How can body positioning and location in a vessel used in the management of motion sickness?

Updated: Oct 22, 2018
  • Author: Andrew Brainard, MD, MPH; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Selecting the most stable portion of the vessel is helpful. Patients should attempt to locate themselves near the centerline of the vessel and nearest to the ground or waterline. Conversely, locations below deck and high in the vessel often produce the most uncomfortable motion. Supporting the head to minimize additional head motion and to reduce neck strain helps reduce both vestibular and proprioceptive stimuli.

After all attempts to decrease the amount of motion have been made, adjustments to the characteristics of the motion can be tried. Facing forward or in-line with the direction of the largest motion can reduce the amount of off-axis motion, which can reduce symptoms. Reclining the head back 30º or more can alleviate symptoms by isolating the motion to a single axis within the semicircular canal.

Attempting to reduce conflicting visual stimuli can best be accomplished by attempting to maintain a steady visual horizon with an expansive of a view as possible. Looking down at the floor or water may seem comfortable, but watching the horizon or looking up is more likely to minimize symptoms. Patients should avoid closed spaces without an accurate horizon. Window seats and open-air locations are preferable. If possible, looking forward toward the source of the motion in order to be able anticipate the movements is optimal.

Body position is also very important. In addition to minimizing head motion and neck twisting relative to the patient’s body, patients should face forward in the location of the vehicle with minimal motion. Safely standing with flexed knees and actively anticipating the motion can be effective.

Finally, lying completely prone (with closed eyes) often reduces symptoms to a manageable level presumably by aligning full-body symmetrical proprioceptive input.


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