Virtual Reality Application For The Vestibular Ocular Motor Screen: A Comparison With A Novel Prototype.

Abstract

Clinical assessment of sport related concussion (SRC) involves a multifaceted test battery reliant upon accurate baseline measures. Advances in technology have prompted the use of virtual reality (VR) platforms to improve enjoyment of baseline and post-injury assessments. Possible influence of VR sickness for some users may deter the use symptom provocation tests like the Vestibular/Ocular Motor Screening (VOMS) exam in VR. It is important to understand baseline performance of the VOMS in VR as it might influence overall symptom provocation. PURPOSE: The purpose of this study was to examine differences in the VOMS using a clinical prototype (PRO) versus using a virtual reality (VR) stimulus with respect to symptom provocation change score (SPCS) and near point convergence (NPC) average score in a healthy population. METHODS: Data was collected from 15 healthy subjects (Female = 9, male = 6, avg. age = 20.86 years) who completed the VOMS assessment using the PRO and VR method in the same sitting. Symptoms assessed consisted of headache, nausea, dizziness, and fogginess. Subjects were asked to state the severity of each symptom based upon a scale of 0-10. After a 5-minute break, the same subjects completed the VOMS with an HTC Vive Pro Eye HMD (90 Hz; 2880x1600 pixels). The headset was powered by an Acer Predator gaming laptop with a 7th Generation Intel Core i7 Quad-Core processor with 16GB of memory and NVIDIA GeForce GTX 1070 graphics card. The VOMS stimuli was created with the Unity Software package (Unity3D engine version 2019.1.6) in which the VOMS protocol was simulated in a VR environment. Mann-Whitney U tests assessed the differences in total SPCS and NPC average score from baseline between both methods. RESULTS: For SPCS, the results indicate that the PRO method (avg = 1.4 ± 1.77 symptoms) and the VR method (avg = 0.9 ± 1.18 symptoms) of administering the VOMS were not significantly different (p = 0.33, Cohen’s d = 0.33). With respect to NPC average, there was no significant difference (p = 0.19, Cohen’s d = 0.22) between the PRO method (avg = 2.33 ± 1.74 cm) and the VR method (avg = 3.08 ± 4.42 cm). CONCLUSION: These data suggests that using a VR system to administer the VOMS may not elicit additional symptoms and it may be a viable tool for the collection of baseline symptom provocation data in a healthy population.