Real-time Visual Feedback Research Articles

The Impact of Task Difficulty on Neural Modulation Throughout A Visuomotor Multi-day Practice Training

The effectiveness of rehabilitation is contingent upon the motor recovery process which typically involves long-term motor skill re-acquisition. Given that the learning process can be modulated by task difficulty, elucidating the underlying neural mechanism is essential for optimizing rehabilitation prescription to suit different patient conditions. This study aimed to investigate the impact of task difficulty on cortical response during force-control training via electroencephalography (EEG). An 8-day visuomotor force-tracking training experiment was conducted. Healthy right-handed participants (N=33) were recruited and randomly assigned to 3 groups, and each group was tasked with a different level of difficulty. The task difficulty was manipulated by variation in force-production complexity and execution sequence assignments, with real-time visual feedback provided to participants for self-output adjustment. Behavioral performance was quantitatively assessed using a pre-defined score metric related to performance accuracy. The EEG signals were collected, and corresponding event-related desynchronization (ERD) and relative functional connectivity (FC) during the task execution were analyzed within the alpha- (8-13Hz) and beta- (15-30Hz) bands. A post-training experiment was also performed to evaluate the near-transfer capability of learning. Results showed all the behavioral performances improved during practice, while higher task difficulty level was affiliated with better post-training near-transfer ability. The dynamic neural response to training could be mediated by changes in difficulty level, where increased task complexity corresponded with the heightened activities in the beta-band priorly within the right dorsolateral prefrontal area. Additionally, stronger alpha-band functional connectivity was observed to be predominantly associated with the left motor area (LMA) during challenging tasks, and the intensification in connectivity persisted selectively post-training which appeared to be acritical factor for skill transfer performance improvement. These findings illustrated the dynamic neural mechanism through which task difficulty affects behavioral performance during long-term motor training with accurate force-control purpose. The selectively strengthened functional connectivity may contribute to facilitating new task execution after training interventions. Therefore, beneficial neural modulation can be expected to be feasible by well-designed task difficulty strategies for effective motor rehabilitation.

Computed tomography and structured light imaging guided orthopedic navigation puncture system: effective reduction of intraoperative image drift and mismatch.

Image-guided surgical navigation systems are widely regarded as the benchmark for computer-assisted surgical robotic platforms, yet a persistent challenge remains in addressing intraoperative image drift and mismatch. It can significantly impact the accuracy and precision of surgical procedures. Therefore, further research and development are necessary to mitigate this issue and enhance the overall performance of these advanced surgical platforms. The primary objective is to improve the precision of image guided puncture navigation systems by developing a computed tomography (CT) and structured light imaging (SLI) based navigation system. Furthermore, we also aim to quantifying and visualize intraoperative image drift and mismatch in real time and provide feedback to surgeons, ensuring that surgical procedures are executed with accuracy and reliability. A CT-SLI guided orthopedic navigation puncture system was developed. Polymer bandages are employed to pressurize, plasticize, immobilize and toughen the surface of a specimen for surgical operations. Preoperative CT images of the specimen are acquired, a 3D navigation map is reconstructed and a puncture path planned accordingly. During surgery, an SLI module captures and reconstructs the 3D surfaces of both the specimen and a guiding tube for the puncture needle. The SLI reconstructed 3D surface of the specimen is matched to the CT navigation map via two-step point cloud registrations, while the SLI reconstructed 3D surface of the guiding tube is fitted by a cylindrical model, which is in turn aligned with the planned puncture path. The proposed system has been tested and evaluated using 20 formalin-soaked lower limb cadaver specimens preserved at a local hospital. The proposed method achieved image registration RMS errors of 0.576 ± 0.146 mm and 0.407 ± 0.234 mm between preoperative CT and intraoperative SLI surface models and between preoperative and postoperative CT surface models. In addition, preoperative and postoperative specimen surface and skeletal drifts were 0.033 ± 0.272 mm and 0.235 ± 0.197 mm respectively. The results indicate that the proposed method is effective in reducing intraoperative image drift and mismatch. The system also visualizes intraoperative image drift and mismatch, and provides real time visual feedback to surgeons.

Intra- and interlimb effects of gait retraining in individuals with knee hyperextension

BackgroundGait retraining, which typically focuses on the most severely affected limb or joint, has shown promising results in treating faulty running and walking patterns. The closed-chain nature of gait during the stance phase may influence kinematic changes in the adjacent joints of the trained leg. In addition, the coupled nature of the lower extremity motion of gait suggests that changes in one leg may transfer to the other. This study aimed to assess the intra- and inter-limb transfer of kinematic changes following gait retraining to reduce knee extension in individuals with hyperextension walking patterns. MethodsSeventeen women with knee hyperextension gait patterns participated in six treadmill retraining sessions. All participants received verbal and real-time visual kinematic feedback in the form of knowledge of results. This intervention study took place at the Gait Analysis Laboratory at the University of Iowa. Mean peak sagittal-plane lower extremity joint kinematics during overground walking at pretraining, post-training, and 1- and 8-month follow-ups were calculated for analysis and comparisons. FindingsThe post-training changes in ankle range of motion returned to baseline values by the 8-month follow-up. There was a significant transfer effect of kinematic changes to the untrained knee following gait retraining. InterpretationTraining one knee did not result in long-term compensatory kinematic changes in the other joints. In addition, the improvements in knee extension range of motion were transferred to the untrained knee and retained at the 8-month follow-up. This study supports the use of gait retraining as an effective clinical intervention.

Application of Handheld Point-of-Care Ultrasound in the Setting of Craniomaxillofacial Trauma: A Technical Note

Computed tomography (CT) is the standard of care imaging in craniomaxillofacial (CMF) trauma. Despite the clear advantages of high-resolution multiplanar and three-dimensional (3D) reconstructions, which facilitate accurate diagnosis and provide intraoperative (IO) real-time visual feedback, CT's main drawbacks remain availability, cost, and high radiation exposure. The decision to perform a CT scan is based on the integration of the patient's trauma mechanism, clinical examination, subjective judgment of the CMF surgeon, and the complexity of the surgery if used IO. Handheld point-of-care ultrasound (HPOCUS) is a small, portable device that can provide valuable additional data directing clinical decisions for CT referral in minor trauma cases and assist IO maneuvers. We describe a novel HPOCUS application concept as a clinical supplementary tool in CMF trauma diagnosis and surgery.

Effects of increasing walking cadence on gait biomechanics in adults with knee osteoarthritis

Gait retraining is a strategy to manage altered loading patterns and pain characteristic of knee osteoarthritis. Lower walking cadence is associated with higher knee joint loading, vertical ground reaction forces, and risk for cartilage worsening. Therefore, we determined the acute effects of increasing walking cadence on measures of lower extremity loading and knee pain in knee osteoarthritis. Twenty-five participants with knee osteoarthritis (age = 62.5 ± 7.2; 76.0 % female) walked at fixed speed on an instrumented treadmill from which baseline cadence was measured. Five, randomized experimental cadence conditions (2 %, 4 %, 6 %, 8 %, or 10 % over baseline cadence) were completed. Real-time auditory and visual feedback on cadence was provided while kinematics and ground reaction forces were sampled. Linear mixed effects models evaluated the effect of cadence on knee adduction and flexion moment peaks and impulses, impact loading metrics (vertical ground reaction force impact peak, vertical average and instantaneous loading rates), and knee pain. Increasing cadence by 2–10 % did not significantly change knee adduction moment peaks or impulse. Peak knee flexion moment increased by 3–32 % and knee flexion moment impulse reduced by 2–9 % with increases in cadence, but these results were not significant (peak knee flexion moment, p = 0.070; knee flexion moment impulse, p = 0.085). Increasing cadence significantly increased the vertical impact peak (p < 0.001), and the vertical average (p = 0.010), and instantaneous (p = 0.007) loading rates. Small increases in cadence at a fixed gait speed does not significantly change surrogate measures of knee joint loading or pain, but does increase measures of impact loading.

DendroTweaks: An interactive approach for unraveling dendritic dynamics.

Neurons rely on the interplay between dendritic morphology and ion channels to transform synaptic inputs into a sequence of somatic spikes. Detailed biophysical models with active dendrites have been instrumental in exploring this interaction. However, such models can be challenging to understand and validate due to the large number of parameters involved. In this work, we introduce DendroTweaks - a toolbox designed to illuminate how morpho-electric properties map to dendritic events and how these dendritic events shape neuronal output. DendroTweaks features a web-based graphical interface, where users can explore single-cell neuronal models and adjust their morphological and biophysical parameters with real-time visual feedback. In particular, DendroTweaks is tailored to interactive fine-tuning of subcellular properties, such as kinetics and distributions of ion channels, as well as the dynamics and allocation of synaptic inputs. It offers an automated approach for standardization and refinement of voltage-gated ion channel models to make them more comprehensible and reusable. The toolbox allows users to run various experimental protocols and record data from multiple dendritic and somatic locations, thereby enhancing model validation. Finally, it aims to deepen our understanding of which dendritic properties are essential for neuronal input-output transformation. Using this knowledge, one can simplify models through a built-in morphology reduction algorithm and export them for further use in faster, more interpretable networks. With DendroTweaks, users can gain better control and understanding of their models, advancing research on dendritic input-output transformations and their role in network computations.

Individualized EEG-Based Neurofeedback Targeting Auditory Steady-State Responses: A Proof-of-Concept Study.

Gamma-band (> 30Hz) brain oscillatory activity is linked with sensory and cognitive processes and exhibits abnormalities in neuropsychiatric disorders. Therefore, neuromodulation techniques targeting gamma activity are being developed. One promising approach is neurofeedback (NFB) which is based on the alteration of brain responses via online feedback. However, the existing gamma-based NFB systems lack individualized approach. In the present work, we developed and tested an individualized EEG-NFB system. 46 healthy volunteers participated in three sessions on separate days. Before NFB training, individual gamma frequency (IGF) was estimated using chirp-modulated auditory stimulation (30-60Hz). Participants were subjected to IGF-increase (if IGF was ≤ 45Hz) or IGF-decrease conditions (if IGF was > 45Hz). Gamma-band responses were targeted during NFB training, in which participants received auditory steady-state stimulation at frequency slightly above or below IGF and were instructed to try to increase their response while receiving real-time visual feedback. Each time a pre-defined response goal was reached, stimulation frequency was either increased or decreased. After training, IGF was reassessed. Experimental group participants were divided into equal groups based on the median success rate during NFB training. The results showed that high-responders had a significantly higher IGF modulation compared to control group, while low-responders did not differ from controls. No differences in IGF modulation were found between sessions and between NFB repetitions in all participant groups. The initial evaluation of the proposed EEG-NFB system showed potential to modulate IGF. Future studies could investigate longer-lasting electrophysiological and behavioural effects of the application of ASSR/IGF-based NFB system in clinical populations.

Real time eye dose reduction in fluoroscopy with auditory and visual feedback dosimeter through swine model experiments

This paper proposes measurement and reduction of eye dose in real time for the physician and the assistant performing fluoroscopy guided arterial puncture. Eye dose rates were measured for 30 fluoroscopy-guided punctures of bilateral femoral arteries in pigs. Fifteen fluoroscopy-guided punctures were performed using real time radiation dosimeter without auditory and visual feedback and other fifteen punctures were done using real time radiation dosimeter with visual and auditory feedback worn on forehead by an interventional cardiologist having experience of more than 10 years. The mean radiation dose rate for eyes of physician during arterial puncturing with real time radiation dosimeter with auditory feedback was 0.07 mSv/h (n = 15) whereas it was 0.18 mSv/h (n = 15) without visual and auditory feedback. The percentage of reduction with the device was 61% for eyes. In case of assistant the reduction was 33% for eyes (n = 15). The real time visual and auditory feedback dosimeter has reduced the eye dose rate of the physician and assistant and also helped him staying away from the X-ray source. Real time radiation dosimeters can be an effective tool to measure and reduce the dose to the eyes. The radiation eye dose rate for physician and assistant was significantly reduced by using real time radiation dosimeter with visual and auditory feedback. The real time radiation dosimeter not only helps in measuring but also help in minimizing the radiation dose rate for the physician and assistant in real time.

Interoceptive training with real-time haptic versus visual heartbeat feedback.

The perception of signals from within the body, known as interoception, is increasingly recognized as a prerequisite for physical and mental health. This study is dedicated to the development of effective technological approaches for enhancing interoceptive abilities. We provide evidence of the effectiveness and practical feasibility of a novel real-time haptic heartbeat supplementation technology combining principles of biofeedback and sensory augmentation. In a randomized controlled study, we applied the developed naturalistic haptic feedback on a group of 30 adults, while another group of 30 adults received more traditional real-time visual heartbeat feedback. A single session of haptic, but not visual heartbeat feedback resulted in increased interoceptive accuracy and confidence, as measured by the heart rate discrimination task, and in a shift of attention toward the body. Participants rated the developed technology as more helpful and pleasant than the visual feedback, thus indicating high user satisfaction. The study highlights the importance of matching sensory characteristics of the feedback provided to the natural bodily prototype. Our work suggests that real-time haptic feedback might be a superior approach for strengthening the mind-body connection in interventions for physical and mental health.

Step width modification to change rearfoot eversion and medial longitudinal arch angle during walking and running in individuals with pronated feet

BackgroundIndividuals with pronated feet often experience altered foot biomechanics, leading to increased risk of lower limb injuries. Step width modification has been proposed as a potential intervention to improve foot alignment during gait. Research questionDoes modifying step width influence rearfoot eversion and medial longitudinal arch angle (MLAA) in individuals with pronated feet during walking and running? MethodsTwenty individuals with pronated feet underwent analysis during walking and running on treadmill, maintaining increased or decreased step width using real-time visual feedback. Three-dimensional motion analysis measured rearfoot eversion and MLAA during the stance phase of gait. ResultsWide step width significantly reduced peak rearfoot eversion during waking (mean difference — with normal step width — (MD) = 3.6°, p < 0.001) and running (MD = 4.4°, p < 0.001), time to peak rearfoot eversion during walking (MD = 16.6 p < 0.001) and running (MD = 13.8°, p = 0.014), rearfoot eversion at touch down (TD) during walking (MD = 1.3°, p = 0.004), rearfoot eversion excursion during running (MD = 4.3°, p < 0.001), and peak MLAA during walking (MD = 2.9°, p = 0.006) and MLAA excursion during running (MD = 4.8°, p = 0.004).By contrast, during running, narrow condition significantly increased peak rearfoot eversion (MD = 3.4°, p < 0.001). During walking, time to peak rearfoot eversion (MD = 16.1, p < 0.001), rearfoot eversion at TD (MD = 1.4°, p = 0.008), rearfoot eversion excursion (MD = 5.9°, p < 0.001), and peak MLAA (MD = 3.4°, p < 0.001) were significantly increased. SignificanceThis study highlights the potential of step width modification as a simple yet effective intervention to improve foot biomechanics in pronated feet individuals during walking and running. Further research could lead to the development of personalized strategies for pronated feet individuals.

Real-time visual feedback can cue changes in grip force during electric hand tool operation

Objectives. Grip force applied during repetitive hand tool use varies amongst individuals and some apply more force than necessary. Augmented feedback may help modify grip force to reduce the risk of developing cumulative trauma disorders but has been scarcely investigated during electric hand tool operation. This study evaluated the feasibility of using real-time visual feedback to modify grip force and forearm electromyography (EMG) during electric hand tool operation. A secondary objective was to evaluate the effect of hand and tool orientation on any effects of visual feedback. Methods. Grip force and forearm muscle EMG were recorded as participants fastened bolts at three locations (low, high and overhead) using an electric pistol-grip nut-runner, without and with visual feedback. Results. Feedback decreased grip force (36.1% decrease; p < 0.001) and EMG of three wrist flexor muscles (22.8–33.0%; p < 0.008). Grip force and EMG also differed between fastening locations, but there were no interactions with condition (baseline and feedback; p > 0.266), suggesting that visual feedback can modify grip force across varying hand and tool orientations. Conclusion. Visual feedback can successfully modify grip force during hand tool operation. However, further investigation is needed to understand how to appropriately implement visual feedback during hand tool operation.

Real-Time Visual Feedback Based on MIMUs Technology Reduces Bowing Errors in Beginner Violin Students.

Violin is one of the most complex musical instruments to learn. The learning process requires constant training and many hours of exercise and is primarily based on a student-teacher interaction where the latter guides the beginner through verbal instructions, visual demonstrations, and physical guidance. The teacher's instruction and practice allow the student to learn gradually how to perform the correct gesture autonomously. Unfortunately, these traditional teaching methods require the constant supervision of a teacher and the interpretation of non-real-time feedback provided after the performance. To address these limitations, this work presents a novel interface (Visual Interface for Bowing Evaluation-VIBE) to facilitate student's progression throughout the learning process, even in the absence of direct teacher intervention. The proposed interface allows two key parameters of bowing movements to be monitored, namely, the angle between the bow and the string (i.e., α angle) and the bow tilt (i.e., β angle), providing real-time visual feedback on how to correctly move the bow. Results collected on 24 beginners (12 exposed to visual feedback, 12 in a control group) showed a positive effect of the real-time visual feedback on the improvement of bow control. Moreover, the subjects exposed to visual feedback judged the latter as useful to correct their movement and clear in terms of the presentation of data. Although the task was rated as harder when performed with the additional feedback, the subjects did not perceive the presence of a violin teacher as essential to interpret the feedback.

Real-Time Remote-Controlled Human Manipulation Medical Robot Using IoT Module

INTRODUCTION: Innovative robotics and advanced computer vision technology converge in the Human Manipulation-Controlled Robot, utilized for medical applications. The robot operates through human gestures, and includes a camera module for real-time visual feedback, enhancing its functionality and user interaction. OBJECTIVES: The primary goal of the research was to harness the natural expressiveness of human gestures to provide a more intuitive and engaging method of controlling medical robots. The focus is on enabling precise control through programmed responses to specific gestures, ensuring effective interaction with medical tasks. METHODS: The robot’s hardware configuration consists of a mobile platform with motorized components, an ESP32 module, gesture recognition sensors and a camera modules. The ESP32 module interprets signals from gesture recognition sensors to execute precise commands for the robot's movements and actions. Simultaneously, the camera module captures live footage, providing visual feedback through an intuitive interface for seamless interaction. RESULTS: The Human Manipulation-Controlled Robot has been successfully developed, featuring a fetch arm capable of autonomous movement and object manipulation. This research address critical needs in medical centers, demonstrating the feasibility of using only minimalistic EEG electrode wireless transmission to operate a robot effectively. CONCLUSION: Through the provision of a more intuitive and engaging method of controlling and interacting with medical robots, this innovation has the potential to significantly improve user experience. It represents a most important development in medical robotic vehicles, enhancing user experience and operational efficiency through advanced human-robot interaction techniques.

Neurofeedback-enabled beta power control with a fully implanted DBS system in patients with Parkinson’s disease

ObjectiveParkinsonian motor symptoms are linked to pathologically increased beta oscillations in the basal ganglia. Studies with externalised deep brain stimulation electrodes showed that Parkinson patients were able to rapidly gain control over these pathological basal ganglia signals through neurofeedback. Studies with fully implanted deep brain stimulation systems duplicating these promising results are required to grant transferability to daily application. MethodsIn this study, seven patients with idiopathic Parkinson’s disease and one with familial Parkinson’s disease were included. In a postoperative setting, beta oscillations from the subthalamic nucleus were recorded with a fully implanted deep brain stimulation system and converted to a real-time visual feedback signal. Participants were instructed to perform bidirectional neurofeedback tasks with the aim to modulate these oscillations. ResultsWhile receiving regular medication and deep brain stimulation, participants were able to significantly improve their neurofeedback ability and achieved a significant decrease of subthalamic beta power (median reduction of 31% in the final neurofeedback block). ConclusionWe could demonstrate that a fully implanted deep brain stimulation system can provide visual neurofeedback enabling patients with Parkinson’s disease to rapidly control pathological subthalamic beta oscillations. SignificanceFully-implanted DBS electrode-guided neurofeedback is feasible and can now be explored over extended timespans.

Assessing the Impact of Real-Time Visual Feedback during Treadmill Training on Walking Improvement in Stroke Patients

Assessing the Impact of Real-Time Visual Feedback during Treadmill Training on Walking Improvement in Stroke Patients

Offistretch: camera-based real-time feedback for daily stretching exercises

AbstractIn this paper, we present OffiStretch, a camera-based system for optimal stretching guidance at home or in the workplace. It consists of a vision-based method for real-time assessment of the user’s body pose to provide visual feedback as interactive guidance during stretching exercises. Our method compares the users’ actual pose with a pre-trained target pose to assess the quality of stretching for a number of different exercises. We utilize angular and spatial pose features to perform this comparison for each individual exercise. The result of this pose assessment is presented to the user as real-time visual feedback on an "augmented mirror" display. As our method relies simply on a single RGB camera, it can be easily utilized in everyday training scenarios. We validate our method in a user study, comparing users’ performance and motivation in stretching when receiving audio-visual guidance on a TV screen both with and without our live feedback. While participants performed equally well in both conditions, feedback boosted their motivation to perform the exercises, highlighting its potential for increasing users’ well-being. Moreover, our results suggest that participants preferred stretching exercises with our live feedback over the condition without the feedback. Finally, an expert evaluation with professional physiotherapists reveals that further work must target improvements of the feedback to ensure correct guidance during stretching.

Acoustic and Articulatory Visual Feedback in Classroom L2 Vowel Remediation.

This paper presents L2 vowel remediation in a classroom setting via two real-time visual feedback methods: articulatory ultrasound tongue imaging, which shows tongue shape and position, and a newly developed acoustic formant analyzer, which visualizes a point correlating with the combined effect of tongue position and lip rounding in a vowel quadrilateral. Ten Czech students of the Swedish language participated in the study. Swedish vowel production is difficult for Czech speakers since the languages differ significantly in their vowel systems. The students selected the vowel targets on their own and practiced in two classroom groups, with six students receiving two ultrasound training lessons, followed by one acoustic, and four students receiving two acoustic lessons, followed by one ultrasound. Audio data were collected pre-training, after the two sessions employing the first visual feedback method, and at post-training, allowing measuring Euclidean distance among selected groups of vowels and observing the direction of change within the vowel quadrilateral as a result of practice. Perception tests were performed before and after training, revealing that most learners perceived selected vowels correctly already before the practice. The study showed that both feedback methods can be successfully applied to L2 classroom learning, and both lead to the improvement in the pronunciation of the selected vowels, as well as the Swedish vowel set as a whole. However, ultrasound tongue imaging seems to have an advantage as it resulted in a greater number of improved targets.

Improving walking via real-time visual feedback after stroke in treadmill training (RE-VISIT): a protocol for randomized controlled trial

BACKGROUND: After a stroke, most patients often suffer reduced walking ability and balance. Restoring walking ability and improving balance are major goals of stroke rehabilitation. Treadmills are often used in clinical setups to achieve these goals. Adding dimensions to the visual feedback in addition to the mirror for real-time frontal view is proven to enhance the gait. It is, therefore, important to design additional real-time visual feedback in treadmill training, in particular for the sagittal view involved side. OBJECTIVE: The objective of this study is to test if the real-time sagittal visual feedback during treadmill training is superior to the conventional mirror feedback treadmill training program of equivalent intensity in improving walking speed and balance after stroke. METHODS/DESIGN: The RE-VISIT trial (Real-time Visual feedback after Stroke in Treadmill training) is registered in the Clinical Trial Registry of India (CTRI/2023/10/058299). In this two-arm randomized control trial, which will be a single-blinded study, 42 eligible stroke survivors undergoing rehabilitation will be randomly allocated (1:1 ratio) to either real-time visual sagittal feedback along with front mirror (experimental) group or only front mirror treadmill training (control) group, all the participants will receive 15 sessions of treadmill training for up to 15 min at a safe self-selected speed over 5-6 weeks. The RE-VISIT (experimental) group will receive real-time, visual sagittal view feedback of the involved lower limb trajectory along with the routine front mirror view during treadmill training and will be asked to modify their gait pattern. The control group will receive treadmill walking training only with the routine front mirror view feedback. Clinical and gait assessments will be conducted at the baseline, immediately following the final session of training, and at the 9th week during follow-up. The outcome measures of interest are walking speed (primary) and balance (secondary), which will be measured prior to baseline, post 15 sessions of training, and at the 9th week following training. DISCUSSION: This REVISIT trial will provide insight and contribute to the existing innovation and modifications of incorporating real-time visual feedback during treadmill training in post-stroke gait rehabilitation. The findings will help the better designing of a gait rehabilitation program with a treadmill for post-stroke subjects to improve walking speed, and balance for those who have greater difficulties in community ambulation. We anticipate that those in the REVISIT training will demonstrate improved walking ability.

Enhancing BPPV Treatment Outcomes: A Comparative Study of the Epley Maneuver with and without the Dizzy-Fix Training Device.

This study evaluates the effectiveness of combining the Epley Maneuver with the Dizzy-Fix Training Device in treating Benign Paroxysmal Positional Vertigo (BPPV), aiming to enhance treatment outcomes and patient satisfaction. In this randomized controlled trial, 50 patients diagnosed with posterior canal BPPV were allocated into two groups: one receiving the traditional Epley Maneuver and the other undergoing the Epley Maneuver supplemented with the Dizzy-Fix Training Device. Key measures included the proportion of symptom-free patients at one month, changes in the Visual Analogue Scale (VAS) and Dizziness Handicap Inventory (DHI) scores, the recurrence rate within one month, and patient satisfaction. The Dizzy-Fix group achieved a significantly higher symptom resolution rate by day 7 (90% vs. 60%) and reported greater patient satisfaction (4.5/5 vs. 3.8/5) compared to the Epley Maneuver alone group. Additionally, this group exhibited a more substantial decrease in DHI scores (from an average of 30 to 5) and a lower recurrence rate (10% vs. 40%) within the first month post-treatment. Incorporating the Dizzy-Fix Training Device with the Epley Maneuver significantly improves the management of BPPV, evidenced by faster symptom resolution, enhanced patient satisfaction, and reduced symptom recurrence. These findings underscore the value of integrating real-time visual feedback technologies in vestibular rehabilitation, promising better patient outcomes, and advancing the quality of care in BPPV treatment.

SEX DIFFERENCE IN ABSOLUTE AND NORMALIZED FORCE AT FOUR DIFFERENT ISOMETRIC CONTRACTION INTENSITIES

Purpose: When measuring isometric contractions, providing real-time visual feedback differs from the practices in general clinical environment. In addition, even though men and women have clear physical and physiological differences, most of the existing studies analyzed absolute muscle contractions with no distinction between men and women. The aim of this study was to investigate whether there are differences in absolute and normalized hip extension forces measured without visual feedback between men and women. Methods: Twenty-eight healthy adults participated (13 men and 15 women; age=- 22.00±11.44 years; height=165.86±18.30 cm; and weight=61.91±12.34 kg) in the study. Maximum (MVC) and submaximal voluntary contraction forces (75%, 50%, and 25% of MVC, in a random order) of hip extension were measured using a wireless strain gauge and with no visual feedback. Results: Absolute contraction forces measured at four target intensities were significantly greater in men (p