Exergame training with integrated head turns helps patients with chronic vestibular hypofunction


A study was recently carried out by the University Hospital Zurich in collaboration with the ETH Zurich, which examined whether exergames (active video games) with integrated head turns have an impact on vestibular functions and gait pattern of patients with unilateral chronic peripheral vestibular hypofunction (cPVH).

Patients with vestibular disorders often suffer from symptoms such as dizziness, visual difficulties or imbalance. These symptoms, in turn, can lead to restrictions in everyday life, a reduced quality of life as well as anxiety and stressfulness, all the way to a depressed state. Therefore, there is a need for effective therapies for chronic vestibular diseases. A promising approach is the use of training with «virtual reality» e.g. Exergame training for such patients. To reduce dizziness, most patients try to move their heads as little as possible during daily activities - a strategy that has a negative effect on balance and walking. Improving gait is an important goal of vestibular rehabilitation. This should be achieved by explicitly integrating head movements into the training. In this way, a certain “getting used to” is sought. The therapy should explicitly require that eye movements take place together with movements of the head and body.

12 patients (including 8 men) with cPVH with an average age of 65 ± 12 years were recruited for this study. The study included a 4 week control period followed by a 4 week intervention period. The intervention included exergame training on the Dividat Senso, in which movements (e.g. step movements or balance movements) are used to control the training games. The training games also represent cognitive challenges and address various brain functions (e.g. attention and executive functions). In this study, the training games were not presented “statically” on a screen, but were projected onto a wall, with this projection moving. Therefore, the study participants had to turn their heads constantly during the training. Various measurements were carried out before and after the intervention period, including a video head-impulse test, a gait analysis, a test for measuring motor functions and a questionnaire (e.g. dizziness questionnaire). All vestibular functions such as e.g. vestibulo-ocular reflexes.

The study showed an improvement in vestibular functions and gait in half of the patients with cPVH. It is the first study to show the positive effects of specifically designed exergame training (with integrated head movements) for patients with chronic vestibular problems.

Here you can download the paper: https://www.frontiersin.org/articles/10.3389/fneur.2020.00601/full