Home-based Computer Gaming in Vestibular Rehabilitation
Condition: Peripheral Vestibular Disorders; Vestibular Syndromes &/or Disorders (Labyrinthine); Vestibular Neuronitis
MeSH terms: Vestibular Diseases; Vestibular Neuronitis
Study type: Interventional

Summary: 
      It is hypothesized that a home-based computer gaming rehabilitation program will improve gaze
      control and balance impairments in those with peripheral vestibular disorders (PVD). Ten
      people with peripheral vestibular disorders were started on a treatment program that
      consisted of playing computer games and while performing various balance exercises. On a
      weekly basis, each participant was contacted by email or telephone and asked to submit their
      computer gaming data to a trained vestibular physical therapist. Following review of this
      data, the physical therapist would contact the participant and progress their computer gaming
      program appropriately. At the completion of twelve weeks of home treatment, the participants
      returned for re-assessment and it was determined that the computer gaming program was an
      effective treatment for those with PVD. It was also determined that a monitored
      telerehabilitation program was an efficient and effective delivery method for this treatment.
    

Detailed description: 
      A pre to post intervention case series study was carried out on ten participants diagnosed
      with peripheral vestibular disorders (PVD). Inclusion criteria consisted of: a) 20 to 70 year
      old, b) confirmed diagnosis of PVD on neuro-opthalmic, neuro-orthoptic, electronystagmography
      and caloric testing; and use of a home computer. Exclusion criteria consisted of those with
      migraine, central nervous system disorders (for example cerebral vascular accident or
      Multiple Sclerosis), recent fractures of the spine or lower extremities, inability to stand
      for 20 minutes continuously, or presence of dementia. It was hypothesized that a home-based
      computer gaming treatment delivered in a monitored telerehabilitation platform would be an
      effective treatment for those with PVD in that increased gaze stability and improved balance
      would be observed post-treatment. It was also hypothesized that decreased dizziness would be
      reported post-treatment. After initial assessment (pre-treatment), three in-clinic sessions
      were given to each participant to develop their specific home treatment computer program and
      ensure ability to use the program effectively. They were then started on their home program
      and monitored by a trained vestibular physical therapist for a 12-week telerehabilitation
      program. After the completion of the 12-weeks, the participants returned for a post-treatment
      assessment.
    

Intervention name(s): home-based computer gaming
Intervention type(s): Behavioral
Intervention description(s): A computer mouse mounted to a headband and placed on the participant's head is used to interact with the game cursor. In order to interact with/play the game the participant must visually focus on the moving target and perform unpredictable head movements. Balance exercises are incorporated progressively and simultaneously during computer gaming.
Other intervention name(s): home-based computer gaming for people with PVD
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: dizziness; vertigo; unsteadiness; unbalance; falls