Authors (including presenting author) :
Lam WHJ(1), Li MK (1), Siu HK (1), Leung SM (1)
Affiliation :
(1) Physiotherapy Department, Prince of Wales Hospital
Introduction :
Physiotherapy plays a pivotal role in the management of vestibular disorder. Vestibular rehabilitation training is a specialised form of therapy that uses series of physical exercises to promote central nervous system compensation for inner ear deficits.
Virtual reality (VR) has been introduced as a transformative tool in vestibular rehabilitation therapy recently. The immersive nature of VR not only facilitates the engagement of multiple sensory systems but also enhances vestibular compensation and neuroplasticity, thus promoting the brain's ability to adapt to more effectively in comparison to conventional physiotherapy.
Objectives :
This project aimed to evaluate and compare the therapeutic effect in conventional physiotherapy and in adjunct with VR physiotherapy in subjects with vestibular dysfunction
Methodology :
There were 52 patients with vestibular dysfunction in the study. Patients with benign paroxysmal positional vertigo were excluded. All patients received conventional physiotherapy. Twenty-six patients had received an additional 4-6 sessions of VR training (VR group).Outcome measures of the patients (26 VR group and 26 non-VR group) were assessed before and after the treatments.
There was no significant difference in the demographic characteristics and baseline outcome measures in the non-VR and VR groups.
Outcome measures included the Dizziness Handicap Inventory (DHI) and Sensory Organisation Test (SOT) failing rate in vestibular function were recorded in before-and-after treatment sessions.
Result & Outcome :
1. Both groups have showed a within group difference in before-and-after treatment DHI score in all domains. The physical domain VR group within group difference = 3.50, p< 0.05; non-VR group = 1.79, p < 0.05. The emotional domain VR group within group difference = 3.43, p< 0.05; non-VR group =1.21 p=0.102. The Functional domain VR group within group difference = 5.14 p< 0.05; non-VR group =4.53 p< 0.05. The minimal clinical important difference (MCID) in DHI is reported to be 11-18.
2. The VR group has showed a superior between group difference in post treatment DHI score as compared with non-VR group. In Physical domain, the between group difference=1.79, p=0.108. In Emotional domain, the between group difference=3.32, p< 0.05. The Functional domain showed a difference of 1.79, p=0.179.
3. The VR group was superior in reducing the failure risk in SOT vestibular function after treatment. Subjects who have completed VR therapy has 50% less chance of failing in SOT vestibular function. The absolute risk reduction of failing vestibular function in SOT is 25%. Every 1 in 4 subjects treated will be prevented from failing vestibular function in the SOT test (NNT=4, p=1.79).
