Effects of Wiifit vs Conventional Vestibular Rehabilitation on Dizziness and Balance in Patients With Unilateral Peripheral Vestibular Dysfunction

May 8, 2026 updated by: Foundation University Islamabad

Unilateral Peripheral Vestibular Dysfunction (UPVD) causes dizziness, imbalance, vertigo, and reduced quality of life.

Conventional Vestibular Rehabilitation Therapy (cVRT) is effective, while WiiFit-based virtual reality training may further enhance motivation and neuroplasticity.

This study aims to compare WiiFit-based training with conventional rehabilitation in improving balance and reducing dizziness in UPVD patients.

A randomized controlled trial will include participants aged 18-65 meeting specific inclusion and exclusion criteria.

Participants will be randomly divided into two groups: Group A receiving conventional therapy (40 minutes, 3 sessions/week) and Group B receiving WiiFit-based exercises for 4 weeks.

Outcomes will be assessed using DHI, Mini-BESTest, and VADL before and after intervention.

Study Overview

Detailed Description

Unilateral Peripheral Vestibular Dysfunction (UPVD) is a common vestibular disorder resulting in symptoms such as dizziness, imbalance, vertigo, and postural instability.

These symptoms significantly affect patients' daily functioning and quality of life. Conventional Vestibular Rehabilitation Therapy (cVRT), including gaze stabilization, balance training, and habituation exercises, has proven effective in reducing dizziness and improving balance.

However, newer approaches like virtual reality-based rehabilitation using WiiFit offer interactive, task-oriented, and engaging exercises that may enhance motivation and neuroplasticity, potentially leading to better outcomes.This study aims to compare the effectiveness of WiiFit-based vestibular training and conventional vestibular rehabilitation in improving balance and reducing dizziness in patients with UPVD.

The objective is to determine whether the addition of a virtual reality component can yield superior clinical outcomes compared to traditional therapy.

A randomized controlled trial will be conducted on participants diagnosed with UPVD selected through purposive sampling.

Participants aged 18-65 years, confirmed positive on the Head Thrust Test, experiencing persistent dizziness or imbalance for more than four weeks, able to walk independently, and scoring above 12 on the Vertigo Symptom Scale will be included.

Individuals with central vestibular disorders, active BPPV, severe visual or musculoskeletal impairments, seizure history, current participation in other vestibular rehabilitation programs, or severe cervical spine disease will be excluded.

Eligible participants will be randomly assigned into two equal groups using a computer-generated sequence.

Group A will receive conventional vestibular rehabilitation that includes exercises like foam surface standing, VORx1 and 2 training, tandem walking, side shuffles each for a session of 40 mins with a total of 3 sessions per week.

Group B will receive WiiFit-based vestibular rehabilitation exercises like ski salom, soccer heading, table tilt, penguin slide, obstacle course using the Nintendo WiiFit balance board for 4 weeks.

Outcome measures, including the Dizziness Handicap Inventory (DHI), Mini-BESTest, and Vestibular Activities of Daily Living Scale (VADL), will be assessed pre- and post-intervention to evaluate changes in dizziness and functional balance.

Study Type

Interventional

Enrollment (Actual)

42

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Islamabad, Pakistan, 44000
        • Foundation University College of Physical Therapy

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18-65 years
  • Diagnosed with UPVD (confirmed via Positive Head Thrust Test)
  • Experiencing persistent dizziness or imbalance for >4 weeks after acute onset
  • Able to stand and walk independently
  • VSS total score >12

Exclusion Criteria:

  • Central vestibular disorders (e.g., stroke, multiple sclerosis)
  • Active BPPV (confirmed by Dix-Hallpike Test)
  • Severe visual or MSK impairments affecting balance
  • History of epileptic seizures or motion sickness triggered by video games
  • Participation in other vestibular rehab programs during study period -- Diagnosed with severe cervical spine disease

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Vestibular Rehabilitation Therapy

Participants in the control group will undergo standard vestibular rehabilitation therapy, which includes gaze stabilization, habituation, and balance retraining activities.

The program will consist of three sessions weekly, spanning four consecutive weeks, with each session lasting around 30 to 40 minutes.

Exercises will start in a sitting posture and gradually move to standing and dynamic balancing activities, customized to the patient's tolerance and safety.

Following exercises will be administered:

Week 1:

  1. Romberg (EO → EC)
  2. Foam surface standing (eyes open)
  3. VOR x1 (seated) 3 sets/ 10 reps

Week 2:

  1. Standing VOR x1
  2. Tandem walking
  3. Walking with head turns 3 sets/10 reps

Week 3:

  1. Side shuffle with head turns
  2. Ball Toss with Head Turns
  3. Bowling with ball 3 sets/10 reps

Week 4:

  1. Multi-directional stepping
  2. TUG with Head Turns
  3. VOR x1/x2 While Walking
  4. Dual-task walking 3 sets/10 reps
Participants in the control group will undergo standard vestibular rehabilitation therapy, which includes gaze stabilization, habituation, and balance retraining activities. The program will consist of three sessions weekly, spanning four consecutive weeks, with each session lasting around 30 to 40 minutes. Exercises will start in a sitting posture and gradually move to standing and dynamic balancing activities, customized to the patient's tolerance and safety. To mitigate danger, sessions will occur in a peaceful, organized environment with supportive aids (e.g. chair or wall) accessible. Safety standards will encompass a pre-session fall risk assessment and therapist oversight, while any adverse events will be recorded and addressed under physician consultation.
Experimental: Wii Fit Vestibular Training

Participants in the experimental group will undergo vestibular training using the Wii Fit on the Nintendo Wii balance platform.

Sessions will include interactive balance tasks targeting postural control, coordination, and visual-vestibular integration.

Training will be conducted three times per week for four weeks, with each session lasting approximately 30 minutes and progressively advancing from basic to more complex activities based on participant performance and safety.

Real-time feedback from the Wii system will be used to enhance motivation, adherence, and engagement.

Week 1 will include Table Tilt (basic) and Soccer Heading (10 min each with 5 min warm-up and 5 min cool-down).

Week 2 will include Balance Bubble, Bowling, and Ski Slalom (slow), 10 min each with warm-up and cool-down.

Week 3 will include Obstacle Course (basic), Table Tilt (advanced), and Penguin Slide, 10 min each.

Week 4 will involve a combination of all games, 5 min each with 2-3 min rest intervals.

Participants in the experimental group will engage in vestibular training via the Wii Fit on the Nintendo Wii balancing platform. Sessions will include interactive balancing activities aimed at challenging postural control, coordination, and visual-vestibular integration. Training will consist of three sessions each week over four weeks, with each session lasting about 30 minutes, progressively increasing from fundamental to more intricate activities based on participant performance and safety considerations. Real-time feedback from the Wii system will be utilized to improve motivation, adherence, and task engagement. Safety measures will encompass therapist oversight at all times, the prevention of abrupt head movements or visual distractions during initial phases, and the delivery of both written and vocal directives to avert falls.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perceived effects of dizziness
Time Frame: 4 weeks
Dizziness Handicap Inventory (DHI) is a 25-item self-administered questionnaire intended to assess the perceived effects of dizziness on an individual's everyday activities. Values vary from 0 (no handicap) to 100 (highest handicap), with increasing values signifying more incapacity interpretation: 16-34- mild impairment 36-52- moderate impairment 52+ - severe impairment
4 weeks
Dynamic Balance
Time Frame: 4 weeks

The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a performance-based instrument designed to evaluate dynamic balance. The assessment comprises 14 items rated on a 3-point scale (0 = severe impairment to 2 = normal), yielding a maximum total score of 28.

interpretation: 28- normal 20-22- minor balance impairment Below 20- significant fall risk

4 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
disability in adults with vestibular dysfunction
Time Frame: 4 weeks
The Vestibular Disorders Activities of Daily Living Scale (VADL) 1-2 = independent (normal) 3-5= independent with difficulty (mild) 6-8= dependent on others( moderate) 8-10= unable to participate in activity (severe)
4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 18, 2025

Primary Completion (Actual)

April 29, 2026

Study Completion (Actual)

April 29, 2026

Study Registration Dates

First Submitted

May 8, 2026

First Submitted That Met QC Criteria

May 8, 2026

First Posted (Actual)

May 14, 2026

Study Record Updates

Last Update Posted (Actual)

May 14, 2026

Last Update Submitted That Met QC Criteria

May 8, 2026

Last Verified

May 1, 2026

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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