Unilateral Peripheral Vestibular Dysfunction (UPVD) causes dizziness, imbalance, vertigo, and reduced quality of life. Conventional Vestibular Rehabilitation Therapy (cVRT) is effective, while WiiFit-based virtual reality training may further enhance motivation and neuroplasticity. This study aims to compare WiiFit-based training with conventional rehabilitation in improving balance and reducing dizziness in UPVD patients. A randomized controlled trial will include participants aged 18-65 meeting specific inclusion and exclusion criteria. Participants will be randomly divided into two groups: Group A receiving conventional therapy (40 minutes, 3 sessions/week) and Group B receiving WiiFit-based exercises for 4 weeks. Outcomes will be assessed using DHI, Mini-BESTest, and VADL before and after intervention.
Unilateral Peripheral Vestibular Dysfunction (UPVD) is a common vestibular disorder resulting in symptoms such as dizziness, imbalance, vertigo, and postural instability. These symptoms significantly affect patients' daily functioning and quality of life. Conventional Vestibular Rehabilitation Therapy (cVRT), including gaze stabilization, balance training, and habituation exercises, has proven effective in reducing dizziness and improving balance. However, newer approaches like virtual reality-based rehabilitation using WiiFit offer interactive, task-oriented, and engaging exercises that may enhance motivation and neuroplasticity, potentially leading to better outcomes.This study aims to compare the effectiveness of WiiFit-based vestibular training and conventional vestibular rehabilitation in improving balance and reducing dizziness in patients with UPVD. The objective is to determine whether the addition of a virtual reality component can yield superior clinical outcomes compared to traditional therapy. A randomized controlled trial will be conducted on participants diagnosed with UPVD selected through purposive sampling. Participants aged 18-65 years, confirmed positive on the Head Thrust Test, experiencing persistent dizziness or imbalance for more than four weeks, able to walk independently, and scoring above 12 on the Vertigo Symptom Scale will be included. Individuals with central vestibular disorders, active BPPV, severe visual or musculoskeletal impairments, seizure history, current participation in other vestibular rehabilitation programs, or severe cervical spine disease will be excluded. Eligible participants will be randomly assigned into two equal groups using a computer-generated sequence. Group A will receive conventional vestibular rehabilitation that includes exercises like foam surface standing, VORx1 and 2 training, tandem walking, side shuffles each for a session of 40 mins with a total of 3 sessions per week. Group B will receive WiiFit-based vestibular rehabilitation exercises like ski salom, soccer heading, table tilt, penguin slide, obstacle course using the Nintendo WiiFit balance board for 4 weeks. Outcome measures, including the Dizziness Handicap Inventory (DHI), Mini-BESTest, and Vestibular Activities of Daily Living Scale (VADL), will be assessed pre- and post-intervention to evaluate changes in dizziness and functional balance.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
42
Participants in the control group will undergo standard vestibular rehabilitation therapy, which includes gaze stabilization, habituation, and balance retraining activities. The program will consist of three sessions weekly, spanning four consecutive weeks, with each session lasting around 30 to 40 minutes. Exercises will start in a sitting posture and gradually move to standing and dynamic balancing activities, customized to the patient's tolerance and safety. To mitigate danger, sessions will occur in a peaceful, organized environment with supportive aids (e.g. chair or wall) accessible. Safety standards will encompass a pre-session fall risk assessment and therapist oversight, while any adverse events will be recorded and addressed under physician consultation.
Participants in the experimental group will engage in vestibular training via the Wii Fit on the Nintendo Wii balancing platform. Sessions will include interactive balancing activities aimed at challenging postural control, coordination, and visual-vestibular integration. Training will consist of three sessions each week over four weeks, with each session lasting about 30 minutes, progressively increasing from fundamental to more intricate activities based on participant performance and safety considerations. Real-time feedback from the Wii system will be utilized to improve motivation, adherence, and task engagement. Safety measures will encompass therapist oversight at all times, the prevention of abrupt head movements or visual distractions during initial phases, and the delivery of both written and vocal directives to avert falls.
Foundation University College of Physical Therapy
Islamabad, Pakistan
Perceived effects of dizziness
Dizziness Handicap Inventory (DHI) is a 25-item self-administered questionnaire intended to assess the perceived effects of dizziness on an individual's everyday activities. Values vary from 0 (no handicap) to 100 (highest handicap), with increasing values signifying more incapacity interpretation: 16-34- mild impairment 36-52- moderate impairment 52+ - severe impairment
Time frame: 4 weeks
Dynamic Balance
The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a performance-based instrument designed to evaluate dynamic balance. The assessment comprises 14 items rated on a 3-point scale (0 = severe impairment to 2 = normal), yielding a maximum total score of 28. interpretation: 28- normal 20-22- minor balance impairment Below 20- significant fall risk
Time frame: 4 weeks
disability in adults with vestibular dysfunction
The Vestibular Disorders Activities of Daily Living Scale (VADL) 1-2 = independent (normal) 3-5= independent with difficulty (mild) 6-8= dependent on others( moderate) 8-10= unable to participate in activity (severe)
Time frame: 4 weeks
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