Utility of VestAid to Detect Eye-Gaze Accuracy in a Participant Exposed to Directed Energy

Whitney, Susan L.; Ou, Victoria; Hovareshti, Pedram; Costa, Claudia M; Cassidy, Amy R; Dunlap, Pamela M; Roeder, Shamus; Holt, Lisa; Tolani, Devendra; Klatt, Brooke N; Hoppes, Carrie W.

doi:10.1093/milmed/usac294

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…The VestAid, as demonstrated in other studies, is a feasible method to attempt clinically quantify VOR impairments 3,9 , and the Clinical Practice Guidelines on vestibular hypofunction and concussion/mild traumatic from the Academy of Neurologic Physical Therapy of the American Physical Therapy Association recommend VOR exercises in the pitch plane when needed for patients with vertical VOR deficits 2,15 . Neither of these documents suggests the size of the target to focus on or if glasses wearers should complete the activity with glasses on or off 2,15 .…”

Section: Discussionmentioning

confidence: 99%

“…The VOR exercises are lowtech as the patient is often asked to view text on a tongue depressor or post-it note as they move their head while keeping the text in focus. As technology advances, there are now higher-tech applications for monitoring compliance with VOR exercises [3][4][5] . There is no consensus about the correct size optotype for the VOR exercises in these new application-based programs.…”

Section: Original Manuscriptmentioning

confidence: 99%

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Determining the ideal optotype size for pitch plane interventions: an exploratory study (Preprint)

Harrell,

Klatt,

Hovareshti

et al. 2024

Preprint

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BACKGROUND Clinicians prescribe vestibulo-ocular reflex (VOR) exercises when there is a deficit in gaze stability associated with vestibular hypofunction. The exercises aim to maintain focus on an object while the head is moving in the pitch and yaw planes. Many people who complete VOR exercises use progressive or bifocal lens. For multi-focal corrective lenses, the user must look through the correct part of their lens when viewing targets in the pitch plane. OBJECTIVE This study aimed to identify if healthy multi-focal corrective lens users had difficulty with VOR exercises in the pitch plane based on optotype size. METHODS Participants completed VOR exercises on the VestAid tablet, which can record both eye gaze compliance and head movement compliance. Participants completed pitch plane VOR exercises at 80 bpm with optotype sizes 14-, 16-, 18-, 20-, and 22-point fonts for 30 seconds in the seated position with no visual background. All participants then rated symptom severity (dizziness, nausea, headache, fogginess) and overall level of exercise difficulty. RESULTS Twelve healthy multi-focal correct lens users (seven progressive and three bifocal lens users) completed the study. All participants were 100% compliant with moving their head at the correct speed and 100% compliant with maintaining their eyes on the optotype during the exercises regardless of the optotype size. Participants rated all exercises as “extremely easy.” CONCLUSIONS There was no difference in optotype performance in healthy multi-focal corrective lens users when completing pitch plane VOR exercises. Additional work is needed to determine if optotype size makes a difference in gaze stability in persons with vestibular hypofunction.

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Section: Discussionmentioning

confidence: 99%

Section: Original Manuscriptmentioning

confidence: 99%

Determining the ideal optotype size for pitch plane interventions: an exploratory study (Preprint)

Harrell,

Klatt,

Hovareshti

et al. 2024

Preprint

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“…VestAid is an innovative tablet-based system for vestibulo-ocular reflex exercises [ 32 ]. VestAid validated eye-gaze accuracy as part of the study and detected eye movement abnormalities in the participants with directed energy exposure, concussion, and vestibular neuritis [ 33 ]. Although not included in the review as this paper is in the initial evaluation stage of the system, this system is capable of recognizing facial movements and providing rehabilitation for vertigo through games.…”

Section: Discussionmentioning

confidence: 99%

Smartphone-Assisted Medical Care for Vestibular Dysfunction as a Telehealth Strategy for Digital Therapy Beyond COVID-19: Scoping Review

Noda¹,

Kuroda²,

Nomura³

et al. 2023

JMIR Mhealth Uhealth

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Background Dizziness and vertigo can be caused by various factors, such as peripheral vestibular and central disorders. Although consultations with specialists are advisable when necessary, patients with severe vertigo symptoms may have limited mobility, which may interfere with hospital visits. The spread of COVID-19 has further limited the number of hospital visits for patients with dizziness; therefore, a method of medical care that enables more accurate treatment under time and geographical constraints is needed. Telemedicine has become widespread, owing to the popularity of smartphone and tablet devices in recent years, and the use of devices and systems has made it possible to provide efficient medical care. However, no previous scoping review has mapped existing studies on telemedicine for vertigo and dizziness, and no recommendations have been made regarding which devices and systems should be used for specific diseases. Objective The aim of this review was to map and assess previous studies on the use of information communications technology, smartphones, and apps for treating patients with vertigo and discuss the added value of introducing telemedicine to improve the quality of medical care and create an environment that builds security and trust among patients. Methods A scoping review was conducted with the methodological framework of Arksey and O’Malley and in accordance with the of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews) guidelines. The PubMed, MEDLINE, and Cochrane Library databases were searched to retrieve previous reports on smartphone-assisted telemedicine treatment for vertigo published between January 2000 and May 2023. Two authors independently assessed eligibility and extracted data. Results This review included 20 papers that reported devices or systems for telemedicine for vestibular dysfunction. Among studies that reported the use of a device or app, 2 were related to anamnesis and subjective symptoms, 12 were related to objective examination, 7 were related to remote diagnosis, and 7 were related to treatment and rehabilitation. Conclusions With the advancement of technology, the use of telemedicine in patients with dizziness may be feasible. In the future, it will be necessary to consider how telemedicine can be used in dizziness treatment and develop an effective treatment system combining in-person medical care and the effective use of devices for the management of severe vertigo and related diseases. The smooth introduction of telemedicine in vertigo treatment is expected to improve the quality of treatment, increase opportunities for patients to receive medical care, and reduce time and travel costs, leading to a sense of security and trust among patients.

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“…Whitney et al [20] developed VestAid (BlueHalo, Rockville, MD, USA), a tablet device that utilizes eye and facial recognition software to record head velocities and eyegaze accuracy while patients perform gaze stability exercises. Their small case series demonstrates that advanced technological devices can enhance the precision of clinical measurements for assessment and monitoring of rehabilitation progress.…”

Section: Assessment Treatment and Monitoring Rehabilitation Progressmentioning

confidence: 99%

Leveraging Technology for Vestibular Assessment and Rehabilitation in the Operational Environment: A Scoping Review

Hoppes,

Lambert,

Whitney

et al. 2024

Bioengineering

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Introduction: The vestibular system, essential for gaze and postural stability, can be damaged by threats on the battlefield. Technology can aid in vestibular assessment and rehabilitation; however, not all devices are conducive to the delivery of healthcare in an austere setting. This scoping review aimed to examine the literature for technologies that can be utilized for vestibular assessment and rehabilitation in operational environments. Materials and Methods: A comprehensive search of PubMed was performed. Articles were included if they related to central or peripheral vestibular disorders, addressed assessment or rehabilitation, leveraged technology, and were written in English. Articles were excluded if they discussed health conditions other than vestibular disorders, focused on devices or techniques not conducive to the operational environment, or were written in a language other than English. Results: Our search strategy yielded 32 articles: 8 articles met our inclusion and exclusion criteria whereas the other 24 articles were rejected. Discussion: There is untapped potential for leveraging technology for vestibular assessment and rehabilitation in the operational environment. Few studies were found in the peer-reviewed literature that described the application of technology to improve the identification of central and/or peripheral vestibular system impairments; triage of acutely injured patients; diagnosis; delivery and monitoring of rehabilitation; and determination of readiness for return to duty. Conclusions: This scoping review highlighted technology for vestibular assessment and rehabilitation feasible for use in an austere setting. Such technology may be leveraged for prevention; monitoring exposure to mechanisms of injury; vestibular-ocular motor evaluation; assessment, treatment, and monitoring of rehabilitation progress; and return-to-duty determination after vestibular injury. Future Directions: The future of vestibular assessment and rehabilitation may be shaped by austere manufacturing and 3D printing; artificial intelligence; drug delivery in combination with vestibular implantation; organ-on-chip and organoids; cell and gene therapy; and bioprinting.

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Utility of VestAid to Detect Eye-Gaze Accuracy in a Participant Exposed to Directed Energy

Cited by 3 publications

References 22 publications

Determining the ideal optotype size for pitch plane interventions: an exploratory study (Preprint)

Determining the ideal optotype size for pitch plane interventions: an exploratory study (Preprint)

Smartphone-Assisted Medical Care for Vestibular Dysfunction as a Telehealth Strategy for Digital Therapy Beyond COVID-19: Scoping Review

Leveraging Technology for Vestibular Assessment and Rehabilitation in the Operational Environment: A Scoping Review

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