Effectiveness of virtual reality-based programs as vestibular rehabilitative therapy in peripheral vestibular dysfunction: a meta-analysis. 2023

Nagwa Mohamed Hazzaa, and Ayat Farouk Manzour, and Eman Yahia, and Eman Mohamed Galal
Audiology Unit, Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

OBJECTIVE To study the efficacy of virtual reality (VR) interventional programs as a vestibular rehabilitative method for patients with uncompensated peripheral vestibular disorders. METHODS The databases PubMed, Google scholar, Embase and Cochrane Library were used (up to July 2021). Studies selected in this study were controlled trials in which virtual reality was used as vestibular rehabilitative therapy in comparison to any other vestibular rehabilitative methods or medical or dietary recommendations. Comparison was made in at least one of these outcomes measures; Subjective measures such as Dizziness Handicap Inventory, Vertigo Symptom Scale-Short Form questionnaire, Activities-specific Balance Confidence questionnaire, Dizziness Analogue Scale or Visual Analogue Scale, besides objective measures as posturography. Six articles were included in the meta-analysis; tested for heterogeneity of the estimates using chi-squared and I2 tests, outcomes were expressed as mean difference and 95% CI. Estimates from included studies were pooled using the random-effect model. RESULTS virtual reality as a vestibular rehabilitative intervention was able to improve scores of Dizziness Handicap Inventory, Vertigo Symptom Scale-Short Form questionnaire, Visual Analogue sale and posturography as outcome measures of vestibular rehabilitation. CONCLUSIONS virtual reality has a potential clinical benefit for vestibular rehabilitation in peripheral vestibular dysfunction compared with conventional vestibular rehabilitation methods. However, further research is needed to document the exact parameters of an optimal protocol for virtual reality rehabilitation, the period needed for effective rehabilitation and its side effects.

UI MeSH Term Description Entries
D004244 Dizziness An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. Lightheadedness,Orthostasis,Dizzyness,Light-Headedness,Light Headedness
D004856 Postural Balance A POSTURE in which an ideal body mass distribution is achieved. Postural balance provides the body carriage stability and conditions for normal functions in stationary position or in movement, such as sitting, standing, or walking. Postural Control,Posture Balance,Posture Control,Posture Equilibrium,Balance, Postural,Musculoskeletal Equilibrium,Postural Equilibrium,Balance, Posture,Control, Postural,Control, Posture,Equilibrium, Musculoskeletal,Equilibrium, Postural,Equilibrium, Posture,Postural Controls,Posture Balances,Posture Controls,Posture Equilibriums
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000076142 Virtual Reality Using computer technology to create and maintain an environment and project a user's physical presence in that environment allowing the user to interact with it. Virtual Reality, Educational,Virtual Reality, Instructional,Educational Virtual Realities,Educational Virtual Reality,Instructional Virtual Realities,Instructional Virtual Reality,Realities, Instructional Virtual,Reality, Educational Virtual,Reality, Instructional Virtual,Reality, Virtual,Virtual Realities, Educational,Virtual Realities, Instructional
D014717 Vertigo An illusion of movement, either of the external world revolving around the individual or of the individual revolving in space. Vertigo may be associated with disorders of the inner ear (EAR, INNER); VESTIBULAR NERVE; BRAINSTEM; or CEREBRAL CORTEX. Lesions in the TEMPORAL LOBE and PARIETAL LOBE may be associated with FOCAL SEIZURES that may feature vertigo as an ictal manifestation. (From Adams et al., Principles of Neurology, 6th ed, pp300-1) CNS Origin Vertigo,Central Nervous System Origin Vertigo,Positional Vertigo,Spinning Sensation,Vertigo, Brain Stem,Vertigo, Brainstem,Vertigo, Central Nervous System Origin,Vertigo, Central Origin,Vertigo, Constant,Vertigo, Essential,Vertigo, Intermittant,Vertigo, Paroxysmal,Vertigo, Peripheral,Vertigo, Subjective,Brain Stem Vertigo,Brain Stem Vertigos,Brainstem Vertigo,Brainstem Vertigos,CNS Origin Vertigos,Central Origin Vertigo,Central Origin Vertigos,Constant Vertigo,Constant Vertigos,Essential Vertigo,Essential Vertigos,Intermittant Vertigo,Intermittant Vertigos,Origin Vertigo, CNS,Origin Vertigo, Central,Origin Vertigos, CNS,Origin Vertigos, Central,Paroxysmal Vertigo,Paroxysmal Vertigos,Peripheral Vertigo,Peripheral Vertigos,Sensation, Spinning,Sensations, Spinning,Spinning Sensations,Subjective Vertigo,Subjective Vertigos,Vertigo, CNS Origin,Vertigo, Positional,Vertigos,Vertigos, Brain Stem,Vertigos, Brainstem,Vertigos, CNS Origin,Vertigos, Central Origin,Vertigos, Constant,Vertigos, Essential,Vertigos, Intermittant,Vertigos, Paroxysmal,Vertigos, Peripheral,Vertigos, Subjective
D015837 Vestibular Diseases Pathological processes of the VESTIBULAR LABYRINTH which contains part of the balancing apparatus. Patients with vestibular diseases show instability and are at risk of frequent falls. Disease, Vestibular,Diseases, Vestibular,Vestibular Disease

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