vestibular habituation
exercises and controlled breathing can improve motion sickness as the best
methods for preventing motion sickness without the use of medication that has
undesired side effects. 30 participants of 18-30 years of age were given the
intervention. In this study outcome measure was assessed by using the severity
criteria of acute motion sickness & Motion Sickness Assessment
Questionnaire (MSAQ). Data was analysed using mean, standard deviation and
student paired t test which showed positive effect of habituation exercises and
controlled breathing on decreasing the symptoms and their motion sickness. The
results of Motion Sickness Assessment Questionnaire & the severity criteria
of acute motion sickness depict that the motion sickness improved significantly
after 2 weeks of intervention as indicated by decrease in mean values. Also a
home exercise programme was given for 8th weeks, results at the end
of 8th week showed that those who followed the home exercise
programme, the visual vestibular habituation exercises caused habituation
effect in them and had decreased their motion sensitivity. Although subjects
were not completely free of symptoms, but their ability to function while
travelling was no longer limited and their symptoms were mild. Furthermore, the
study suggests that during the time the patient reduce the amount of exercise,
the progress was minimal. This leads to conclusion that with an increase in
amount of exercise and level of difficulty, improvement is increased.

The sensory
conflict hypothesis by Reason and Brand et al implies that, ‘how’ of motion sickness
is based on some form of sensory conflict or sensory mismatch. The sensory
conflict or sensory mismatch is between actual versus expected invariant
patterns of vestibular, visual and kinesthetic inputs. These also include
intra-vestibular conflicts between rotational accelerations sensed by the
semi-circular canals and linear-translational accelerations (including
gravitational) sensed by the otolith.40

Habituation is superior to anti-motion sickness drugs, and it is
free of side effects. The most extensive habituation programmes, often denoted
“motion sickness desensitisation,” are run by the military, where anti-motion
sickness medication is contraindicated for pilots because of side-effects
including drowsiness and blurred vision. Neural structures such as the amygdala
as well as such areas as the nucleus tractus solitarius are thought to be
important in processes of induction of and habituation to motion sickness.
Habituation programmes have success rates exceeding 85% but can be extremely
time consuming, lasting many weeks. Critical features include:

(a)   
the massing of stimuli
(exposures at intervals greater than a week almost prevents habituation),

(b)   
use of graded stimuli to
enable faster recoveries and more sessions to be scheduled, which may help
avoid theopposite process of sensitization, and

(c)   
maintenance of a
positive psychological attitude to therapy.51

Miles and
Braitman examined activity in cranial nerve VIII and reported that the changes
are not due to adaptation at the peripheral level, but rather to habituation
that involves central nervous system changes.53

In summary, a
conflict between visual and vestibular information regarding spatial
orientation has been identified as the primary causal factor for motion
sickness, and visual stimuli alone have been shown to induce motion sickness
symptoms.13 The intervention presented in this study was developed based on
these reports and implemented for a patient with vision-induced motion
sickness.

The results of
this study showed that their symptoms of motion sickness were reduced at the
end of 2nd week. After the end of 8th week again data was
collected from 10 participants who travelled. The MSAQ total score and sub
scores from Baseline and at the end 2nd week & 8th
week was found to be decreased as indicated by decrease in mean values. This
concluded that subjects having most common symptoms of Gastrointestinal (sick,
queasy, ill, stomach awareness/discomfort, vomiting) followed by Sopite related (irritated, drowsy,
fatigue, uneasy) , central(faint-like, lightheaded, dizzy, spinning) and
Peripheral(sweaty, clammy, hot/warm,) were reduced and experienced only slight
motion sickness ( mild light-headedness, clammy but no nausea, dizziness or
sweating) respectively. On comparison of total score in level of severity
criteria for acute motion sickness between the Baseline and at the end of 2nd
Week & 8th week was found to be improved, as those having Frank,
severe or moderate malaise was decreased to moderate to mild. For few the
symptoms of motion sickness were completely resolved.  

Although
time alone may have resulted in reduction of symptoms, this study indicates
worsening of the symptoms while travelling which did not stabilize or reduce
until the exercise regimen began. Thus the study can be generalized to all
individuals with motion sickness; it describes a non-pharmacological treatment
option for this syndrome