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. 2015 Jan 13;2015(1):CD005397. doi: 10.1002/14651858.CD005397.pub4

Pavlou 2012.

Methods Design: randomised controlled trial
Participants Number: 16
Age: intervention group: mean age 42.0, range 25 to 51, comparator group: mean age 42.1, range 28 to 54
Gender: intervention group: 2 males, comparator group: 7 males
 Setting: university
 Eligibility criteria: participants with a history of acute onset of vertigo and with a confirmed peripheral vestibular deficit on the basis of the caloric tests and/or rotational tests on ENG
 Exclusion criteria: those with migrainous vertigo, Ménière's disease, BPPV, central vestibular disorders, other neurological disorders, significant systemic illness or psychiatric disorders
 Baseline characteristics: symptom duration was significantly longer in the intervention group
Interventions Intervention group: dynamic virtual reality, performed for 45 minutes twice weekly for 4 weeks plus home exercises and general conditioning programme (walking) (n = 5)
Comparator group 1: static virtual reality image rehabilitation, performed for 45 minutes twice weekly for 4 weeks plus home exercises and general conditioning programme (walking) (n = 11)
Comparator group 2: cross‐over of 5 group 1 participants who then received dynamic virtual reality (not included in our analysis) (n = 5)
VR versus VR versus VR
Outcomes Primary outcome: Dynamic Gait Index
Secondary outcomes: Beck Depression Inventory, Beck Anxiety Inventory, Fear Questionnaire, Situational Vertigo Questionnaire, virtual reality exercise symptom scores
Notes No participants were lost to follow‐up
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Insufficient information about the sequence generation process
Allocation concealment (selection bias) Unclear risk Insufficient information about the method of allocation
Blinding (performance bias and detection bias) 
 All outcomes Low risk It is not clear whether participants were blinded to the purpose of the experiment or whether they were aware that there were 2 types of virtual reality training groups. An independent observer was used to collect the Dynamic Gait Index outcome data
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Only 1 participant did not complete the study in the static virtual reality group and their data were not included in the analysis
Selective reporting (reporting bias) Low risk Study protocol not available but all data appear to be reported
Other bias Low risk The study appears to be free of other sources of bias