Temporal virtual reality-guided, dual-task, trunk balance training in a sitting position improves persistent postural-perceptual dizziness: proof of concept

Tomoya Yamaguchi; Toru Miwa; Kaoru Tamura; Fumiko Inoue; Naomi Umezawa; Toshiki Maetani; Masahiko Hara; Shin-Ichi Kanemaru

doi:10.1186/s12984-022-01068-6

Temporal virtual reality-guided, dual-task, trunk balance training in a sitting position improves persistent postural-perceptual dizziness: proof of concept

J Neuroeng Rehabil. 2022 Aug 20;19(1):92. doi: 10.1186/s12984-022-01068-6.

Authors

Tomoya Yamaguchi^{1

2}, Toru Miwa^{3

4

5}, Kaoru Tamura¹, Fumiko Inoue¹, Naomi Umezawa¹, Toshiki Maetani¹, Masahiko Hara^{6

7}, Shin-Ichi Kanemaru¹

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
² Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan.
³ Department of Otolaryngology-Head and Neck Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan. t-miwa@omu.ac.jp.
⁴ Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto, Japan. t-miwa@omu.ac.jp.
⁵ Department of Otolaryngology, Osaka Metropolitan University School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. t-miwa@omu.ac.jp.
⁶ Department of Medical Device Development, mediVR, Inc., Toyonaka, Japan.
⁷ Center for Community-Based Healthcare Research and Education, Shimane University, Izumo, Japan.

Abstract

Background: Persistent postural-perceptual dizziness (PPPD) is a newly defined disorder characterized by functional dizziness. Due to its recent discovery, definitive treatment for PPPD has not been established; therefore, this study aimed to assess the effectiveness of virtual reality (VR)-guided, dual-task, trunk balance training for the management of PPPD using the mediVR KAGURA system.

Methods: We analyzed data of patients who presented with PPPD from January 1, 2021, to February 28, 2021. The VR group included patients who underwent mediVR KAGURA-guided training for 100 tasks (10 min). Patients with PPPD who received standard treatment and rehabilitation were assigned to the control group. Equilibrium tests were performed at baseline and immediately after mediVR KAGURA-guided training to examine its effectiveness in improving static and dynamic balance. Additionally, clinical questionnaires related to balance disorders were administered at baseline and 1 week after mediVR KAGURA-guided training to examine its effects on balance-related symptoms. The primary outcome was improvements in static and dynamic balance and Niigata PPPD Questionnaire (NPQ) scores.

Results: VR-guided training using mediVR KAGURA improved objective outcomes, including static and dynamic postural stability, after a single 10-min training session. Additionally, mediVR KAGURA-guided training improved scores on the Hospital Anxiety and Depression Scale and NPQ 1 week after the 10-min training session.

Conclusion: VR-guided training using mediVR KAGURA represents a viable method for managing balancing ability, anxiety, and symptoms in patients with PPPD. Such training provides a safe and cost-effective solution for PPPD management. Further studies are required to evaluate the clinical efficacy of this strategy.

Trial registration: Institutional Ethics Committee of Kitano Hospital, approval number: 1911003. Registered 18 December 2019, https://kitano.bvits.com/rinri/publish_document.aspx?ID=426 .

Keywords: Persistent postural-perceptual dizziness; Rehabilitation; Virtual reality.

MeSH terms

Dizziness* / diagnosis
Humans
Postural Balance
Sitting Position
Treatment Outcome
Virtual Reality*