Liu Xiaoyi, Yang Sha, Wang Yiru, Tong Ziwei, An Xiao, Ren Xiaoqing, Sun Xu, Zhou Zhicong, Wang Hong, Liu Xiaoying
School of Nursing, Shandong Second Medical University, Weifang, China.
The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
Front Neurol. 2025 Jul 17;16:1638868. doi: 10.3389/fneur.2025.1638868. eCollection 2025.
Vertigo is the most common clinical manifestation in patients with peripheral vestibular dysfunction (PVD), and severe episodes may be accompanied by nystagmus, tinnitus, and hearing loss, which can seriously affect quality of life. Virtual reality (VR) technologies (immersive or non-immersive) play an important role in improving vertigo in patients with PVD, but the comparative effectiveness of VR technologies with different levels of immersion is unknown.
To investigate the effectiveness of VR technology at different immersion levels in reducing vertigo symptoms in patients with PVD.
PubMed, MEDLINE, Embase, Cochrane Library, Web of Science, CINAHL and 4 Chinese databases were systematically searched. Standardized mean difference (SMD) was calculated using RevMan 5.4 software, and risk of bias was assessed using the Cochrane Collaboration tool and Stata software. The review process was reported according to PRISMA.
Twelve studies involving 600 participants met the inclusion criteria. The results indicated that both non-immersive and immersive VR significantly improved vertigo symptoms in patients with PVD; however, the immersive VR intervention demonstrated greater effectiveness (SMD = -2.08, 95% CI = -3.13 to -1.04, < 0.001). Further subgroup analyses revealed that immersive VR intervention programs with a duration of ≤7 weeks (SMD = -2.73; 95% CI = -4.17 to -1.28, < 0.001), a single intervention duration of <30 min/ times (SMD = -2.80, 95% CI = -4.89 to -0.70, = 0.009), and a frequency of ≥5 times/week (SMD = -2.64; 95% CI = -4.91 to -0.38, = 0.02) were more effective in alleviating vertigo symptoms.
Immersive VR has been shown to be more effective in alleviating vertigo symptoms in patients with PVD. Specifically, an immersive VR program that includes an intervention period of ≤7 weeks, a single intervention duration of <30 min, and an intervention frequency of ≥5 times/week is recommended for optimal improvement of vertigo symptoms. Further high-quality, multicenter randomized controlled trials are recommended to confirm the findings of this study. Healthcare professionals should focus on the individual differences of elderly patients with PVD and provide personalized VR vestibular rehabilitation programs for optimal rehabilitation outcomes.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42025638469.
眩晕是外周前庭功能障碍（PVD）患者最常见的临床表现，严重发作时可能伴有眼球震颤、耳鸣和听力损失，这会严重影响生活质量。虚拟现实（VR）技术（沉浸式或非沉浸式）在改善PVD患者的眩晕方面发挥着重要作用，但不同沉浸程度的VR技术的比较效果尚不清楚。
探讨不同沉浸程度的VR技术在减轻PVD患者眩晕症状方面的有效性。
系统检索PubMed、MEDLINE、Embase、Cochrane图书馆、Web of Science、CINAHL和4个中文数据库。使用RevMan 5.4软件计算标准化均值差（SMD），并使用Cochrane协作工具和Stata软件评估偏倚风险。根据PRISMA报告综述过程。
12项涉及600名参与者的研究符合纳入标准。结果表明，非沉浸式和沉浸式VR均能显著改善PVD患者的眩晕症状；然而，沉浸式VR干预显示出更大的效果（SMD = -2.08，95%CI = -3.13至-1.04，P < 0.001）。进一步的亚组分析显示，持续时间≤7周的沉浸式VR干预方案（SMD = -2.73；95%CI = -4.17至-1.28，P < < 0.001）、单次干预持续时间<30分钟/次（SMD = -2.80，95%CI = -4.89至-0.70，P = 0.009）以及频率≥5次/周（SMD = -2.64；95%CI = -4.91至-0.38，P = 0.02）在缓解眩晕症状方面更有效。
沉浸式VR已被证明在减轻PVD患者眩晕症状方面更有效。具体而言，建议采用持续时间≤7周、单次干预持续时间<30分钟且干预频率≥5次/周的沉浸式VR方案，以最佳改善眩晕症状。建议进一步开展高质量、多中心随机对照试验以证实本研究结果。医疗保健专业人员应关注老年PVD患者的个体差异，并提供个性化的VR前庭康复方案以实现最佳康复效果。
