The effect of using virtual reality on balance in people with persistent postural-perceptual dizziness: A randomized controlled trial

BackgroundPersistent postural-perceptual dizziness (PPPD) represents a relatively new vestibular diagnosis that has garnered attention within the medical community. Consequently, there is a pressing demand for efficacious management strategies.ObjectiveTo assess the comparative effectiveness of virtual reality (VR) versus vestibular rehabilitation therapy (VRT) in improving PPPD symptoms.MethodsWe randomly assigned a cohort of 42 individuals conclusively diagnosed with PPPD to two distinct groups. The experimental group included 21 participants who received a combination of VR and optokinetic stimulation in addition to VRT, while the control group, also made up of 21 individuals, only received optokinetic stimulation in conjunction with VRT. We administered the intervention sessions twice weekly over a span of 6 weeks, resulting in a total of 10-intervention sessions. Additionally, baseline, post-intervention, and follow-up assessments were conducted.ResultsOur analysis revealed that participants in both groups significantly improved with no significant differences between the groups. Individuals undergoing VR interventions demonstrated marked improvements across all of the assessed parameters including the primary outcome measure that were reduced from 41.55 (11.87) to 23.40 (14.17) (<i>p</i><0.001). Moreover, participants in the control group also displayed notable enhancements in select outcome measures post-intervention including the primary outcome measure that were reduced from 43.60 (12.75) to 26.10 (16.25) (<i>p</i> = 0.001). All participants in both groups maintained significant improvement in the severity of PPPD after 1 year of the. However, the study cannot determine if this change was definitely from the treatment because there was no non-treatment control group.ConclusionsThe study found that the addition of VR to a well-structured VRT did not significantly improve clinical outcomes, indicating a need for further investigation into more effective approaches to yield meaningful clinical benefits. Moreover, adding a control group with no intervention would help revealing a real effect of the intervention.