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Rosiak O, Pietrzak N, Szczęsna A, Kulczak I, Zwoliński G, Kamińska D, Konopka W, Jozefowicz-Korczynska M. The effect of Immersive Virtual Reality on balance: an exploratory study on the feasibility of head-mounted displays for balance evaluation. Sci Rep 2024; 14:3481. [PMID: 38347127 PMCID: PMC10861529 DOI: 10.1038/s41598-024-54274-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/10/2024] [Indexed: 02/15/2024] Open
Abstract
Global interest in applying virtual reality (VR) in research and medicine has grown significantly, with potential benefits for patients suffering from balance disorders, instability, and a high risk of falling. This exploratory study assesses the impact of immersive VR (IVR) delivered through a head-mounted display (HMD) on balance and explores the feasibility of using the HMD VR unit as a standalone posturography tool. Using the Meta Quest 2 HMD and a mid-range Android smartphone equipped with standard sensors, the research employed a VR environment that simulated a ship at sea, with thirty-eight healthy participants with no otoneurologic abnormalities. Measurements were conducted in repeated trials, including static assessments on both stable ground and foam, as well as a 3-m walk. This was conducted in two settings: one within a VR environment with three different intensity levels and the other in non-VR settings. Statistical analysis and clinical evaluation revealed that IVR with HMD influences head-level sway velocity, which correlates with increased visual disturbance, suggesting its potential as a low-risk standalone posturography tool.
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Affiliation(s)
- Oskar Rosiak
- Department of Otolaryngology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.
| | - Nikodem Pietrzak
- Department of Otolaryngology, Student's Scientific Circle, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Anna Szczęsna
- Department of Otolaryngology, Student's Scientific Circle, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Izabela Kulczak
- Department of Otolaryngology, Student's Scientific Circle, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Grzegorz Zwoliński
- Institute of Mechatronics and Information Systems, Lodz University of Technology, Lodz, Poland.
| | - Dorota Kamińska
- Institute of Mechatronics and Information Systems, Lodz University of Technology, Lodz, Poland
| | - Wiesław Konopka
- Department of Otolaryngology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Magdalena Jozefowicz-Korczynska
- Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, Lodz, Poland
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Ting KC, Lin YC, Chan CT, Tu TY, Shih CC, Liu KC, Tsao Y. Inertial Measurement Unit-Based Romberg Test for Assessing Adults With Vestibular Hypofunction. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2023; 12:245-255. [PMID: 38196821 PMCID: PMC10776102 DOI: 10.1109/jtehm.2023.3334238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/22/2023] [Accepted: 10/18/2023] [Indexed: 01/11/2024]
Abstract
This work aims to explore the utility of wearable inertial measurement units (IMUs) for quantifying movement in Romberg tests and investigate the extent of movement in adults with vestibular hypofunction (VH). A cross-sectional study was conducted at an academic tertiary medical center between March 2021 and April 2022. Adults diagnosed with unilateral vestibular hypofunction (UVH) or bilateral vestibular hypofunction (BVH) were enrolled in the VH group. Healthy controls (HCs) were recruited from community or outpatient clinics. The IMU-based instrumented Romberg and tandem Romberg tests on the floor were applied to both groups. The primary outcomes were kinematic body metrics (maximum acceleration [ACC], mean ACC, root mean square [RMS] of ACC, and mean sway velocity [MV]) along the medio-lateral (ML), cranio-caudal (CC), and antero-posterior (AP) axes. A total of 31 VH participants (mean age, 33.48 [SD 7.68] years; 19 [61%] female) and 31 HCs (mean age, 30.65 [SD 5.89] years; 18 [58%] female) were recruited. During the eyes-closed portion of the Romberg test, VH participants demonstrated significantly higher maximum ACC and increased RMS of ACC in head movement, as well as higher maximum ACC in pelvic movement along the ML axis. In the same test condition, individuals with BVH exhibited notably higher maximum ACC and RMS of ACC along the ML axis in head and pelvic movements compared with HCs. Additionally, BVH participants exhibited markedly increased maximum ACC along the ML axis in head movement during the eyes-open portion of the tandem Romberg test. Conversely, no significant differences were found between UVH participants and HCs in the assessed parameters. The instrumented Romberg and tandem Romberg tests characterized the kinematic differences in head, pelvis, and ankle movement between VH and healthy adults. The findings suggest that these kinematic body metrics can be useful for screening BVH and can provide goals for vestibular rehabilitation.
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Affiliation(s)
- Kuan-Chung Ting
- Department of Otolaryngology-Head and Neck SurgeryTaipei Veterans General HospitalTaipei11217Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung UniversityTaipei11221Taiwan
- School of MedicineNational Yang Ming Chiao Tung UniversityTaipei11221Taiwan
| | - Yu-Chieh Lin
- Department of Biomedical EngineeringNational Yang Ming Chiao Tung UniversityTaipei11221Taiwan
| | - Chia-Tai Chan
- Department of Biomedical EngineeringNational Yang Ming Chiao Tung UniversityTaipei11221Taiwan
| | - Tzong-Yang Tu
- Department of Otolaryngology-Head and Neck SurgeryTaipei Veterans General HospitalTaipei11217Taiwan
| | - Chun-Che Shih
- Institute of Clinical Medicine, National Yang Ming Chiao Tung UniversityTaipei11221Taiwan
- Division of Cardiovascular SurgeryTaipei Municipal Wanfang HospitalTaipei11608Taiwan
- Taipei Heart Institute, Taipei Medical UniversityTaipei11013Taiwan
| | - Kai-Chun Liu
- Research Center for Information Technology InnovationAcademia SinicaTaipei11529Taiwan
| | - Yu Tsao
- Research Center for Information Technology InnovationAcademia SinicaTaipei11529Taiwan
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Gawronska A, Rosiak O, Pajor A, Janc M, Kotas R, Kaminski M, Zamyslowska-Szmytke E, Jozefowicz-Korczynska M. Instrumental and Non-Instrumental Measurements in Patients with Peripheral Vestibular Dysfunctions. SENSORS (BASEL, SWITZERLAND) 2023; 23:1994. [PMID: 36850594 PMCID: PMC9963841 DOI: 10.3390/s23041994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Vestibular dysfunction is a disturbance of the body's balance system. The control of balance and gait has a particular influence on the quality of life. Currently, assessing patients with these problems is mainly subjective. New assessment options using wearables may provide complementary and more objective information. Posturography makes it possible to determine the extent and type of posture dysfunction, which makes it possible to plan and monitor the effectiveness of physical rehabilitation therapy. This study evaluates the effectiveness of non-instrumental clinical tests and the instrumental mobile posturography MediPost device for patients with unilateral vestibular disorders. The study group included 40 patients. A subjective description of the symptoms was evaluated using a questionnaire about the intensity of dizziness using the Dizziness Handicap Inventory (DHI) and Vertigo Syndrome Scale-short form (VSS-sf). The clinical protocol contained clinical tests and MediPost measurements using a Modified Clinical Test of Sensory Interaction on Balance. All patients underwent vestibular rehabilitation therapy (VRT) for four weeks. The non-instrumental measurement results were statistically significant, and the best was in the Timed Up and Go test (TUG). In MediPost, condition 4 was the most valuable. This research demonstrated the possibilities of using an instrumental test (MediPost) as an alternative method to assess balance.
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Affiliation(s)
- Anna Gawronska
- Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert BarlickMemorial Teaching Hospital, 90-153 Lodz, Poland
| | - Oskar Rosiak
- Department of Otolaryngology, Polish Mother Memorial Hospital Research Institute, 93-338 Lodz, Poland
| | - Anna Pajor
- Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert BarlickMemorial Teaching Hospital, 90-153 Lodz, Poland
| | - Magdalena Janc
- Audiology and Phoniatrics Clinic, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
| | - Rafal Kotas
- Department of Microelectronics and Computer Science, Lodz University of Technology, 90-924 Lodz, Poland
| | - Marek Kaminski
- Department of Microelectronics and Computer Science, Lodz University of Technology, 90-924 Lodz, Poland
| | - Ewa Zamyslowska-Szmytke
- Audiology and Phoniatrics Clinic, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
| | - Magdalena Jozefowicz-Korczynska
- Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert BarlickMemorial Teaching Hospital, 90-153 Lodz, Poland
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Rosiak O, Puzio A, Kaminska D, Zwolinski G, Jozefowicz-Korczynska M. Virtual Reality-A Supplement to Posturography or a Novel Balance Assessment Tool? SENSORS (BASEL, SWITZERLAND) 2022; 22:s22207904. [PMID: 36298254 PMCID: PMC9608655 DOI: 10.3390/s22207904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/07/2022] [Accepted: 10/15/2022] [Indexed: 06/08/2023]
Abstract
Virtual reality (VR) is a well-established technology in medicine. Head-mounted displays (HMDs) have made VR more accessible in many branches of medical research. However, its application in balance evaluation has been vague, and comprehensive literature on possible applications of VR in posture measurement is scarce. The aim of this review is to conduct a literature search on the application of immersive VR delivered using a head-mounted display in posturographic measurements. A systematic search of two databases, PubMed and Scopus, using the keywords "virtual reality" and "posturography," was performed following PRISMA guidelines for systematic reviews. Initial search results returned 89 non-duplicate records. Two reviewers independently screened the abstracts. Sixteen papers fulfilled the inclusion criteria and none of the exclusion criteria and were selected for complete text retrieval. An additional 16 records were identified from citation searching. Ultimately, 21 studies were included in this review. virtual reality is often used as additional visual stimuli in static and dynamic posturography evaluation. Only one study has attempted to evaluate a VR environment in a head-mounted display as an independent method in the assessment of posture. Further research should be conducted to assess HMD VR as a standalone posturography replacement.
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Affiliation(s)
- Oskar Rosiak
- Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, 90-153 Lodz, Poland
| | - Anna Puzio
- Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, 90-153 Lodz, Poland
| | - Dorota Kaminska
- Institute of Mechatronics and Information Systems, Lodz University of Technology, 90-924 Lodz, Poland
| | - Grzegorz Zwolinski
- Institute of Mechatronics and Information Systems, Lodz University of Technology, 90-924 Lodz, Poland
| | - Magdalena Jozefowicz-Korczynska
- Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, 90-153 Lodz, Poland
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Gawrońska A, Zamysłowska-Szmytke E, Janc M, Kotas R, Kamiński M, Marciniak P, Tylman W, Woźniak S, Napieralski J, Sakowicz B, Pajor A, Rosiak O, Puzio A, Lucas-Brot W, Józefowicz-Korczyńska M. Innovative System for Evaluation and Rehabilitation of Human Imbalance. Otolaryngol Pol 2022; 76:7-11. [DOI: 10.5604/01.3001.0015.7927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b>Introduction:</b> Mobile posturography is based on wearable inertial sensors; it allows to test static stability (static posturography) and gait disturbances. </br> </br> <b>Aim:</b> The aim of this work was to present the results of research on the innovative MEDIPOST system used for diagnosis and rehabilitation of balance disorders. </br> </br> <b>Material and methods:</b> Fourteen articles published in influenced foreign journals were presented and discussed. The deve-lopment and construction of the device was preceded by a literature review and methodological work. The Dizziness Handi-cap Inventory (DHI) questionnaire was translated and validated. The methodology of posturography with head movements with a frequency of 0.3 Hz was also developed in the group with chronic vestibular disorders. Simultaneous measurements were performed (static posturogrphy vs. MEDIPOST) in the CTSIB-M (Modified Clinical Test of Sensory Interaction in Balance) test in healthy subjects and patients with unilateral peripheral dysfunction.</br> </br> <b>Results:</b> In the posturography with head movements the improvement of sensitivity (67 to 74%) and specificity (65 to 71%) was noted. In the CTSIB-M test the intraclass correlation coefficients for both methods were 0.9. The greatest differences between examinations were observed for the mean angular velocity in the tests on the foam (trials no. 3 and 4), in particular on the foam with eyes closed (trial no. 4 – sensitivity 86.4%, specificity 87.7%). Two functional tests were analyzed: the Swap Seats test and the 360 degree turn test. In the former, the results are studied from 6 sensors – 86% of the true positives and 73% of the true negatives for the fall/ no-fall group classification. The second test differentiates people with vestibular impairment and healthy people. It can be analyzed with 1 (sensitivity 80%) and 6 sensors (sensitivity 86%, specificity 84%). Currently, the MEDIPOST device is in the development and certification phase
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Affiliation(s)
- Anna Gawrońska
- Department of the Balance System, 1st Department of Otolaryngology, Medical University of Lodz, University Clinical Hospital No. N. Barlicki, Poland
| | | | - Magdalena Janc
- Audiology and Phoniatrics Clinic, Nofer Institute of Occupational Medicine in Lodz, Poland
| | - Rafal Kotas
- Department of Microelectronics and Computer Science, Lodz University of Technology, Poland
| | - Marek Kamiński
- Department of Microelectronics and Computer Science, Lodz University of Technology, Poland
| | - Paweł Marciniak
- Department of Microelectronics and Computer Science, Lodz University of Technology, Poland
| | - Wojciech Tylman
- Department of Microelectronics and Computer Science, Lodz University of Technology, Poland
| | - Sebastian Woźniak
- Department of Microelectronics and Computer Science, Lodz University of Technology, Poland
| | - Jan Napieralski
- Department of Microelectronics and Computer Science, Lodz University of Technology, Poland
| | - Bartosz Sakowicz
- Department of Microelectronics and Computer Science, Lodz University of Technology, Poland
| | - Anna Pajor
- Department of the Balance System, 1st Department of Otolaryngology, Medical University of Lodz, University Clinical Hospital No. N. Barlicki, Poland
| | - Oskar Rosiak
- Department of the Balance System, 1st Department of Otolaryngology, Medical University of Lodz, University Clinical Hospital No. N. Barlicki, Poland
| | - Anna Puzio
- Department of the Balance System, 1st Department of Otolaryngology, Medical University of Lodz, University Clinical Hospital No. N. Barlicki, Poland
| | - Weronika Lucas-Brot
- Department of the Balance System, 1st Department of Otolaryngology, Medical University of Lodz, University Clinical Hospital No. N. Barlicki, Poland
| | - Magdalena Józefowicz-Korczyńska
- Department of the Balance System, 1st Department of Otolaryngology, Medical University of Lodz, University Clinical Hospital No. N. Barlicki, Poland
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