Section: 
Otiology
OtiologyCombined application of binaural acoustic stimulation and virtual reality methods for vestibular rehabilitation. Report I. Efficacy in patients with persistent unilateral peripheral vestibular hypofunction
E. N. Kravtsova (1), A. Yu. Meigal (2), L. V. Shchegoleva (3), L. I. Gerasimova-Meigal (4), V. V. Dvoryanchikov (5)
(1), (2), (3), (4) Petrozavodsk State University, Petrozavodsk, 185910, Russian Federation, (5) Saint Petersburg Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation
UDK: УДК 616.28-008.5-073.175-053:616.281
DOI: https://doi.org/10.18692/1810-4800-2026-1-84-91
ABSTRACT
Abstract. Introduction. Persistent unilateral vestibular hypofunction (UVH) leads to imbalance and chronic dizziness, which reduces the quality of life of patients. Vestibular rehabilitation (VR) is the «gold standard» of treatment, but finding ways to improve its effectiveness remains an urgent task. Objective. To evaluate the effectiveness of a combined VR method integrating training based on a virtual reality system with incomplete immersion with biofeedback and synchronous binaural acoustic stimulation of bone conduction (110 Hz) in patients with persistent UVH. Patients and methods. The study involved 32 patients (11 men, 21 women, average age 49.7 ± 14.6 years) with confirmed UVH from 9 months to 3 years. The criteria for inclusion in the study were the presence in patients of persistent UVH, diagnosed during an otoneurological examination and confirmed by a bithermal caloric test (index of labyrinthine asymmetry ?25%). The etiology of UVH included: post-vestibular neuronitis (n = 24), vascular cochleovestibular syndrome (n = 3), consequences of Meniere’s disease, labyrinthitis, and otosurgical interventions (n = 7). All patients underwent a 4-week course of combined VR. The protocol included: 1) daily virtual reality training with a gradual increase in duration (5–20 min/session) with synchronous acoustic stimulation; 2) outpatient component: dosed walking (2 times/day, 15–60 min) and cognitive-motor exercises with prolonged audio stimulation. For an objective assessment of the dynamics, the method of computer stabilometry was used with the analysis of the length (L, mm) and area (S, mm2) of the statokinesiogram while standing with open (OH) and closed (CH) eyes on a hard surface and with open (OS) and closed (CS) eyes on a soft (foam) mat before and after the course VR. The parameters L and S were compared in the states with open and closed eyes and standing on a hard or soft surface using the Student’s t-test (p < 0.05). The data was processed using the R package. Results. After completing the course of VR, a statistically significant improvement in postural control was recorded in patients with UVH. The length of the trajectory of the common pressure center significantly decreased in all test conditions: by 32.7% in OH conditions (p < 0.05), by 37.9% in CH (p < 0.05), by 27.0% in OS (p < 0.05), by 35.7% in CS (p < 0.05). The area of the statokinesiogram also decreased significantly in the conditions of CH (by 38.2%), OS (by 37.8%) and CS (by 59.0%) (p < 0.05). The analysis of the weight contribution of sensory systems revealed a significant increase in the role of vestibular afferentation (WVest) for controlling the amplitude of oscillations (parameter S) from 0.15±0.12 to 0.24±0.12 (p < 0.05) and optimization of the contribution of the proprioceptive component (WPro). Conclusion. The developed combined VR method, combining virtual reality training with binaural acoustic stimulation of bone conduction, demonstrates high clinical efficacy in patients with persistent OVH. The method helps to improve postural stability even in conditions of maximum sensory deprivation, optimizes sensory integration and enhances the vestibular contribution to maintaining balance, which confirms the expediency of its implementation in cli
Publication date:
24.02.2026
Keywords:
vestibular rehabilitation, unilateral vestibular hypofunction, virtual reality, acoustic stimulation, bone conduction, stabilometry, postural control, sensory integration For citation:
Kravtsova E. N., Meigal A. Yu., Shchegoleva L. V., Gerasimova-Meigal L. I., Dvoryanchikov V. V. Combined application of binaural acoustic stimulation and virtual reality methods for vestibular rehabilitation. Report I. Efficacy in patients with persistent unilateral peripheral vestibular hypofunction. Russian Otorhinolaryngology. 2026;25(1):84-91. (In Russ.) https://doi.org/10.18692/1810-4800-2026-1-84-