![]() However, much of the current literature considers non-immersive commercially available video gaming systems (non-IGS) (ex. Virtual reality is defined as the immersion of the user in an interactive environment that mimics reality 18. Virtual reality and AR are two ways of delivering potential reality type vestibular rehabilitative interventions. Therefore, the use of VR/AR could improve vestibular rehabilitation compliance and overall outcomes 16, 17. Interactive video gaming systems linked to an aerobic training regimen increase adherence and physical fitness attainment more than an aerobic training regimen alone 15. 14 highlighted the importance of adherence to treatment in determining the benefit achieved through home based interventions aimed at preventing falls in the visually impaired. Seventy three percent of patients suffering from vestibular disease report more enjoyment and motivation with VR and AR interventions than vestibular rehabilitation 13. However, home exercises require the patient to be motivated to participate, which is an area where the playful activities utilized in virtual reality (VR) and augmented reality (AR) may add benefit. Vestibular rehabilitation can be done at home, in the clinic or in a combination of these settings. The American Physical Therapy Association Clinical Practice Guidelines indicate that vestibular exercises are effective when compared to no or placebo exercises and that customized exercises are more effective than generic 12. ![]() Vestibular rehabilitation is an umbrella term that covers a range of exercise regimens from the generic such as Cooksey Cawthorne exercises to the customised 11. McDonnell and Hillier's 11 Cochrane review concluded that there was moderate to strong evidence of its effectiveness in individuals with Unilateral Vestibular Hypofunction (UVH). Vestibular rehabilitation is the main therapeutic option for many patients with dizziness. Dizziness and its sequelae can create a dizziness handicap for symptomatic patients and carries a $64,929 lifetime burden for affected older adults 10. ![]() Chronic dizziness symptoms can lead to symptoms of anxiety and depression 8, 9. The vestibular system can be affected by a variety of peripheral vestibular disorders (PVD), including benign paroxysmal positional vertigo (BPV), Menière’s disease (MD), vestibular neuritis (VN) and post-traumatic vestibular dysfunction. This sensory information leads to adjustments in body movements and posture to maintain balance 7. The vestibular apparatus of the inner ear is the primary input for the vestibular system and relays information on head position and motion to the midbrain. The vestibular system consists of sensory organs, cortical and subcortical structures that contribute to balance alongside proprioception and vision. Disorders of the vestibular system are identified in 50–65% of patients seen in specialist dizziness clinics 5, 6. In publicly funded healthcare systems 0.8–1.7% of general practitioner attendances are for symptoms of dizziness or vertigo 2, 3, 9–13% of whom are referred to other specialists such as neurologists, cardiologists and otolaryngologists 3, 4. Similar content being viewed by othersĭizziness is a common complaint affecting up to 23% of the population at any time in a first world setting 1. Adjunct VR interventions reduced patient DHI significantly more than vestibular rehabilitation alone 0–3 months post-intervention in adult patients diagnosed with unilateral vestibular disease. Bias assessment identified DHI scores and side effects to be at high risk or of some concern. ![]() Side effects reported by two studies were reduced by week four of VR intervention. Meta-analysis identified a 1.13 (95% CI, − 1.74, − 0.52) standardized mean difference reduction in DHI in VR and AR treated patients compared to controls. Dizziness Handicap Inventory (DHI) scores 0–3 months post-intervention were reported by four studies. Five studies meeting eligibility criteria were included. Risk of bias assessment and meta analyses were planned. Secondary outcomes included long-term symptom improvement and side effects. Reduction in vestibular dysfunction symptoms 0–3 months post-intervention was the primary outcome. MEDLINE, EMBASE, CENTRAL, CINAHL, PsychInfo, PsychBITE, OTSeeker, Ei Compendex, IEE, Clinical and WebofScience databases were searched. Evidence of the efficacy of VR and AR delivered rehabilitation in patients with peripheral vestibular disorders is reviewed. Virtual reality (VR) and augmented reality (AR) can be utilised in vestibular rehabilitation. Vestibular rehabilitation therapy is an established treatment for patients with vestibular dysfunction.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |