Effects of Traditional and Virtual Reality-Based Vestibular Rehabilitation on Balance and Visual-Motor Skills in Children With Specific Learning Disorders: A Randomized Controlled Trial.

PURPOSE: This study aimed to determine whether children with specific learning disorders (SLDs) exhibit impairments in vestibular and balance functions compared with typically developing peers and to assess the efficacy of traditional and virtual reality (VR)-based vestibular rehabilitation in improving balance performance, vestibular function, visual-motor integration, and learning-related outcomes. METHOD: This randomized controlled study included 63 children aged 7-12 years: 42 children with SLD and 21 typically developing children as controls. All participants underwent baseline assessment of vestibular and balance performance using computerized dynamic posturography and videonystagmography (VNG). Children with SLD were randomly assigned to either a traditional or a VR-based vestibular rehabilitation group, administered twice weekly for 8 weeks. Vestibular and balance assessments were repeated in the rehabilitation groups postintervention. Academic performance and perceptual-motor integration were evaluated in children with SLD before and after rehabilitation using the Mathematics, Reading, and Writing Assessment Scale (MOYA) and the Bender-Gestalt Visual Motor Perception Test (BGT). RESULTS: At baseline, children with SLD demonstrated significantly poorer balance performance on the Sensory Organization Test (SOT), Adaptation Test (AT), and Limits of Stability (LOS) compared with controls (p < .05), while VNG findings did not differ between groups (p > .05). Following rehabilitation, both intervention groups showed significant improvements in SOT, AT, and LOS parameters (p < .05). MOYA and BGT scores also improved significantly (p < .001). The VR-based rehabilitation group demonstrated greater improvement in vestibular-related balance scores and leftward saccadic velocity than the traditional group (p < .05). CONCLUSIONS: Vestibular rehabilitation may improve balance and functional outcomes in children with SLDs. Both traditional and VR-based approaches appeared beneficial, with VR-based rehabilitation showing a tendency toward further improvements in selected vestibular and oculomotor measures. These findings suggest that vestibular rehabilitation, including VR-assisted methods, may represent a complementary intervention in this population, although further studies are needed to clarify long-term effects.