{"id":3311,"date":"2026-10-24T18:31:24","date_gmt":"2026-10-24T18:31:24","guid":{"rendered":"https:\/\/remotion.rehab\/?p=3311"},"modified":"2026-10-24T18:35:59","modified_gmt":"2026-10-24T18:35:59","slug":"vestibular-rehabilitation-virtual-reality-uses-limits","status":"publish","type":"post","link":"https:\/\/remotion.rehab\/ar\/vestibular-rehabilitation-virtual-reality-uses-limits\/","title":{"rendered":"\u0627\u0644\u0627\u0636\u0637\u0631\u0627\u0628\u0627\u062a \u0627\u0644\u062f\u0647\u0644\u064a\u0632\u064a\u0629 \u0648\u0627\u0644\u0648\u0627\u0642\u0639 \u0627\u0644\u0627\u0641\u062a\u0631\u0627\u0636\u064a: \u0645\u0627 \u0627\u0644\u0627\u0633\u062a\u062e\u062f\u0627\u0645\u0627\u062a \u0627\u0644\u0645\u0645\u0643\u0646\u0629 \u0648\u0645\u0627 \u062d\u062f\u0648\u062f\u0647\u0627\u061f"},"content":{"rendered":"

Walking through a busy shop, turning to look at a shelf or watching a moving scene can be difficult for someone experiencing dizziness or imbalance. Digital environments offer ways to present visual situations in a controlled setting. They can also provoke discomfort, and their usefulness depends on the person's condition and the purpose of the activity.<\/p>\n

The starting point is a clinical assessment, not a headset. Virtual reality (VR) is a possible delivery medium within selected rehabilitation programmes. It does not identify the cause of dizziness, replace a vestibular examination or establish that a particular exercise is appropriate.<\/p>\n

Different causes require different decisions<\/h2>\n

\u201cDizziness\u201d describes an experience rather than a diagnosis. Peripheral vestibular hypofunction, benign paroxysmal positional vertigo (BPPV), persistent postural-perceptual dizziness (PPPD) and other conditions should not be treated as interchangeable.<\/p>\n

The 2022 clinical guideline supports vestibular rehabilitation for adults with peripheral vestibular hypofunction. Its recommendations do not automatically apply to every dizziness presentation. [1] For posterior canal BPPV, the condition-specific guideline recommends an appropriate repositioning procedure or referral to someone who can provide it. A virtual scene is not a substitute for that treatment. [2]<\/p>\n

New, unexplained or changing symptoms need appropriate clinical assessment. The question \u201ccould we use VR?\u201d comes after the question \u201cwhat is being assessed or treated, and by whom?\u201d<\/p>\n

Define the role of the virtual environment<\/h2>\n

A therapist might consider a digital scene when there is a clear reason to present a particular visual context. A simulated aisle, for example, can be relevant to discussing difficulty in a visually busy shop. However, a scene's resemblance to daily life does not make it a validated assessment or prove that practice will transfer outside the session.<\/p>\n

Clarify what the activity is intended to address: a specific response to visual complexity, a supervised task within an established programme, or exploration of how a person tolerates a setup. The task, input method and movement requirements must fit that purpose.<\/p>\n

Not every visual game is a vestibular exercise, and not every VR headset provides the functions required for a specialist vestibular intervention. Any claim about gaze stability, vestibulo-ocular reflex function or postural measurement needs evidence for the particular tool and use.<\/p>\n

What does the research actually compare?<\/h2>\n

A small 2021 trial in PPPD compared two programmes that both used VR; one also included optokinetic stimulation. Its findings cannot establish superiority over non-VR care. [3] A separate 2025 randomised trial reported improvement in both groups without a significant between-group difference when VR was added to a rehabilitation programme. [4]<\/p>\n

These studies illustrate why the comparison matters. Ask which diagnosis was included, what each group received, which outcomes changed and whether any benefit persisted. A favourable result in one study is not evidence that all headsets, applications or Remotion products have the same effect.<\/p>\n

Plan an individual, supervised trial<\/h2>\n

Before a trial, agree its purpose and how the person will communicate discomfort or ask to stop. Review the assessment, relevant precautions, previous VR experience and the practical support required. Follow the device and application instructions as well as local clinical procedures.<\/p>\n

The table below is an original planning example for a qualified clinician considering a digital scene. It is not a home-exercise prescription or a validated vestibular treatment protocol.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Planning element<\/th>\nQuestions to resolve<\/th>\n<\/tr>\n<\/thead>\n
Objective<\/td>\nWhich everyday activity or clinically identified difficulty is relevant to this trial?<\/td>\n<\/tr>\n
Intended context<\/td>\nIs the person assessed, clinically suitable and supervised by a professional with the necessary competence?<\/td>\n<\/tr>\n
Task<\/td>\nWhat should the person actually do, beyond simply wearing the headset?<\/td>\n<\/tr>\n
Configuration<\/td>\nWhat scene, viewing conditions, input and movement demands are available and appropriate? Which settings can the specific application change?<\/td>\n<\/tr>\n
Observations<\/td>\nWhat does the person report before, during and after the activity? What assistance and behavioural responses does the clinician observe?<\/td>\n<\/tr>\n
Recorded data<\/td>\nWhich events are genuinely recorded, and what are their technical limitations? Separate these from clinical interpretation.<\/td>\n<\/tr>\n
Adaptation<\/td>\nCould a simpler scene, different presentation or non-headset alternative better serve the goal?<\/td>\n<\/tr>\n
Cautions<\/td>\nWhat symptoms or changes require a pause, ending the activity or further assessment? How will safe positioning and assistance be maintained?<\/td>\n<\/tr>\n
Documentation<\/td>\nRecord the scene, equipment, relevant settings, exposure actually completed, support, symptoms and next decision.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

An application may not offer all the adjustments in this example. Missing controls can make a setup unsuitable for the intended use.<\/p>\n

Distinguish planned challenge from unwanted effects<\/h2>\n

In specialist rehabilitation, a clinician may plan and monitor symptom-related responses as part of an individual programme. This is different from assuming that nausea or dizziness during any VR experience means the treatment is working.<\/p>\n

Record what was present before exposure and what changed during or afterwards. The person should not be encouraged to continue simply to complete a level. Pause or stop for unexpected, marked or concerning symptoms, loss of safe positioning or a request to stop, and reassess appropriately.<\/p>\n

Headset removal does not, by itself, establish readiness to stand up or leave. Check how the person feels and provide assistance as needed. This article does not supply a universal symptom threshold, exposure duration or recovery time.<\/p>\n

Offer alternatives without losing the goal<\/h2>\n

The clinical goal may remain relevant even when immersive VR is unsuitable. Discuss whether real-world practice, a screen-based presentation or another method within the person's care plan is more appropriate. A screen is not automatically symptom-free, and changing the presentation also changes the demands.<\/p>\n

For a person who wants to return to shopping, a useful review asks about the activity that matters: participation, assistance, tolerance and confidence in the relevant context. A completed virtual task or longer headset use does not establish recovery.<\/p>\n

Keep clinical conclusions separate from game results<\/h2>\n

A headset's position tracking is not, by default, a validated vestibular test. A game score cannot independently diagnose a disorder, demonstrate vestibular compensation or determine fall risk.<\/p>\n

Use assessments appropriate to the clinical question, with the required training, and describe what each observation can and cannot show. Document self-reported experience, direct observation and software events separately. If daily-life function was not assessed, say so.<\/p>\n

Use VR when its role is justified<\/h2>\n

VR may have a place in selected, supervised vestibular rehabilitation programmes. The decision should rest on diagnosis, goals, relevant evidence, the person's preferences and the actual capabilities of the equipment. Choosing another approach is appropriate when the headset or task adds no useful contribution.<\/p>\n

Discuss your clinical setting and accessibility needs with the Remotion team through the website contact page<\/a>. Confirm the intended use and capabilities of the specific configuration; this article does not establish a vestibular indication or clinical validation for a Remotion product.<\/p>\n

References<\/h2>\n
    \n
  1. Hall CD, et al. Vestibular rehabilitation for peripheral vestibular hypofunction: updated clinical practice guideline<\/a>. 2022. DOI: 10.1097\/NPT.0000000000000382.<\/li>\n
  2. Bhattacharyya N, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update)<\/a>. 2017. DOI: 10.1177\/0194599816689667.<\/li>\n
  3. Choi SY, et al. Effect of vestibular exercise and optokinetic stimulation using virtual reality in persistent postural-perceptual dizziness<\/a>. Scientific Reports. 2021;11:14437.<\/li>\n
  4. The effect of using virtual reality on balance in people with persistent postural-perceptual dizziness: a randomized controlled trial<\/a>. 2025. PMID: 40085770.<\/li>\n<\/ol>\n

    Related reading<\/h2>\n