Vestibular rehabilitation in older adults with and without mild cognitive impairment: Effects of virtual reality using a head-mounted display

Micarelli, Alessandro; Viziano, Andrea; Micarelli, Beatrice; Augimeri, Ivan; Alessandrini, Marco

doi:10.1016/j.archger.2019.05.008

Cited by 75 publications

(101 citation statements)

References 66 publications

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“…Taken together, the present study confirms the usefulness of posturography as a monitoring tool for postural function due to consistent and reliable correlations with other objective measures. It is noteworthy that only low-frequency PS values reported significant modifications after surgery because these oscillations are mainly under vestibular control, 14,20,23,24 and previous works demonstrated modifications of such range in various conditions associated with vestibular impairment. 14,19,22 This strengthens the hypothesis of neural streams involving vestibular signaling being responsible in the improvement in balance observed in this study.…”

Section: Discussionmentioning

confidence: 83%

“…It could also be of interest to analyze a population of patients undergoing conservative treatment with hearing aid application using the same tests and a similar time frame to further investigate the role of enhanced acoustic stimulation in balance improvement. Finally, with respect to PS analysis, most of the spectral power in postural oscillation is represented within the low-frequency interval 53,54 ; cutoff points between frequency ranges are debated among different groups, 14,23,24 indicating that results could not be attributed solely to a change in vestibular function but may represent the effect of multiple neural circuits influencing balance.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 In this light, static posturography-especially when implemented with power spectra analysis-has been reported to be a useful method of assessing the extent of balance impairment and the relative impact of different sensory domains to postural dysfunction; previous experiences have shown posturographic parameters to well correlate with objective measurements of vestibular function such as vestibulo-ocular reflex (VOR) gain and also to reflect selfreported patient well-being in relation to balance. 14,15 To our knowledge, an evaluation of postural sway coupled with its impact on daily functioning has never been performed in patients with otosclerosis.…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment of otosclerosis leading to changes in postural control and quality of life

et al. 2019

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Objective Evaluating postural function in patients with otosclerosis by assessing otoneurological function and balance‐related quality of life before and 6 weeks after surgical treatment. Correlations between and clinical features were investigated. Methods Thirty‐three patients affected by otosclerosis underwent otoneurological examination, video Head Impulse Test (vHIT), and static posturography before and after stapedotomy. Quality of life and dizziness‐related handicap were screened by means of validated questionnaires. Correlation analysis was performed in order to discover possible relations with audiological pre‐ and postoperative parameters. Results A significant improvement in posturographic parameters was found. Correlation analysis yielded a negative correlation between preoperative bone conduction auditory threshold and both vHIT scores and postural performance improvement, evaluated by spectral analysis. Moreover, a positive correlation was also found between improvements in posturographic scores and quality‐of‐life questionnaires. Conclusion The study results demonstrated an improvement in postural function and self‐reported measures in a cohort of patients with otosclerosis 6 weeks after stapedotomy. The inverse correlation with preoperative auditory levels may reflect lesser chance for balance restoration in cases with worse sensorineural function. Possible implications for daily activities and overall quality of life were suggested by improved self‐report questionnaire results. Level of Evidence 4 Laryngoscope, 130:2448–2454, 2020

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical treatment of otosclerosis leading to changes in postural control and quality of life

et al. 2019

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“…Micarelli et al [42] This case control study examined the effect of a VR racing game, steered via head movement, on vestibular rehabilitation. Participants with unilateral vestibular hypoactivity (UVH, n = 47) comprising older adults and MCI were further divided into treatment (older adults n = 12, MCI n = 11) and control groups (older adults and MCI n = 12).…”

Section: Correlation Between Novel and Existing Measuresmentioning

confidence: 99%

Use of Immersive Virtual Reality in the Assessment and Treatment of Alzheimer’s Disease: A Systematic Review

Clay

Howett

FitzGerald

et al. 2020

JAD

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Background: Immersive virtual reality (iVR) allows seamless interaction with simulated environments and is becoming an established tool in clinical research. It is unclear whether iVR is acceptable to people with Alzheimer's disease (AD) dementia or useful in their care. We explore whether iVR is a viable research tool that may aid the detection and treatment of AD. Objectives: This review examines the use of iVR in people with AD or mild cognitive impairment (MCI). Methods: Medline, PsycINFO, Embase, CINAHL, and Web of Science databases were searched from inception. PRISMA guidelines were used with studies selected by at least two researchers. Results: Nine studies were eligible for inclusion. None reported any issues with iVR tolerability in participants with MCI and AD on assessment or treatment tasks. One study demonstrated capability for detecting prodromal AD and correlated with neuroanatomical substrates. Two studies showed iVR to have high accuracy in differentiating participants with AD from controls but were not hypothesis driven or with adequate controls measures. In a small validation study and two longitudinal case studies, iVR cognitive training was positively rated but did not demonstrate reliable benefit. Conclusion: iVR is emerging as a viable method of assessing older adults and people with AD. Strongest benefits were seen when closely integrated with theoretical models of neurodegeneration and existing screening methods. Further randomized controlled trials integrated with clinical populations are required. This will consolidate the power of iVR for assessment of MCI and clarify treatment efficacy beyond current applications in physical rehabilitation.

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“…There has also been success with using HMDs for memory training in older adults with significant improvements in memory tests (d=.7) compared with a control group receiving music therapy (Optale et al, 2009). Other uses including older adults have seen increased performance in daily living activities in stroke victims (Cho & Lee, 2019) and success with vestibular rehabilitation in older adults with mild cognitive impairment (Micarelli, Viziano, Micarelli, Augimeri, & Alessandrini, 2019). These findings of HMD use in older adults suggest that expansion into other areas is possible.…”

Section: Introductionmentioning

confidence: 99%

Using Virtual Reality to Improve Apathy in Residential Aged Care: Mixed Methods Study

Saredakis¹,

Keage²,

Corlis³

et al. 2019

Preprint

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Background and Objectives: Apathy is a common symptom in neurological disorders including dementia and is associated with a faster rate of cognitive decline, reduced quality of life and high carer burden. A lack of effective pharmacological treatments for apathy has placed an emphasis on non-pharmacological interventions. Virtual reality (VR) using head-mounted displays (HMD) has been successfully used in exposure and distraction-based therapies, however, there is limited research in using HMDs for symptoms of neurological disorders. This feasibility study assessed if VR using HMDs could be used to deliver tailored reminiscence therapy. Willingness to participate; response rates to measures; time taken to create tailored content; and technical problems were examined.Methods: A mixed methods study was conducted in a sample of older adults residing in aged care, 17 participants were recruited. Apathy was measured using the Apathy Evaluation Scale, verbal fluency was used as a proxy measure of improvements in apathy and debriefing interviews assessed feedback from participants. Side effects that can occur from using HMDs were also measured. Results: Those with higher levels of apathy demonstrated the greatest cognitive improvements after a VR reminiscence experience. All participants enjoyed the experience despite 35% of participants experiencing temporary side effects.Implications: There is a need to closely monitor side effects from HMD use in older adults. This study provides initial evidence that it is feasible to use VR with HMDs for therapy to treat symptoms of apathy in older adults in residential aged care.

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Vestibular rehabilitation in older adults with and without mild cognitive impairment: Effects of virtual reality using a head-mounted display

Cited by 75 publications

References 66 publications

Surgical treatment of otosclerosis leading to changes in postural control and quality of life

Surgical treatment of otosclerosis leading to changes in postural control and quality of life

Use of Immersive Virtual Reality in the Assessment and Treatment of Alzheimer’s Disease: A Systematic Review

Using Virtual Reality to Improve Apathy in Residential Aged Care: Mixed Methods Study

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