Use of virtual reality devices for vestibular rehabilitation in patients with vestibular dysfunction

Today, the concept of vestibular rehabilitation is a comprehensive clinical approach based on individual, programmed exercises for the treatment of dizziness and balance disorders, especially for the disorders and functional limitations detected during the evaluation. The aim of this study is to investigate the effects of vestibular rehabilitation exercises with virtual reality glasses on static and dynamic balance, risk of falling, fear of falling, anxiety, and depression. A total of 41 patients, 21 people were included in the traditional vestibular rehabilitation group, and 20 people were included in the virtual reality-based vestibular rehabilitation group. The group, who received vestibular rehabilitation with virtual reality, was given 20 sessions of exercise, 20 minutes a day, within 1 month. Patient controls were performed before treatment, at day 15, day 30, day 90, and day 180. Patient controls were performed with dynamic posturography, Berg balance scale, static SVV (Subjective visual vertical), and dynamic SVV, subjective quality of life scales. Dynamic posturography, SVV, Berg balance scale (BBS), hospital depression and anxiety scale (HAD), dizziness handicap inventory-screening form (DHI-S), and Montreal cognitive assessment were used. In the dynamic posturography results, a statistical difference was observed in the postural stability test, anterior posterior stability index and medial lateral stability index in the virtual reality-based vestibular rehabilitation group, but; In the traditional rehabilitation group, statistical difference was observed only in the medial lateral stability index. In the comparison between groups in dynamic posturography tests, no statistical difference was observed between the virtual reality-based vestibular rehabilitation group and the conventional vestibular rehabilitation group. No statistical difference was observed between the two groups in static SVV and dynamic SVV tests. Statistically significant improvement was found in all Berg Balance Scale(BBS), HAD (depression), HAD (anxiety), and DHI-S scores in group 2 who underwent Virtual Reality-assisted vestibular rehabilitation (p<0.05). When we look at the traditional rehabilitation group, there was a statistically significant difference in HAD (depression), HAD (anxiety), and DHI-S scores (p<0.05). But; No statistical difference was observed in the BBS score. There was no statistical difference in the BBS, HAD (depression), HAD (anxiety) and Montreal Cognitive Assesment scales between the virtual reality assisted vestibular rehabilitation group and the traditional vestibular rehabilitation group. Considering these promising findings, we can advocate the use of virtual reality devices in conjunction with traditional vestibular rehabilitation. The aim of this would be to maximize the effects on patients affected by unilateral vestibular hypofunction, even in the long term.