Virtual reality-based interventions for the rehabilitation of vestibular and balance impairments post-concussion: a scoping review.
Soraya J LeMarshall, Lachlan M Stevens, Nicholas P Ragg and 3 others
PMID 36869367WHAT IT FOUND
Across ten studies, every balance, gait and function measure improved after virtual reality therapy for post-concussion dizziness and balance problems.
The evidence was mostly low or very low quality, so this does not prove virtual reality is better than usual therapy.
Key findings
01All 19 outcome measures improved from before to after virtual reality-based interventions.
02The Activities-Specific Balance Confidence Scale, Dizziness Handicap Inventory, Berg Balance Scale and Functional Gait Assessment achieved moderate quality evidence.
03No study reported an effect size, and only three studies reported p values.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only ten studies were included, and they used 19 different outcome measures, so the review could not quantify how effective virtual reality is. Six full texts could not be retrieved. Most evidence was low or very low quality, and only four outcome measures reached moderate quality. No study reported an effect size, and only three studies reported p values, so it is hard to know whether changes were large or unlikely to be chance. The review could not say whether virtual reality is better than traditional vestibular rehabilitation. The authors reported improvement per hour of exposure, but many patients may not tolerate an hour of therapy. No consensus emerged on which type of virtual reality works best.
The easy way to misread this
Do not conclude that virtual reality is proven better than standard vestibular rehabilitation. The review found improvements, but the evidence was mostly low or very low quality, no study reported an effect size, only three studies reported p values, and it remains unclear whether virtual reality outperforms traditional therapy.