الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Peripheral vestibular dysfunction has negative effects on balance control and gaze stability, this lead to significant disability, depression, anxiety and may also has an impact on individual’s quality of life.
Many of the peripheral vestibular disorders are self-limited and recover spontaneously. However, there are many patients who complain from persistence of vestibular symptoms and this means incomplete vestibular compensation. In case of defective compensation, vestibular rehabilitation therapy could be used in vestibular compensation improvement.
Vestibular rehabilitation is the main therapeutic option for many patients with peripheral vestibular disorders. But many factors may negatively affect the outcomes of the conventional vestibular rehabilitation, including incorrect performance of exercises and the necessity of active efforts and interest from the patient.
With the recent technologies in computer and video games, virtual Reality therapy has been developed as a new therapeutic method. In Virtual reality technologies the users interact with displayed images, move and manipulate virtual objects and perform other actions in a way that attempts to ”immerse” them within the simulated environment so it provides the patient with feeling of presence in the virtual world.
Many studies were done exploring the efficacy of virtual reality in vestibular lesions as a rehabilitative tool, but there are no standardized guidelines settled in the literature and also there is high diversity of settings and protocols involving virtual reality settings for the treatment of this pathology.
As a result, this study was designed to study the efficacy of virtual reality interventions in vestibular rehabilitation in patients with peripheral vestibular disorders through searching and critically appraising the previous studies documenting the use of virtual reality settings for peripheral vestibular disorders rehabilitation.
The search in this study was done by using keyword search strategies in different digital libraries (PubMed, Google Scholar, Cochrane and Embase).
The simple or advanced search when possible was conducted. This search yielded 501 articles. After removing duplicates, 480 articles remained. Of these, 252 were excluded based on title and abstract. After reading the full text of 228 articles; 222 were excluded. Finally, 6 articles were included in this study as shown in the flowchart (fig 10).
The included studied were chosen according to the inclusion criteria (controlled trials in which VR was used as vestibular rehabilitative therapy in comparison to any vestibular rehabilitative modalities other than virtual reality methods or in comparison to medical or dietary recommendations) and the exclusion criteria (Studies without a comparison group and studies that include patients with other causes of vestibular dysfunction as Central or mixed causes).
The statistical analysis was done and the included studies were tested for heterogeneity by using the chi-squared (χ2, or Chi2) test and the I2 test. Due to the presence of some heterogeneity between the studies in some scales, the data was analyzed using the random effect model as it is the more conservative approach even if there is no heterogeneity.
The results of the meta-analysis of the outcome measures showed significant results in DHI total score, DHI physical score, DHI functional score, DHI emotional score, Posturography, VSS-SF and VAS (SAT). But showed non-significant results in ABC scale and dizziness analogue scale.
The results showed that virtual reality rehabilitation can improve many parameters used in assessment of balance function in patients with peripheral vestibular disorders. The results in this study are in alignment with the results of other systematic reviews done in the same field.
This study suggests that virtual reality has potential clinical benefit for vestibular rehabilitation in peripheral vestibular dysfunction compared with conventional vestibular rehabilitation.
Despite these promising results, it is recommended that further research is needed to document the exact parameters of an optimal protocol of virtual reality rehabilitation, the period needed for effective rehabilitation and the number of sessions needed for proper rehabilitation. These further researches need to monitor, measure, and report side effects of virtual reality in patients with peripheral vestibular dysfunction.