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SYSTEMATIC REVIEW article

Front. Neurol.

Sec. Neuro-Otology

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1638868

Comparison of the effectiveness of immersive and non-immersive virtual reality in the treatment of vertigo in patients with peripheral vestibular dysfunction: a systematic review and meta‑analysis

Provisionally accepted
Xiaoyi  LiuXiaoyi Liu1Sha  YangSha Yang2Yiru  WangYiru Wang2Ziwei  TongZiwei Tong2Xiao  AnXiao An2Xiaoqing  RenXiaoqing Ren2Xu  SunXu Sun2Zhicong  ZhouZhicong Zhou2Hong  WangHong Wang2*Xiaoying  LiuXiaoying Liu1
  • 1Shandong Second Medical University, Weifang, China
  • 2Shandong Provincial Qianfoshan Hospital, Jinan, China

The final, formatted version of the article will be published soon.

Background 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. Objective To investigate the effectiveness of VR technology at different immersion levels in reducing vertigo symptoms in patients with PVD. Method 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. Results 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, P < 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, P < 0.001), a single intervention duration of <30 min/ times (SMD = -2.80, 95% CI = -4.89 to -0.70, P = 0.009), and a frequency of ≥5 times/week (SMD = -2.64; 95% CI = -4.91 to -0.38, P = 0.02) were more effective in alleviating vertigo symptoms. Conclusion 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.

Keywords: peripheral vestibular dysfunction, virtual reality, Vertigo, Systematic review, metaanalysis

Received: 02 Jun 2025; Accepted: 03 Jul 2025.

Copyright: © 2025 Liu, Yang, Wang, Tong, An, Ren, Sun, Zhou, Wang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Hong Wang, Shandong Provincial Qianfoshan Hospital, Jinan, China

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