An innovative visuolocomotor training program for people on waiting list for vestibular rehabilitation

Dizziness and imbalance are debilitating symptoms of vestibular dysfunction (VD) that can be treated through vestibular rehabilitation. The C-Mill ForceLink treadmill (C-Mill) allows for the integration of virtual reality and cognitive dual-tasking during treatment. No research has been conducted on its use in vestibular rehabilitation. The purpose of this pilot study was to develop a visuolocomotor training protocol on the C-Mill for individuals with VD, and to establish feasibility of both future research on, and clinical use of, this protocol to improve symptoms of dizziness and imbalance in individuals with VD who were on the waiting list for vestibular rehabilitation to undergo 10 one-hour sessions on the C-Mill. The Dizziness Handicap Inventory (DHI), Visual Vertigo Analog Scale (VVAS), and Functional Gait Assessment (FGA) were used as outcome measures, in conjunction with subjective reports. Nine participants completed the study, 55% demonstrated improvement in all outcome measures as well as subjective reports, while 0% digressed. The average percent of improvement from defined baseline to follow-up was 42.43% for the DHI (standard deviation (SD)=23.82%), 54.59% for the VVAS (SD=31.95%) and 21.89% for the FGA (SD=33.64%). Results support the use of the C-Mill as an intervention for patients on a waiting list with VD under the supervision of a physiotherapist. A larger and more comprehensive study is feasible in order to further investigate the effects of this protocol on symptoms of dizziness and imbalance in individuals with VD.