What are the effects of Internet-interventions for audio-vestibular disorders?

Background:Internet-interventions have been developed within the field of audiology for those with hearing loss, tinnitus, and vestibular rehabilitation. Although individual studies have been conducted, knowledge of the efficacy and effectiveness oftheseInternet interventions is still being sought. This review examines the effects of Internet-Interventions for Audio-vestibular disorders.Methods:A comprehensive systematic reviewregarding the evidence-base of Internet-based interventions for auditory-related conditionswas undertaken. The aims were to identify theprimary, secondary and long-term effectsof Internet interventions for adults with hearing loss, tinnitus, and vestibular disorders.Results:Fifteen studies (1,811 participants) met the inclusion criteria, with nine studies targetingtinnitusdistress, five considering hearing lossandone for vestibular difficulties. Only the tinnitus and hearing loss Internet intervention studies were eligible for data synthesis. Internet-based interventions for hearing loss were diverse. Overalltheyshowed no significanteffects, although a statistically significant moderate effect (d= 0.59) was foundafterremoving the studywith the highest risk of bias (as a result of high attrition). Most Internet-basedinterventionsfor tinnitusprovided cognitive behavioural therapy. They yieldedstatistically significant mean effect sizesfor reducing tinnitus distresscompared with both inactive(d= 0.59) and active controls (d = 0.32). Significant effects were also presentfor thesecondary outcomes of anxiety, depression, insomnia,and quality of life (combined effect d = 0.28). Only Internet-based interventions for tinnitus evaluated the 1-yearpost-interventioneffects indicated that results were maintained long-term (d= 0.45). Scientific study quality was appraised using the GRADE approach and found to vary from very low to moderate.Conclusion:This review indicates the potential of Internet interventions to provide evidence-based accessible care to those with audio-vestibular disorders. Further development of these interventions are encouraged where few exist, particularly for vestibular rehabilitation and for each phase of hearing rehabilitation. Additional high-quality evidence is required before conclusive results can be established.These findings are of importanceto guide future planning of audio-vestibularintervention research and clinical services by healthcare providers, researchers, consumers, and stakeholders.