Comparison of virtual reality based therapy with customized vestibular physical therapy for the treatment of vestibular disorders

Khalid A Alahmari, Patrick J Sparto, Gregory F Marchetti, Mark S Redfern, Joseph M Furman, Susan L Whitney, Khalid A Alahmari, Patrick J Sparto, Gregory F Marchetti, Mark S Redfern, Joseph M Furman, Susan L Whitney

Abstract

We examined outcomes in persons with vestibular disorders after receiving virtual reality based therapy (VRBT) or customized vestibular physical therapy (PT) as an intervention for habituation of dizziness symptoms. Twenty subjects with vestibular disorders received VRBT and 18 received PT. During the VRBT intervention, subjects walked on a treadmill within an immersive virtual grocery store environment, for six sessions approximately one week apart. The PT intervention consisted of gaze stabilization, standing balance and walking exercises individually tailored to each subject. Before, one week after, and at six months after the intervention, subjects completed self-report and balance performance measures. Before and after each VRBT session, subjects also reported symptoms of nausea, headache, dizziness, and visual blurring. In both groups, significant improvements were noted on the majority of self-report and performance measures one week after the intervention. Subjects maintained improvements on self report and performance measures at six months follow up. There were not between group differences. Nausea, headache, dizziness and visual blurring increased significantly during the VRBT sessions, but overall symptoms were reduced at the end of the six-week intervention. While this study did not find a difference in outcomes between PT and VRBT, the mechanism by which subjects with chronic dizziness demonstrated improvement in dizziness and balance function may be different.

Figures

Fig.1
Fig.1
A subject is shown pushing on an instrumented grocery cart while ambulating on a treadmill. The speed of the walking and movement through the virtual grocery store is proportional to the force applied to load cells on the cart. The subject walks inside the store and looks for products randomly called out by the physical therapist.
Fig.2
Fig.2
Four of the sixteen aisles from the virtual grocery store are shown. The aisles are 2 (upper left), 6 (upper right), 10 (lower left) and 14 (lower right), and there is a progression in visual complexity, primarily determined by the spatial frequency and color contrast of the product textures, as the aisle number increases.

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