Anat V. Lubetzky, Jennifer Kelly, Zhu Wang, Marta Gospodarek, Gene Fu, John Sutera & Bryan D. Hujsak (2020) Contextual sensory integration training via head mounted display for individuals with vestibular disorders: a feasibility study, Disability and Rehabilitation: Assistive Technology, DOI: 10.1080/17483107.2020.1765419
Author(s): Anat V. Lubetzky, Jennifer Kelly, Zhu Wang, Marta Gospodarek, Gene Fu, John Sutera and Bryan D. Hujsak
Purpose: Virtual reality (VR) interventions can simulate real-world sensory environments. The purpose of this study was to test the feasibility of a novel VR application (app) developed for a Head Mounted Display (HMD) to target dizziness, imbalance and sensory integration in a functional context for patients with vestibular disorders. Here we describe the design of the app as well as self-reported and functional outcomes in vestibular patients before and after participating in vestibular rehabilitation using the app.
Material and methods: Our app includes a virtual street, airport, subway or a park. The clinician controls the visual and auditory load including several levels of direction, amount and speed of virtual pedestrians. Clinicians enrolled 28 patients with central (mild-traumatic brain injury [mTBI] or vestibular migraine) and peripheral vestibular disorders. We recorded the Simulator Sickness Questionnaire, Visual Vertigo Analogue Scale (VVAS), Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence Scale (ABC), 8-foot up and go (8FUG) and Four-Step Square Test (FSST) before and after the intervention.
Results: Within the 15 patients who completed the study, 12 with peripheral hypofunction showed significant improvements on the VVAS (p = 0.02), DHI (p = 0.008) and ABC (p = 0.02) and a small significant improvement on the FSST (p = 0.015). Within-session changes in symptoms were minimal. Two patients with mTBI showed important improvements, but one patient with vestibular migraine, did not.
Conclusion: HMD training within increasingly complex immersive environments appears to be a promising adjunct modality for vestibular rehabilitation. Future controlled studies are needed to establish effectiveness.