Interactive wiimote gaze stabilization exercise training system for patients with vestibular hypofunction

Po-Yin Chen,Chung-Lan Kao,Wan-Ling Hsieh,Shun-Hwa Wei

doi:10.1186/1743-0003-9-77

Abstract

BackgroundPeripheral vestibular hypofunction is a major cause of dizziness. When complicated with postural imbalance, this condition can lead to an increased incidence of falls. In traditional clinical practice, gaze stabilization exercise is commonly used to rehabilitate patients. In this study, we established a computer-aided vestibular rehabilitation system by coupling infrared LEDs to an infrared receiver. This system enabled the subjects’ head-turning actions to be quantified, and the training was performed using vestibular exercise combined with computer games and interactive video games that simulate daily life activities.MethodsThree unilateral and one bilateral vestibular hypofunction patients volunteered to participate in this study. The participants received 30 minutes of computer-aided vestibular rehabilitation training 2 days per week for 6 weeks. Pre-training and post-training assessments were completed, and a follow-up assessment was completed 1 month after the end of the training period.ResultsAfter 6 weeks of training, significant improvements in balance and dynamic visual acuity (DVA) were observed in the four participants. Self-reports of dizziness, anxiety and depressed mood all decreased significantly. Significant improvements in self-confidence and physical performance were also observed. The effectiveness of this training was maintained for at least 1 month after the end of the training period.ConclusionReal-time monitoring of training performance can be achieved using this rehabilitation platform. Patients demonstrated a reduction in dizziness symptoms after 6 weeks of training with this short-term interactive game approach. This treatment paradigm also improved the patients’ balance function. This system could provide a convenient, safe and affordable treatment option for clinical practitioners.

Highlights

Dizziness is a complex feeling that is often characterized by a combination of poor spatial orientation and a sense of unsteadiness
Among the many vestibular system reflexes, the role of the vestibulo-ocular reflex (VOR) is to produce eye movements in the direction opposite to that of head rotation to stabilize the image in the retina, avoid retinal slip and maintain visual acuity
Gaze stabilization is a simple exercise that can be performed at home, the vestibular effect cannot be achieved unless the head movement velocity reaches 120-180o/s, which is difficult for patients to estimate while exercising

Summary

Introduction

Dizziness is a complex feeling that is often characterized by a combination of poor spatial orientation and a sense of unsteadiness. Among the many vestibular system reflexes, the role of the vestibulo-ocular reflex (VOR) is to produce eye movements in the direction opposite to that of head rotation to stabilize the image in the retina, avoid retinal slip and maintain visual acuity. The function of gaze stabilization training, which is one of the vestibular exercises that have been developed, is to improve visual acuity through the increase in VOR gain (eye velocity/head velocity). The goal of the gaze stabilization exercise is to improve the interaction between the visual and the vestibular systems during high-velocity head movements. We established a computer-aided vestibular rehabilitation system by coupling infrared LEDs to an infrared receiver This system enabled the subjects’ head-turning actions to be quantified, and the training was performed using vestibular exercise combined with computer games and interactive video games that simulate daily life activities

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