Long

To investigate the long-term effects of adding virtual reality–based home exercises to vestibular rehabilitation in people with unilateral vestibular hypofunction. Follow-up otoneurological examination in two randomized groups following a previous one-month trial. Tertiary rehabilitation center. A total of 47 patients with unilateral vestibular hypofunction, one group (n？=？24) undergoing conventional vestibular rehabilitation and the other one (n？=？23) implementing, in addition, head-mounted gaming home exercises, 20？minutes per day for one month. One year after completing rehabilitation, patients underwent testing with static posturography, video head impulse test, self-report questionnaires, and a performance measure. Vestibulo-ocular reflex gain, posturographic parameters such as length, surface, and fast Fourier transform power spectra, self-report, and gait performance measure scores. Vestibulo-ocular reflex gain was significantly better with respect to pretreatment in both groups. The mixed-method group showed significantly higher gain scores: mean (standard deviation (SD)) at 12？months was 0.71 (0.04), versus 0.64 (0.03) for the vestibular rehabilitation–only group (P？<？0.001). Accordingly, some classical posturography scores such as surface with eyes open and length with eyes closed and low-frequency power spectra were significantly different between groups, with the virtual reality group showing improvement (P？<？0.001). Self-report measures were significantly better in both groups compared to pretreatment, with significant improvement in the mixed-method group as compared to conventional rehabilitation alone: Dizziness Handicap Inventory mean total score was 24.34 (2.8) versus 35.73 (5.88) with a P-value <0.001. Results suggest that head-mounted gaming home exercises are a viable, effective, additional measure to improve long-term vestibular rehabilitation outcomes