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    Acute changes in postural stability during Instagram Reels viewing using virtual reality-based posturography
    (Frontiers Media Sa, 2026) Korkmaz, Hanifi; Tok, Yasin; Alkahtani, Rania; Alsaleh, Hadeel; Elbeltagy, Reem
    Short-form video platforms such as Instagram Reels deliver continuous high-visual-flow stimulation that imposes substantial visual-cognitive load even in the absence of active motor interaction, yet their impact on postural control remains largely unexplored. This study examined whether passive Instagram Reels viewing acutely alters postural stability in healthy adolescents and young adults, and whether addiction severity and habitual use patterns modulate this effect. Regular Instagram users aged 16-21 years completed virtual reality-based static posturography before and during passive Instagram Reels viewing (i.e., viewing short-form, algorithm-driven video content without active user interaction such as scrolling or screen contact). Instagram addiction severity and usage habits were assessed, and their associations with viewing-related postural changes were evaluated. Vestibular-related postural stability decreased during Reels viewing. Higher Instagram addiction severity and longer daily Instagram use were associated with smaller reductions in vestibular-related postural stability between pre- and during-viewing conditions, a pattern compatible with partial habituation and/or compensatory postural control strategies. The purpose of Instagram use was not meaningfully associated with the magnitude of change. Passive short-video exposure can acutely compromise vestibular-related postural stability even during quiet standing, while habitual exposure appears to attenuate the immediate destabilizing effect. These findings extend smartphone-balance research toward a more ecologically relevant exposure model and provide a reference framework for future studies in clinically vulnerable populations, future studies in clinically vulnerable populations, such as individuals with vestibular disorders, neurological conditions, or balance impairments.
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    Virtual reality-based assessment of visuo-vestibular integration in vestibular migraine and migraine: static and dynamic visual vertical and rod-and-frame tests
    (Frontiers Media Sa, 2026) Korkmaz, Hanifi; Ciplak, Sibel; Alkahtani, Rania
    Background: Vestibular migraine (VM) is the most common cause of episodic vertigo, yet its diagnostic markers remain limited. Perception of verticality, measured via static subjective visual vertical (SVV), dynamic SVV (DSVV), and the rod-and-frame test (RFT), provides insight into visuo-vestibular integration. Traditional approaches, however, often test these paradigms in isolation with limited ecological validity. Objective: To evaluate a novel virtual reality (VR)-based protocol combining SVV, DSVV, and RFT to characterize visuo-vestibular integration in VM, migraine without vestibular symptoms (M), and healthy controls (HC). Methods: Fifty participants (VM n = 15, M n = 15, HC n = 20) completed VR-based SVV, DSVV, and RFT assessments using the BalanceVR system. Disability was assessed using the Dizziness Handicap Inventory (DHI) and Migraine Disability Assessment (MIDAS). Between-group differences were analyzed using Kruskal-Wallis tests with Mann-Whitney U post-hoc comparisons. Correlations between orientation measures and questionnaires were assessed using Spearman's rho. Results: VM patients exhibited significantly greater SVV deviations than HC (p = 0.015). DSVV errors were elevated in VM vs. HC (p = 0.040). RFT showed robust group differences (p < 0.001), with the most significant visual dependence in VM. DHI and MIDAS scores were significantly higher in both patient groups than HC (p < 0.001). DSVV (rho approximate to 0.45) and RFT (rho approximate to 0.69) showed stronger correlations with disability than static SVV (rho approximate to 0.30). Conclusion: VM is characterized by difficulties in dynamic and visually complex situations, rather than static balance problems. Combining DSVV and RFT with SVV enhances diagnostic sensitivity, explains patients' daily challenges, and supports rehabilitation approaches aimed at reducing visual dependence and improving sensory balance.