Interactive 3-dimensional virtual reality rehabilitation for patients with chronic imbalance and vestibular dysfunction

BACKGROUND: Chronic imbalance is common in patients with vestibular dysfunction. Vestibular rehabilitation is effective in improving upright balance control. Vestibular rehabilitation exercises, such as Cawthorne-Cooksey exercises, include simple repetitive movements and have limited feedback and adaptive training protocols. Interactive systems based on virtual reality (VR) technology may improve vestibular rehabilitation. OBJECTIVE: The objective of this study was to examine the effectiveness of an interactive 3-dimensional VR system for vestibular rehabilitation. METHODS: In 49 subjects with vestibular dysfunction, VR rehabilitation exercises were performed in 6 sessions. Before and after rehabilitation, subjects were evaluated for performance of the training exercises; the center of pressure was measured for 20 seconds and balance indices were determined. RESULTS: Five training scores (total 6) showed a significant improvement. For balance indices in condition of non-stimulation, all of them (total 5) showed a trend of improvement, in which there was a significant improvement in mean mediolateral. For balance indices in condition of post-stimulation, there was a significant improvement in statokinesigram and maximum mediolateral. CONCLUSIONS: The VR rehabilitation exercises were effective in improving upright balance control in patients with vestibular dysfunction.