The use of virtual reality (VR) in vestibular rehabilitation is gaining some popularity but availability is hampered by cost. One VR system in use in some centres is the Hybrid VR unit which incorporates motion trackers and force platforms. This study was designed to compare the effectiveness of a low-cost Hybrid VR system (Group 1) with static posturography with visual feedback (Group 2) in the rehabilitation of patients with uncompensated unilateral peripheral vestibulopathy. Fifty adults with conformed unilateral peripheral vestibular dysfunction were prospectively recruited and assigned alternately the two groups, 25 in each arm. The outcome measures were centre of pressure (COP) parameters (with eyes open and eyes closed in quiet stance) on a static posturography platform and Vestibular Symptoms Scale – short form (VSS-SF), completed before intervention and one month after rehabilitation. In both groups the therapy sessions were supervised by a physiotherapist, but all participants were instructed to perform Cawthorne-Cooksey exercises at home. At one-month post-intervention, in both groups, COP parameters in quiet stance with eyes closed improved significantly. The VSS-SF scores reduced in the anxiety and balance sub-scales. Statistically, the total improvement in the patient-reported outcome, particularly the balance subscale, was far better in the hybrid VR group than in group 2. The authors concluded that Hybrid VR was not superior in reducing postural sway in comparison with the established form of vestibular rehabilitation, which is static posturography with visual feedback training. However, the advantage of VR training was the better effect on the subjective reduction of symptoms. 

Evaluation of the effectiveness of a Virtual Reality-based exercise program for Unilateral Peripheral Vestibular Deficit.
Rosiak O, Krajewski K, Woszczak M, Jozefowicz-Korczynska M.
JOURNAL OF VESTIBULAR RESEARCH
2018;28:409-15.
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Victor Osei-Lah

Bournemouth, UK.

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