Abstract
Vestibular rehabilitation is effective for providing relief from dizziness and improving imbalance in uncompensated patients with unilateral vestibulopathy. However, some patients are refractory to conventional vestibular rehabilitation. We developed a new vestibular rehabilitation method using virtual reality technology, to induce the sensory reweighting mechanism in the brain. In the preliminary study, vestibular rehabilitation using the virtual reality technology changed the balance control strategy in normal subjects. We then developed a new wearable device, Tilt Perception Adjustment Device (TPAD), that senses head-tilt vestibular information and transmits it to the mandible through vibration. Vestibular rehabilitation using TPAD improved dizziness and restored body sway and walking in patients with unilateral vestibulopathy who were refractory to conventional vestibular rehabilitation. We speculate that the vibratory somatosensory input of TPAD conveying head-tilt vestibular information serves as a substitute for the impaired processing of vestibular information by the brain, and a sensory reweighting mechanism changes the balance control strategy by reweighting sensorimotor dominance from vision to proprioception for posture and gait regulation in the brain in patients with unilateral vestibulopathy. Virtual reality and TPAD might be a promising tools to increase the efficacy of vestibular rehabilitation.
