Motion Sickness: The Role of Occupational Therapy Paris Anton, OTDS | Doctor of Occupational Therapy Program | Huntington University

Project Description

Motion sickness has been around seemingly forever, however, understanding of the causes and management techniques for this phenomenon remains limited. Motion sickness is a syndrome with multiple symptoms driven by individual factors and a provocative stimulus that can occur as a result of physical motion or visual motion (Mallinson, 2011; Cha et al, 2021). Research has demonstrated that anyone with a functioning vestibular system has the potential to experience motion sickness with a stimulus that is provocative enough (Reason and Brand, 1975; Cha et al, 2021). Additionally, the discomfort caused by motion sickness symptoms may lead to decreased participation and performance of activities. For this very reason, occupational therapy may have a unique role in the evaluation and management of motion sickness. Occupational therapy (OT) is defined as a service that promotes the acquisition and preservation of identity in life occupations such as activities and instrumental activities of daily living, health management, rest and sleep, education, work, play, leisure, and social participation (American Occupational Therapy Association [AOTA], 2020). It is essential for an occupational therapist to understand the theories of motion sickness and potential treatment options because, with the proper clinical resources, motion sickness could be managed and possibly prevented through occupational therapy intervention and adjunct treatment. In addition, OT interventions themselves have the potential to induce motion sickness. It is important to not only understand how and why these symptoms occur but to also identify what may make an individual more susceptible and which management techniques are available in order to decrease prevalence within the general population. Thus, there is a need to review the evaluation and management techniques of motion sickness to guide clinical practice. The purpose of this project was to investigate the theories that lead to symptoms of motion sickness in order to identify and address risk factors and determine the prevalence and role of the OT in the evaluation and management of motion sickness through reference tools and interventional techniques. A secondary purpose of this project was to determine what role, if any, pelvic floor health plays in motion sickness susceptibility.

Needs Assessment & Literature Review

• Motion sickness has been around for centuries with the earliest reports dating back to the ancient Greeks (Reason & Brand, 1975). While motion sickness has been around seemingly forever, understanding of the causes and management techniques for this phenomenon remains limited.
• The term motion sickness is a misnomer because it implies that an individual is ill when in fact, motion sickness is a symptom-based response to certain provocative motion stimuli within a healthy individual (Benson, 2002).
• The incidence of motion sickness is very difficult to determine due to the variability of provocative stimuli and individual factors. Any person with an intact and functioning vestibular system has the potential to become motion sick with prolonged exposure to a provocative stimulus (Reason and Brand, 1975; Cha et al, 2021).
• Factors involved in the experience of motion sickness include characteristics of the stimulus itself, such as frequency, intensity, direction, and duration; activity at the time of stimulus exposure, such as reading during passive motion; and individual susceptibilities such as physiological characteristics, previous exposure and experiences, and psychological factors (Dobie, 2019).
• While it is commonly accepted that females are more susceptible to experiencing motion sickness symptoms than males, there is speculation as to why this might be. Research has determined that increased susceptibility in females may be due to the menstrual cycle, pregnancy and postpartum, or hormones. What has not been researched, however, is the potential impact of pelvic floor health.
• According to the Occupational Therapy Practice Framework: Domain and Process (OTPF), it is within the occupational therapy (OT) scope of practice to evaluate, assess and treat motion sickness, a result of sensory function, as it affects the client’s performance in occupations (American Occupational Therapy Association [AOTA], 2020).
• With the proper clinical resources, motion sickness could be managed and possibly prevented through OT evaluation, intervention, and adjunct treatment.

Area of Focus

Research | Education

Target Population

Rehabilitation specialists such as occupational therapists as well as individuals within the general population who may experience motion sickness symptoms.

Project Site

This project was completed as individual research from a remote location in partnership with a Huntington University staff member and an expert in vestibular rehabilitation

Project Mission Statement

To compile and assess research regarding overall motion sickness susceptibility and treatment within the OT scope of practice with a special interest in the correlation between pelvic floor health and postural instability as a potential indicator of motion sickness.

Project Leader

The project leader was responsible for overarching factors related to the current project, including project scheduling and planning, management, execution, and dissemination while engaging and maintaining communication with all key stakeholders.

Project Mentors

Project Outcomes

The current project had a total of 9 deliverables that are outlined below

Deliverable #1: Completion of systematic/scoping review

Deliverable #2: Creation of risk factor infographic

Deliverable #3: Document of visual-vestibular CEU completion

Deliverable #4: Creation of pelvic floor infographic

Deliverable #5: Interview transcripts from interviews with pelvic floor specialists

Deliverable #6: Document of pelvic floor CEU completion

Deliverable #7: Creation of clinical and patient reference guides

Deliverable #8: Creation of at least one educational resource for clinicians

Deliverable #9: Lecture presentation to a group of OT students

Individual topic areas with visual depictions

Research

• Reviewed current literature regarding motion sickness risk factors, theories, evaluation, and management.
• Created an infographic demonstrating common causes and risk factors of motion sickness.
• Created an infographic correlating pelvic floor health to motion sickness based on the postural instability theory of motion sickness.
• Completed scoping review of motion sickness research as it pertains to occupational therapy to guide future research and clinical practice.
• Conducted interviews with several pelvic floor therapists in order to gain knowledge about the prevalence of motion sickness in individuals with pelvic floor dysfunction
• Completed additional interviews with both professor and student at Reykjavik University to learn from their motion sickness research

Education

• Completion of CEU courses in visual/vestibular rehabilitation through occupationaltherapy.com
• Completion of CEU courses in pelvic floor health through occupationaltherapy.com
• Lecture presentation to occupational therapy students to educate on my project scope and outcomes
• Creation of an educational resource to educate clinicians on the various management techniques for motion sickness that can be utilized in clinical practice
• Creation of quick reference guides to be used by both clinicians and patients to inform of basic management techniques for motion sickness

Impact on the profession

• Research: A scoping review helps fulfill the gap within motion sickness literature to assist clinicians in the evaluation and management of motion sickness. Additionally, correlations between pelvic floor health and motion sickness can assist with future research and management techniques.
• Education: Provided education to future occupational therapy practitioners and encouraged them to enhance clinical practice skills in the area of motion sickness.

Future Directions

• This doctoral capstone project has enhanced my professional and personal development skills to better support me as an occupational therapy clinician in the future
• The project itself still possesses an open-ended question providing an opportunity for future research and study

Contact information

• Huntington email: antonp@huntington.edu
• Personal email: parishopena@gmail.com