Guide to Balanceland – a rehabilitation game for visually-induced dizziness

Visually-induced dizziness

Balanceland is the new rehabilitation game for visually-induced dizziness, created by the Cardiff University Dizzy Lab.

VIsually-induced dizziness is when certain visual environments or features make people feel dizzy. It can occur, for example, in supermarkets, crowds or buildings with stripes and repeating patterns. It can also occur with motion stimuli, such as in films/TV/computer games, or traffic.

Visually-induced dizziness can occur in several conditions, including PPPD, vestibular migraine, Ménière’s disease and others. It can also occur to some degree in people without any vestibular condition.

What is Balanceland?

Rehabilitation for visually-induced dizziness symptoms relies on desensitisation. This means exposing the person to situations that trigger their symptoms. Eventually, the brain will adjust and those situations will no longer trigger symptoms. It is important the situations that trigger symptoms are not too severe, so that rehabilitation can be tolerated and does not make people worse.

Balanceland simply makes this type of rehabilitation into a game, to make it a bit more fun and interesting and to provide some record of what you have achieved. It currently features three environments designed to be progressively more challenging: the desert, the park and the supermarket.

This means Balanceland is designed to trigger mild dizziness symptoms, which may make you feel unpleasant. But if the symptoms are too bad, you are attempting a level or a speed that is too challenging for you at the moment.

Balanceland has not yet gone through a formal clinical trial. It is based on established rehabilitation principles, and in a recent study, we found evidence that people who played the recommended time reported improved symptoms (see recent publications list). However that does not prove it works (it is possible those people might have been improving anyway). Or it might help for some people and not others. Visually-induced dizziness varies from person to person. Your vestibular clinician is best placed to advise on this.

If you decide to try it, please follow these guidelines:

  • It is recommended to play about 10 minutes, twice a day if you can.
  • Don’t stop doing any other rehabilitation your clinician has advised you to do.
  • Start playing with the Desert level, which is the simplest.
  • Start slowly, only increase speed when you are more confident you know how much your symptoms will be triggered.
  • Aim to only trigger MILD symptoms. Doing too much too fast can be detrimental.
  • If your symptoms are too intense, take a break. Try lowering the speed or a different environment.

How to Log-in and Play

Before you play, have a look at the instruction videos below. When you are ready to register and log in, follow these instructions. Please read all of them before you start, as the first login after registration is a bit confusing.

  1. Download the game at: https://game.cudizzylab.org. You will get the following screen:

2. Click the Register button in the bottom left and create an account. IGNORE the login button that appears on that page. If you have an account but have forgotten your password, go to: Lost Password – Cardiff University Dizzy Lab (cudizzylab.org)

3. After you register on the website, you must go back to: https://game.cudizzylab.org and use your new account information to login on the screen that looks like the picture above. Do not login with the login button that appears after the registration page, as this takes you somewhere else!

4. Once you have managed to login, you should get a menu that allows you to explore and play the game. the videos below explain how to play.

How to Move

Quick play will give you the Make-a-Word game mode, whereas Advanced will let you customise some of the settings.

The Worlds

Make-a-Word

This game mode focuses on finding letters and then scoring points by making words. Most words that are legal in Scrabble will get you points!

Find-a-Word

This game mode has you guessing letters to complete a hidden word. Change how many and what type of letters are hidden in the word to make it easier or harder to guess!

Going Shopping

Click on a shopping item to buy it. When you have bought everything on your shopping list, you win! Do not worry if you pick up something you do not need, it can always be put back on a shelf.