Rehabilitation findings of vestibular spatial working memory in patients with vestibular neuritis

Abstract Background Vestibular neuritis (VN) is an acute unilateral vestibular disorder that may impair not only vestibular function but also spatial cognitive processes, particularly spatial working memory. This study evaluated the feasibility and effectiveness of cognitively driven, command-based vestibular spatial rehabilitation games in patients with vestibular neuritis, and examined pre- and post-rehabilitation changes in functional postural control. Methods A total of 30 individuals aged 18 years and older (mean age: 70.9 ± 19.8 years) diagnosed with vestibular neuritis were included in the study. At baseline, the Computerized Dynamic Posturography–Limits of Stability Test (CDP-LOS) was administered to assess vestibular spatial working memory, while the Sensory Organization Test (CDP-SOT) was used to evaluate vestibular function. Participants underwent a vestibular spatial working memory rehabilitation program consisting of 16 sessions conducted once weekly, with each session lasting 48 min and including vestibular spatial working memory rehabilitation games. Outcome measures were repeated after the 8th session as an intermediate evaluation and after the 16th session as the final evaluation. Results Significant improvements were observed across pre-test, mid-test, and post-test assessments. In the CDP-LOS, Total Surface, Front, Back, Right, and Left parameters showed statistically significant increases ( p < 0.05). In the CDP-SOT, significant improvements were found in all anteroposterior (AP) and mediolateral (ML) plane conditions (C1–C6) ( p < 0.05). Sensory analysis demonstrated significant improvements in AP-GLOBAL, AP-VESTIBULAR, AP-VISUAL, ML-GLOBAL, ML-VESTIBULAR, ML-VISUAL, and ML-PREFER parameters ( p < 0.05), whereas no significant changes were found in AP-SOMES, AP-PREFER, or ML-SOMES ( p > 0.05). The similarity between mid-test and post-test CDP-LOS findings suggested adaptation by the 8th session and habituation by the 16th session. Conclusion Vestibular spatial working memory rehabilitation appears to improve vestibular performance, postural control, and vestibular spatial working memory functions in individuals with VN. These findings suggest that such rehabilitation may represent a useful therapeutic approach for addressing both vestibular and cognitive-spatial deficits in this patient population.