http://www.biomedcentral.com/1472-6815/12/3/abstract
Abstract (provisional)
Background
Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness
and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment
remains unkown. Virtual reality is an emerging tool in rehabilitation and provides
opportunities to improve both outcomes and patient satisfaction with treatment. The
Nintendo Wii Fit Plus (R) (NWFP) is a low cost virtual reality system that challenges
balance and provides visual and auditory feedback. It may augment the motor learning
that is required to improve balance and gait, but no trials to date have investigated
efficacy.
Methods
In a single (assessor) blind, two centre randomised controlled superiority trial,
80 patients with unilateral peripheral vestibular loss will be randomised to either
conventional or virtual reality based (NWFP) vestibular rehabilitation for 6 weeks.
The primary outcome measure is gait speed (measured with three dimensional gait analysis).
Secondary outcomes include computerised posturography, dynamic visual acuity, and
validated questionnaires on dizziness, confidence and anxiety/depression. Outcome
will be assessed post treatment (8 weeks) and at 6 months.
Discussion
Advances in the gaming industry have allowed mass production of highly sophisticated
low cost virtual reality systems that incorporate technology previously not accessible
to most therapists and patients. Importantly, they are not confined to rehabilitation
departments, can be used at home and provide an accurate record of adherence to exercise.
The benefits of providing augmented feedback, increasing intensity of exercise and
accurately measuring adherence may improve conventional vestibular rehabilitation
but efficacy must first be demonstrated. Trial registration Clinical trials.gov identifier:
NCT01442623
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