Authors (including presenting author) :
LEUNG PY, POON MWY
Affiliation :
Physiotherapy Department, Hong Kong Buddhist Hospital
Introduction :
People with vestibular disorders often present complaints of dizziness/vertigo, disequilibrium, and gait disturbance, which greatly affect their quality of life. These symptoms hinder daily activities and increase fall risk. Benign paroxysmal positional vertigo(BPPV) and vestibular hypofunction are common vestibular disorders. Vestibular Rehabilitation, which is an evidence-based program, plays an essential role for managing symptoms of dizziness/vertigo and disequilibrium that are associated with vestibular pathology. Nowadays, virtual-reality(VR) technology has been incorporated into the program with emerging evidences obtained. VR-based vestibular rehabilitation simulates daily scenarios, offering sensory input at varying difficulty levels in a safe environment.
Objectives :
This study aims to evaluate the effects of virtual reality-based vestibular rehabilitation program for managing dizziness/vertigo symptoms, balance control, self-perceived impacts on daily activities amongst people with vestibular hypofunction.
Methodology :
This was a pretest-posttest pilot study. Patients with vestibular hypofunction referred to Physiotherapy Outpatient Department for vestibular rehabilitation from July to December 2024 were recruited. All participants underwent vestibular rehabilitation training, which included repositioning maneuvers for BPPV cases and exercise prescription on gaze stability and balance training. Virtual-reality training sessions on simulated daily conditions e.g. grocery shopping, outdoor walking were provided. Outcome measures included 1.Visual Analog Scale(VAS) for vertigo/dizziness intensity; 2.Sensory Organization Test(SOT) for postural control; 3.Chinese version of Dizziness Handicap Inventory(C-DHI) for the impact of dizziness on daily activities living; 4.Chinese version of Activity-based Confidence Scale(C-ABC) for individuals' confidence in engaging activities; 5.Numeric Global Rating of Change Scale(NGRCS) to assess perceived overall improvement of the condition. All outcome measures were assessed before and at the end of training.
Result & Outcome :
Seven patients aged between 58 and 85 completed the program. Upon completion, patient reported significant reduction of vertigo/ dizziness symptoms from 5.3+/-1.8 to 1.1+/-2.3(p=0.015). Significant improvements in vestibular score of SOT from 53.7 to 74.0(p=0.016) was shown, indicating that better balance and stability obtained through enhanced integration of vestibular information. Furthermore, significant improvement in C-ABC from 53.6 to 81.5(p=0.007) and C-DHI from 48.0 to 18.0(p=0.008) was observed, showing the increase in confidence for their balance control and reduction in perceived impact on their daily lives. The NGRCS increased from 0 to +8. The pilot study shows that VR-based vestibular rehabilitation significantly improved vertigo symptoms, balance, and confidence in patients with vestibular hypofunctions. This semi-immersive technology simulates real-life challenges in a safe, monitored environment, hence accelerating rehabilitation progress.
