SEED PROJECT - Feasibility and Acceptability of a Virtual Reality Graded Exposure Intervention for Persistent Dizziness Following Brain Injury in Outpatient Rehabilitation

About the Project

Persistent dizziness is common after acquired brain injury (including concussion) and can limit daily activities, return to work, and quality of life. Many people develop fear-avoidance behaviours—avoiding movements and environments that trigger symptoms—which can slow recovery. Vestibular rehabilitation uses graded exposure (habituation and optokinetic stimulation) to retrain symptoms, but in outpatient settings this is often delivered via 2D video and may lack immersion and real-world relevance. Virtual reality (VR) offers a safe, repeatable and immersive way to deliver graded exposure in clinically supervised, personalised environments.

This project will co-produce and pilot a low-cost, scalable virtual reality (VR) graded exposure program within Metro South Health Brain Injury Rehabilitation Services to target dizziness and fear avoidance behaviours.

Aim and objective:

The aims of this project are to:

Co-produce a virtual reality (VR)–based graded exposure program for people with persistent dizziness following acquired brain injury.
Evaluate the feasibility, safety, and acceptability of the program within multidisciplinary outpatient rehabilitation settings.
Explore preliminary effects on dizziness-related disability, fear-avoidance behaviours, anxiety, and functional outcomes.

Expected outcomes and impact:

This project is expected to demonstrate that a co-produced VR graded exposure program for persisting dizziness in ABI is feasible, safe, and acceptable in outpatient brain injury rehabilitation, and provide preliminary evidence of reduced dizziness-related disability and fear-avoidance, improved anxiety, and better functional outcomes.

This project will support translation of scalable, low-cost VR graded exposure in outpatient brain injury services. It is expected to improve management of persistent dizziness and fear-avoidance, reduce longer-term disability, and generate practical insights to optimise VR content, delivery, and integration into routine practice.

People/organisations involved:

· Kate Graving

· Emily Gibson

· Dr Kylie Ferguson

· Louise Terry

· Gretta Palmer

· Dr Michael Norwood

· Dr Jessie Mitchell

· Dr Jayke Bennett

· Professor Louise Gustafsson

· Rachel Cooper

· Alison Turner

· Jessica Schauer

Project status and timeframe:

Project planning and discussions with clinicians within Metro South Health BIRS.
Co-production workshops to develop VR graded exposure content and delivery model.
Ethics and governance submissions and approvals.
Pilot delivery of the VR graded exposure program in outpatient clinics.
Data analysis, reporting, and dissemination of findings.