Long-term effects of vestibular rehabilitation and head-mounted gaming task procedure in unilateral vestibular hypofunction: a 12-month follow-up of a randomized controlled trial

OBJECTIVE:: To investigate the long-term effects of adding virtual reality-based home exercises to vestibular rehabilitation in people with unilateral vestibular hypofunction. DESIGN:: Follow-up otoneurological examination in two randomized groups following a previous one-month trial. SETTING:: Tertiary rehabilitation center. SUBJECTS:: A total of 47 patients with unilateral vestibular hypofunction, one group ( n = 24) undergoing conventional vestibular rehabilitation and the other one ( n = 23) implementing, in addition, head-mounted gaming home exercises, 20 minutes per day for one month. INTERVENTIONS:: One year after completing rehabilitation, patients underwent testing with static posturography, video head impulse test, self-report questionnaires, and a performance measure. MAIN MEASURES:: Vestibulo-ocular reflex gain, posturographic parameters such as length, surface, and fast Fourier transform power spectra, self-report, and gait performance measure scores. RESULTS:: Vestibulo-ocular reflex gain was significantly better with respect to pretreatment in both groups. The mixed-method group showed significantly higher gain scores: mean (standard deviation (SD)) at 12 months was 0.71 (0.04), versus 0.64 (0.03) for the vestibular rehabilitation-only group ( P < 0.001). Accordingly, some classical posturography scores such as surface with eyes open and length with eyes closed and low-frequency power spectra were significantly different between groups, with the virtual reality group showing improvement ( P < 0.001). Self-report measures were significantly better in both groups compared to pretreatment, with significant improvement in the mixed-method group as compared to conventional rehabilitation alone: Dizziness Handicap Inventory mean total score was 24.34 (2.8) versus 35.73 (5.88) with a P-value <0.001. CONCLUSION:: Results suggest that head-mounted gaming home exercises are a viable, effective, additional measure to improve long-term vestibular rehabilitation outcomes.