The Feasibility of Bal Ex Virtual Room for Balance Rehabilitation to Improve Balance: A Case Study

Dr Zuraida Zainun Senior Medical Lecturer MSc (Medical Audiology), MD School of Health Sciences, Universiti Sains Malaysia drzuraida@yahoo.com http://bal-exercise.blogspot.com/

Study outlines
Study background Objective Of The Study

Study Design/Methodology
Results & Discussions

Conclusion
The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

1. Scientific Background
Balance disordered patients may report visual vertigo. With mixed results, available clinical treatments to reduce visual vertigo include gaze stabilization, postural control, and suppressive medications. All are time consuming and require prolonged treatment. The secondary actions of suppressive medications may prohibit their use. We propose a novel tool as a viable alternative, known as the BAL EX Virtual Room.

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

Virtual rehabilitation encourages patients to use their body weight to perform closed kinematic exercises, as opposed to open kinematic exercises that require external resistive devices, such as dumbbells, Palmaira said. As a result, it is safer and the transfer of movement to a functional task is faster and more enhanced than with traditional therapy.
(Randy Palmaira, can be reached at Beth Abraham Family of Health Services, 612 Allerton Avenue, Bronx, New York 10467; 718-519-4000; email: rpalmaira@cnrhealthcare.org.)
The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

Virtual rehabilitation is a useful technique, both for motor function and body balance recovery in individuals with neuromotor impairment, in addition to enabling motivational aspects. Nonetheless, despite this positive effect for motor function and body balance, the methodological limitation of certain studies clearly shows the need for advances in this field of research. Thus, the method must still be used with caution and studied in groups of individuals with other clinical conditions
(Virtual rehabilitation eff ectiveness in the body balance and motor skills of individuals with neuromotor defi cit: a systematic review by Renato Sobral Monteiro Junior and Elirez Bezerra da Silva)

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

Disco Ball Therapy

Virtual Room

2- Research Objective
To test the feasibility of the BAL EX Virtual Room as a visual vertigo rehabilitation programme to improve balance.

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

3- Materials and Methods

One female subject presenting a one year history of balance problem with a visual vertigo diagnosis was involved in this case study. The subject underwent two treatment sessions within four weeks. Each session took one hour. The duration between sessions was two weeks.

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

Conts..
The BAL EX Virtual Room involved the visual simulation of a disco ball within a darkened room. The rotation of the disco ball with random colours of white, yellow, red and green; was intensified incrementally. The Malay version Activities-specific Balance Confidence (ABC) Scale and Modified Malay Vertigo Symptom Scale (MVVSS) was given to the subject before first treatment and two weeks post second treatment.
The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

DISCO BALL Optokinetic Stimulation

A mirrored "disco ball" to provide optokinetic stimulation for patients with vestibular disorders. All of these techniques "involve some degree of innovative technology to assess treatment effectiveness, measurement of vestibular function, or reveal behavior in people with vestibular dysfunction," Drs. Schubert and Ryan write.
The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

BAL EX VIRTUAL ROOM

BAL EX VIRTUAL ROOM

4- Results
Before treatment, the patients score for Malay version ABC was 50. After treatment, her score was 79.40; an improvement of 59%. The MVVSS showed 35% improvement after rehabilitation

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

MVVSS
Score Before After

35 % Improvement

Subject
Table 1: Improvement score for MVVSS

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

BDI
Score Before After

% Improvement

Subject
Table 2: Improvement score for BDI

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

5- Discussion
The positive improvement of ABC scale and MVVSS scores, indicate the feasibility of this novel BAL EX Virtual Room rehabilitation program The BAL EX Virtual Room programme, in incremental sessions of exposure; may be beneficial in reducing visual vertigo and lessening the use of suppressive medications.

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

CONT
It is suggested that a wider pool of subjects with visual vertigo are tested in order to improve its viability as a rehabilitation programme for balance disordered or visual vertigo patients.

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study

6- Conclusion
Future research with better sample size will improve the outcomes.

The Feasibility of BAL EX Virtual Room For Balance Rehabilitation to Improve Balance: A Case Study