Comparison Between Traditional Vestibular Rehabilitation Therapy And Virtual Reality In Management Of Patients With Chronic Dizziness

Chronic dizziness is a common and often debilitating condition, especially among older adults. It typically presents as a persistent sensation of unsteadiness, spinning, or motion lasting weeks or months. Most cases stem from vestibular system disorders, such as vestibular neuritis, benign paroxysmal positional vertigo (BPPV), Menière's disease, and bilateral vestibulopathy [1,2]. Symptoms may persist beyond the acute phase due to the brain's incomplete adaptation or maladaptive behaviors, like avoiding movement. Psychological factors, such as anxiety and stress, can worsen or prolong symptoms [3].

While many vestibular disorders resolve over time, some patients experience chronic symptoms due to poor central compensation or fear-based movement avoidance [2]. Chronic dizziness significantly impacts daily life-leading to imbalance, increased fall risk, reduced mobility, and emotional distress. Proper management is crucial to improving safety, independence, and quality of life [4].

Initial treatments may include medications or maneuvers like the Epley technique for BPPV. If symptoms persist, Vestibular Rehabilitation Therapy (VRT) is often recommended. VRT is a personalized exercise program aimed at enhancing the brain's ability to adapt, habituate, or compensate through substitution [6-8].

Recently, Virtual Reality (VR) has emerged as an innovative tool in vestibular rehab. It provides engaging, interactive environments for practicing balance and visual-vestibular tasks. Studies suggest that VR is feasible, well-tolerated, and effective, particularly for patients with persistent or visually-induced dizziness [9,10].