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|Long-term effects of vestibular rehabilitation and head-mounted gaming task procedure in unilateral vestibular hypofunction: a 12-month follow-up of a randomized controlled trial [with consumer summary]|
|Viziano A, Micarelli A, Augimeri I, Micarelli D, Alessandrini M|
|Clinical Rehabilitation 2019 Jan;33(1):24-33|
|7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
OBJECTIVE: To investigate the long-term effects of adding virtual reality-based home exercises to vestibular rehabilitation in people with unilateral vestibular hypofunction. DESIGN: Follow-up otoneurological examination in two randomized groups following a previous one-month trial. SETTING: Tertiary rehabilitation center. SUBJECTS: A total of 47 patients with unilateral vestibular hypofunction, one group (n = 24) undergoing conventional vestibular rehabilitation and the other one (n = 23) implementing, in addition, head-mounted gaming home exercises, 20 minutes per day for one month. INTERVENTIONS: One year after completing rehabilitation, patients underwent testing with static posturography, video head impulse test, self-report questionnaires, and a performance measure. MAIN MEASURES: Vestibulo-ocular reflex gain, posturographic parameters such as length, surface, and fast Fourier transform power spectra, self-report, and gait performance measure scores. RESULTS: Vestibulo-ocular reflex gain was significantly better with respect to pretreatment in both groups. The mixed-method group showed significantly higher gain scores: mean (standard deviation (SD)) at 12 months was 0.71 (0.04), versus 0.64 (0.03) for the vestibular rehabilitation-only group (p < 0.001). Accordingly, some classical posturography scores such as surface with eyes open and length with eyes closed and low-frequency power spectra were significantly different between groups, with the virtual reality group showing improvement (p < 0.001). Self-report measures were significantly better in both groups compared to pretreatment, with significant improvement in the mixed-method group as compared to conventional rehabilitation alone: Dizziness Handicap Inventory mean total score was 24.34 (2.8) versus 35.73 (5.88) with a p-value < 0.001. CONCLUSION: Results suggest that head-mounted gaming home exercises are a viable, effective, additional measure to improve long-term vestibular rehabilitation outcomes.