Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial
Identifieur interne : 002446 ( Main/Exploration ); précédent : 002445; suivant : 002447Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial
Auteurs : Dara Meldrum [Irlande (pays)] ; Susan Herdman [États-Unis] ; Roisin Moloney [Irlande (pays)] ; Deirdre Murray [Irlande (pays)] ; Douglas Duffy [Irlande (pays)] ; Kareena Malone [Irlande (pays)] ; Helen French [Irlande (pays)] ; Stephen Hone [Irlande (pays)] ; Ronan Conroy [Irlande (pays)] ; Rory Mcconn-Walsh [Irlande (pays)]Source :
- BMC Ear, Nose, and Throat Disorders [ 1472-6815 ] ; 2012.
Abstract
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® (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.
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.
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.
Clinical trials.gov identifier:
Url:
DOI: 10.1186/1472-6815-12-3
PubMed: 22449224
PubMed Central: 3394213
Affiliations:
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xml:lang="en" level="a" type="main">Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial</title><author><name sortKey="Meldrum, Dara" sort="Meldrum, Dara" uniqKey="Meldrum D" first="Dara" last="Meldrum">Dara Meldrum</name><affiliation wicri:level="1"><nlm:aff id="I1">Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland</nlm:aff><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2</wicri:regionArea><wicri:noRegion>Dublin 2</wicri:noRegion></affiliation></author><author><name sortKey="Herdman, Susan" sort="Herdman, Susan" uniqKey="Herdman S" first="Susan" last="Herdman">Susan Herdman</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Rehabilitation Medicine, School of Medicine, Emory 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9</wicri:regionArea><wicri:noRegion>Dublin 9</wicri:noRegion></affiliation></author><author><name sortKey="Duffy, Douglas" sort="Duffy, Douglas" uniqKey="Duffy D" first="Douglas" last="Duffy">Douglas Duffy</name><affiliation wicri:level="1"><nlm:aff id="I4">Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland</nlm:aff><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2</wicri:regionArea><wicri:noRegion>Dublin 2</wicri:noRegion></affiliation></author><author><name sortKey="Malone, Kareena" sort="Malone, Kareena" uniqKey="Malone K" first="Kareena" last="Malone">Kareena Malone</name><affiliation wicri:level="1"><nlm:aff id="I3">Beaumont Hospital, Dublin 9, Ireland</nlm:aff><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Beaumont Hospital, Dublin 9</wicri:regionArea><wicri:noRegion>Dublin 9</wicri:noRegion></affiliation></author><author><name sortKey="French, Helen" sort="French, Helen" uniqKey="French H" first="Helen" last="French">Helen French</name><affiliation wicri:level="1"><nlm:aff id="I1">Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland</nlm:aff><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2</wicri:regionArea><wicri:noRegion>Dublin 2</wicri:noRegion></affiliation></author><author><name sortKey="Hone, Stephen" sort="Hone, Stephen" uniqKey="Hone S" first="Stephen" last="Hone">Stephen Hone</name><affiliation wicri:level="1"><nlm:aff id="I4">Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland</nlm:aff><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2</wicri:regionArea><wicri:noRegion>Dublin 2</wicri:noRegion></affiliation></author><author><name sortKey="Conroy, Ronan" sort="Conroy, Ronan" uniqKey="Conroy R" first="Ronan" last="Conroy">Ronan Conroy</name><affiliation wicri:level="1"><nlm:aff id="I1">Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland</nlm:aff><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2</wicri:regionArea><wicri:noRegion>Dublin 2</wicri:noRegion></affiliation></author><author><name sortKey="Mcconn Walsh, Rory" sort="Mcconn Walsh, Rory" uniqKey="Mcconn Walsh R" first="Rory" last="Mcconn-Walsh">Rory Mcconn-Walsh</name><affiliation wicri:level="1"><nlm:aff id="I1">Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland</nlm:aff><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2</wicri:regionArea><wicri:noRegion>Dublin 2</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Beaumont Hospital, Dublin 9, Ireland</nlm:aff><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Beaumont Hospital, Dublin 9</wicri:regionArea><wicri:noRegion>Dublin 9</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Ear, Nose, and Throat Disorders</title><idno type="eISSN">1472-6815</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>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<sup>® </sup>(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.</p></sec><sec><title>Methods/Design</title><p>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.</p></sec><sec><title>Discussion</title><p>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.</p></sec><sec><title>Trial registration</title><p>Clinical trials.gov identifier: <ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov/ct2/show/NCT01442623">NCT01442623</ext-link></p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Yardley, L" uniqKey="Yardley L">L Yardley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Herdman, S" uniqKey="Herdman S">S Herdman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Curthoys, Is" uniqKey="Curthoys I">IS Curthoys</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Strupp, M" uniqKey="Strupp M">M Strupp</name></author><author><name sortKey="Brandt, T" uniqKey="Brandt T">T Brandt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hillier, Sl" uniqKey="Hillier S">SL Hillier</name></author><author><name sortKey="Mcdonnell, M" uniqKey="Mcdonnell M">M McDonnell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hansson, Ee" uniqKey="Hansson E">EE Hansson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kammerlind, A Sc" uniqKey="Kammerlind A">A-SC Kammerlind</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Krebs, De" uniqKey="Krebs D">DE Krebs</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bent, Lr" uniqKey="Bent L">LR Bent</name></author><author><name sortKey="Mcfadyen, Bj" uniqKey="Mcfadyen B">BJ McFadyen</name></author><author><name sortKey="Inglis, Jt" uniqKey="Inglis J">JT Inglis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Teggi, R" uniqKey="Teggi R">R Teggi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cakrt, O" uniqKey="Cakrt O">O Cakrt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Burdea, G" uniqKey="Burdea G">G Burdea</name></author><author><name sortKey="Coiffet, P" uniqKey="Coiffet P">P Coiffet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Whitney, Sl" uniqKey="Whitney S">SL Whitney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sveistrup, H" uniqKey="Sveistrup H">H Sveistrup</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Whitney, Sl" uniqKey="Whitney S">SL Whitney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nitz, Jc" uniqKey="Nitz J">JC Nitz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Young, W" uniqKey="Young W">W 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name="États-Unis"><noRegion><name sortKey="Herdman, Susan" sort="Herdman, Susan" uniqKey="Herdman S" first="Susan" last="Herdman">Susan Herdman</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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