Evaluating the effectiveness of virtual reality (VR) game systems in vestibular rehabilitation in motion sickness

Introduction: The main reason of Motion Sickness (MS) is the mismatch of inputs from visual and vestibular afferent. There is not any specific and systematical rehabilitation method for MS. The success of the conventional rehabilitation methods is reduced due to long-lasting duration, cost and their success dependency on the patient's compliance to perform the exercises correctly and regularly. "Virtual reality implementations" which is part of the industry 4.0 technologies can create better visual and vestibular inputs in virtual life that is equivalent to real life environment. Virtual reality can convert disadvantages of the conventional vestibular rehabilitation to low cost, entertaining and more effective rehabilitation. The aim of this study is to evaluate the effect of virtual reality game systems on vestibular system and to investigate the application of virtual reality for rehabilitation of the patients with MS. Methods: The study group consisted of 19 individuals (12 female, 7 male), aged between 18 and 40 years old, who are suffering from MS. The control group consisted of 20 individuals (10 female, 10 male), aged between 18 and 40 years. An anamnesis form which questions the presence and the severity of the 12 most frequent MS symptoms was prepared. This form and also Motion Sickness Susceptibility Questionnaire-Short Form (MMSQ) along with evaluation by audiological and vestibular tests were used in order to choose patients to be included in the study. The participants in the study group and the control group are rehabilitated with a roller coaster game named "Roller Coaster Dreams" in which a program has been designed by us for vestibular rehabilitation inside the Play Station VR systems. All participants were evaluated objectively by Computerized Dynamic Posturography at Pre-rehabilitation, Post-rehabilitation and at the end of 3rd, 6th rehabilitation sessions. Results: The severity of all of the symptoms which were stated to exist by the participants in the study group have decreased after the rehabilitation (p<0.001). There was a significant increase (p:0.001) in the composite scores of the SOT in the first posturography (pre-provocation) compared to that of the last one (after the 6th session). When the sensory analysis results of the SOT of the first one and the last one compared, the visual and vestibular sensory system functions were found to have increased significantly (p<0.001;p<0.005). Conclusion: VR gaming systems is concluded to be meaningfully effective and can be used for the rehabilitation of the patients with MS. Furthermore, rehabilitation with VR gaming systems will accelerate the rehabilitation process by making it fun, which will also reduce the risk of incompliance of the patient with the exercises. Keywords: Virtual Reality, Motion Sickness, Vestibular Rehabilitation