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Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2023

Open Access 01-12-2023 | Research

Contextual sensory integration training vs. traditional vestibular rehabilitation: a pilot randomized controlled trial

Authors: Jennifer Kelly, Daphna Harel, Santosh Krishnamoorthy, Gene Fu, Brittani Morris, Andrew Medlin, Sarah Mischinati, Zhu Wang, John Sutera, Ken Perlin, Maura Cosetti, Anat V. Lubetzky

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2023

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Abstract

Background

We created a clinical virtual reality application for vestibular rehabilitation. Our app targets contextual sensory integration (C.S.I.) where patients are immersed in safe, increasingly challenging environments while practicing various tasks (e.g., turning, walking). The purpose of this pilot study was to establish the feasibility of a randomized controlled trial comparing C.S.I. training to traditional vestibular rehabilitation.

Methods

Thirty patients with vestibular dysfunction completed the Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence Scale (ABC), Visual Vertigo Analog Scale (VVAS), Functional Gait Assessment (FGA), Timed-Up-and-Go (TUG), and Four-Square Step Test (FSST). Following initial assessment, the patients were randomized into 8 weeks (once per week in clinic + home exercise program) of traditional vestibular rehabilitation or C.S.I. training. Six patients had to stop participation due to the covid-19 pandemic, 6 dropped out for other reasons (3 from each group). Ten patients in the traditional group and 8 in the C.S.I group completed the study. We applied an intention to treat analysis.

Results

Following intervention, we observed a significant main effect of time with no main effect of group or group by time interaction for the DHI (mean difference − 18.703, 95% CI [-28.235, -9.172], p = 0.0002), ABC (8.556, [0.938, 16.174], p = 0.028), VVAS, (-13.603, [-25.634, -1.573], p = 0.027) and the FGA (6.405, [4.474, 8.335], p < 0.0001). No changes were observed for TUG and FSST.

Conclusion

Patients’ symptoms and function improved following either vestibular rehabilitation method. C.S.I training appeared comparable but not superior to traditional rehabilitation.

Trial registration

This study (NCT04268745) was registered on clincaltrials.gov and can be found at https://​clinicaltrials.​gov/​ct2/​show/​NCT04268745.
Appendix
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Metadata
Title
Contextual sensory integration training vs. traditional vestibular rehabilitation: a pilot randomized controlled trial
Authors
Jennifer Kelly
Daphna Harel
Santosh Krishnamoorthy
Gene Fu
Brittani Morris
Andrew Medlin
Sarah Mischinati
Zhu Wang
John Sutera
Ken Perlin
Maura Cosetti
Anat V. Lubetzky
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2023
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-023-01224-6

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