Frequency Discrimination Training With and Without Game Format to Treat Tinnitus: A Systematic and Meta-Analysis...

To evaluate the effectiveness of Frequency Discrimination Training (FDT) programs with and without an integrated game format for treating a person with tinnitus. Searches were conducted in Medline, PubMed, Web of Science, Elsevier, Springer, Scopus, and ProQuest databases from early 2000 to 2024. FDT studies of non-randomised and randomised clinical trials that used validated tinnitus handicap index were considered. A total of six articles from non-randomised (four studies) and randomised clinical trials (two studies) met our inclusion criteria. Both types of studies were rated as good quality, as assessed by the Mixed Methods Appraisal Tool. However, the levels of evidence were generally limited by factors such as lack of blinding, failure to calculate effect sizes, and absence of follow-up assessments after the treatment period to monitor outcomes. According to the random-effects model, Frequency Discrimination Training (FDT) reduces tinnitus handicap with a medium effect size of 0.5104 (95% CI: 0.2478 to 0.7729), regardless of game integration. When considering FDT without game integration, the effect size remained medium at 0.473 (95% CI: 0.14 to 0.780). In contrast, FDT with game integration demonstrated a large effect size of 0.90 (95% CI: 0.29 to 1.50) in reducing the handicap caused by the tinnitus. A substantial effect size was observed in THI score reduction among tinnitus participants trained with FDT integrated with a game compared to those without integration.