Effectiveness of virtual reality-based programs as vestibular rehabilitative therapy in peripheral vestibular dysfunction: a meta-analysis

PURPOSE: To study the efficacy of virtual reality (VR) interventional programs as a vestibular rehabilitative method for patients with uncompensated peripheral vestibular disorders. METHODS: The databases PubMed, Google scholar, Embase and Cochrane Library were used (up to July 2021). Studies selected in this study were controlled trials in which virtual reality was used as vestibular rehabilitative therapy in comparison to any other vestibular rehabilitative methods or medical or dietary recommendations. Comparison was made in at least one of these outcomes measures; Subjective measures such as Dizziness Handicap Inventory, Vertigo Symptom Scale—Short Form questionnaire, Activities-specific Balance Confidence questionnaire, Dizziness Analogue Scale or Visual Analogue Scale, besides objective measures as posturography. Six articles were included in the meta-analysis; tested for heterogeneity of the estimates using chi-squared and I2 tests, outcomes were expressed as mean difference and 95% CI. Estimates from included studies were pooled using the random-effect model. RESULTS: virtual reality as a vestibular rehabilitative intervention was able to improve scores of Dizziness Handicap Inventory, Vertigo Symptom Scale—Short Form questionnaire, Visual Analogue sale and posturography as outcome measures of vestibular rehabilitation. CONCLUSION: virtual reality has a potential clinical benefit for vestibular rehabilitation in peripheral vestibular dysfunction compared with conventional vestibular rehabilitation methods. However, further research is needed to document the exact parameters of an optimal protocol for virtual reality rehabilitation, the period needed for effective rehabilitation and its side effects.