@article{ref1,
title="Contextual sensory integration training via head mounted display for individuals with vestibular disorders: a feasibility study",
journal="Disability and rehabilitation. Assistive technology",
year="2020",
author="Lubetzky, Anat V. and Kelly, Jennifer and Wang, Zhu and Gospodarek, Marta and Fu, Gene and Sutera, John and Hujsak, Bryan D.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="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.<br><br>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.<br><br>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.IMPLICATIONS FOR REHABILITATIONVirtual Reality allows for gradual introduction of complex semi-real visual environments.Within VR training patients can re-learn to maintain balance when presented with a sensory conflict in a safe environment.Head Mounted Display training appears to be a promising adjunct modality for vestibular rehabilitation.Portability and affordability of the hardware and software enhance the potential clinical outreach.<p /> <p>Language: en</p>",
language="en",
issn="1748-3107",
doi="10.1080/17483107.2020.1765419",
url="http://dx.doi.org/10.1080/17483107.2020.1765419"
}