The potential use of virtual reality in vestibular rehabilitation of motion sickness

Motion sickness (MS) can be triggered by direct or indirect stimuli due to mismatches in the visual-vestibular autonomic pathways. Various studies in the literature have shown that virtual reality technologies can generate provocative stimuli for MS. Therefore, our primary aim is to investigate the usability of virtual reality systems in MS rehabilitation METHODS: 20 normal and 19 MS patients were included. A total of six virtual reality rehabilitation sessions (VRrs) with a game called "Roller Coaster Dreams" playable via PlayStation VR Head Mounted Display were applied thrice a week for 2 weeks, or twice a week for 3 weeks. Participants were evaluated at the pre-rehabilitation phase twice and after third and sixth rehabilitation sessions with the sensory organization test (SOT). The effectiveness of the rehabilitation program was statistically analyzed by comparing the results of SOTs.

All SOT results of the patient group were compared each other to evaluate the effectiveness of rehabilitation. According to the post-hoc comparisons, a statistically significant difference was found between the 1st, 2nd, 3rd, and 4th SOT- Equilibrium Scores; Condition 2 (p = 0.043), Condition 3 (p = 0.006), Condition 4 (p = 0.031), Condition 5 (p = 0.002) and Condition 6 (p = 0.040). There is no difference obtained in Condition 1 (p > 0.05). The Equilibrium Scores of SOT 3rd and SOT 4th were similar and 4th SOT-Equilibrium Scores were the highest among all SOT measurements. The results show that while the first three sessions were accepted as an orientation and adaptation sessions, 4^th, 5^thand 6^th sessions are habilitation sessions.

VR proved to be significantly effective and useful for MS rehabilitation. Additionally, observations indicated that using VR makes rehabilitation fun, increases the efficiency of the process, and reduces the risk of inadaptability to exercise.