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Otology/Neurotology

(0923) Early Experience Assessing the Effectiveness of Head-Mounted Virtual Reality Vestibular Physical Therapy

Monday, September 30, 2024
12:00 PM – 1:00 PM EDT
Disclosure(s):
Evan J. Patel, MD: No relevant relationships to disclose.


Introduction: Virtual reality vestibular physical therapy (VRVPT) has the potential to offer a complementary and individualized modality that is tailored to specific impairments, such as visual motion sensitivity or unilateral loss. The purpose of this study was to describe an individualized, head-held VRVPT intervention and to examine changes in self-reported and performance-based measures prior to and after treatment.

Methods: A prospective cohort study was performed at a single institution tertiary care center between 2021 and 2024 including 13 patients with a diagnosis of vestibular loss (7 patients, 53.8%) or vestibular migraine (6 patients, 46.2%). Average age was 62.6 years old, and the majority of patients were female (61.5%). Subjects underwent 8 45-minute sessions using the Virtualis head-held virtual reality system over a 12-week period. Interventions targeted gaze stability, optokinetic training and dynamic weight shifting. Main outcome measures included pre and posttreatment Dizziness Handicap Inventory (DHI), Functional Gait Assessment (FGA), and Visual Vertigo Analogue Scale (VVAS).

Results: Median time between pre and posttreatment assessment was 4.5 months (range 3-7.2 months). In the vestibular migraine cohort, there was a significant decrease in DHI (average decrease 17.7, p = 0.03) and VVAS (average decrease 27, p = 0.002) after VRVPT but not in FGA (average decrease -0.8, p = 0.38). In the vestibular loss group, there was a decrease in DHI (average decrease 9.1, p = 0.08), VVAS (average decrease 0.4, p = 0.92), and FGA (average decrease 6, p = 0.29) although these results were not significant.

Conclusions: Use of the Virtualis Virtual Reality system in conjunction with usual therapy appears to hold promise to treat patients with vestibular disorders. The use of VRVPT was safe, well-tolerated and significantly improved self-reported dizziness and dynamic balance for vestibular migraine patients.