Virtual reality helps patients with visual vertigo

Published: 4-Dec-2018

Gaming technology supports patients to become symptom free more quickly

Sheffield Teaching Hospitals NHS Foundation Trust has become the first NHS organisation in the country to begin use virtual reality gaming to treat visual vertigo.

The trust has installed a state-of-the-art virtual reality computer gaming suite at the Royal Hallamshire Hospital.

The use of the technology has already led to a dramatic improvement in recovery times for patients suffering with the debilitating condition, with those using the digital landscape and headsets during rehabilitative therapy regaining control of their symptoms within six to eight weeks of starting therapy. This compares to six months using traditional rehabilitative therapy.

Around 30% of people with balance problems suffer with visual vertigo, a chronic and complex form of dizziness, which leads to social isolation and depression and puts sufferers at increased risk of falling.

The condition occurs when there is a mismatch between the visual, vestibular and somatosensory systems that control the movement and senses of the eye, meaning patients are unable to cope in visually-challenging environments. This includes when in supermarket aisles, train stations, shopping malls or when on escalators or on motorways.

Standard treatment is undertaken through the use of controlled sessions where patients are asked to undertake a range of gaze adaptation therapy activities for 15 to 20 minutes. Typically this involves patients being asked to throw a ball, track the movement of their fingers, sway their head from side to side either at slow or fast pace, or look at visually-stimulating patterns like wallpaper.

However, by using a virtual reality system patients are able to fully immerse themselves in realistic 3D settings during their therapy. This enables them to experience the same physical and psychological movements and reactions they would in real life.

During the augmented reality therapy, patients are able to experience the movements, sounds and sensations of a sequence of different visual stimuli that they would normally find troublesome, such as going up a lift in a skyscraper, swaying scenery or flying.

Professor Jaydip Ray, clinical director and consultant ear, nose and throat surgeon at Sheffield’s Royal Hallamshire Hospital, said: “Visual vertigo is a complex, yet poorly-understood condition that can have a profound effect on people’s lives, with many finding it impossible to do job roles in the fire or police service that require you to cope with visual challenges.

“Our specialist regional neurotology clinic has already pioneered the use of augmented reality video game consoles with balance boards to help patients, so using hi-end virtual reality gaming systems for rehabilitative therapy for patients with visual vertigo is a natural progression for us.

Although a small number of patients have been unable to tolerate the system, for those who can we have seen significant improvements in recovery times. These can be hugely transforming and can be key in preventing a deepening sense of depression and isolation, and most patients who have accessed the system are now being symptom-free.”

Teresa Fox, 53, who works as a clerical support worker at Weston Park Hospital, started to have issues with her balance three years ago.

“It got to the point where I couldn’t stand up, everything was spinning, and I felt very nauseous with it,” she said.

“Things started to settle down when I had some treatment and therapy exercises, but a year later it started again, I was having missteps. It was such a weird experience. I felt like I was walking normally but then I missed bits, corridors wouldn’t look level, and I’d lose my balance.”

She was referred to the the ear, nose and throat department at the Royal Hallamshire Hospital, Sheffield where she was diagnosed with Meniere’s Disease, a condition of the inner ear that causes vertigo, along with visual vertigo. To help her better cope with her visual vertigo, she was able to use the virtual reality computer gaming suite as part of her therapy.

“Initially I was a bit apprehensive as I was terrified of spinning out of control, but virtual reality really helped me psychologically as I realised I could cope in certain situations that I didn’t think I would be able to,” she said.

“I used to really suffer when travelling in a car, walking along corridors, or going up heights but I no longer experience that sensation that I’m moving when I’m stationary.

“I still have episodes of visual vertigo now, but they used to occur on a daily basis with an attack coming on in seconds. I’m a lot better than I was and most days are good days now.”

Over time it is hoped that the technology could be used in patients’ homes for self-help therapy.

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