SBIR-STTR Award

Title: mVOR: An mHealth approach to the clinical assessment of gaze stability and telerehabilitation of vestibular dysfunction : Patients with vestibular dysfunction often suffer from gaze instability and an increased risk of falls. Current practice guidelines recommend the use of vestibular rehabilitation for vestibular dysfunction. If patients need to undergo home therapy, additional sensors and instrumentation can pose a challenge in supporting the use of telehealth to objectively assess the contribution of the vestibulo-ocular reflex (VOR) to gaze stability objectively. Following head velocity-based parameters for vestibular rehabilitation has been shown to be effective in patients with dizziness and disequilibrium due to peripheral vestibular loss. However, head velocity-specific goals can largely be ignored as part of home vestibular physical therapy because there is no user-friendly way to directly measure head and eye motion without being connected to some form of external hardware. Although there have been notable attempts to utilize virtual reality and mobile-based technology to monitor postural balance and head motion, advances in native smartphone-based technology and computer vision models could provide us the ability to develop a simple, patient-friendly approach to assessing the VOR. In this project, we aim to develop a mHealth app (mVOR) under the guidance of expert practitioners who specialize in the care of patients with vestibular dysfunction. mVOR will allow for a self-administered vestibular dysfunction assessment by approximating the VOR with a well-established psychophysical test, the gaze stabilization test (GST) protocol. We plan to develop a user-friendly mHealth app that can provide gaze stability outcomes accessible by patients (mVOR: APP) and clinicians (mVOR: DMP). mVOR will ultimately provide users with a single clinical outcome measure (GST score): the highest head velocity (in degrees per second) at which they can maintain their visual acuity. Through the mVOR, the user's smartphone front camera and microphone will accurately obtain visual acuity data and visual processing speeds and track head and eye movements acquired by computer vision algorithms and human- computer interactions. The mVOR: DMP app will graphically summarize results from the mVOR test protocol, which may aid in further shared decision-making from anywhere. Human subject trials performed at our partnering research institution (University of Virginia) will ultimately pave the way for studying the usability, feasibility, and validity of this tool in patients with vestibular dysfunction best served by home vestibular rehabilitation.

Public Health Relevance Statement:
Narrative: More than a third of adults over 40 suffer from concurrent dizziness secondary to vestibular dysfunction. Real-time teleassessments of vestibular disorders patients remain a challenge. We will develop and demonstrate the performance of a smartphone-based platform (mVOR) using a mobile Gaze Stabilization Test (mGST) protocol as a rehabilitation tool to cost-effectively track and assess vestibular dysfunction patients. Clinicians would receive a real-time assessment report to guide further treatment. Terms: <21+ years old; Abscission; Acoustic Neurilemmoma; Acoustic Neurilemoma; Acoustic Neurinoma; Acoustic Neuroma; Acoustic Schwannoma; Adult; Adult Human; Affect; Algorithms; Bilateral; Biometrics; Biometry; Biostatistics; COVID crisis; COVID epidemic; COVID pandemic; COVID-19 crisis; COVID-19 epidemic; COVID-19 era; COVID-19 global health crisis; COVID-19 global pandemic; COVID-19 health crisis; COVID-19 pandemic; COVID-19 period; COVID-19 public health crisis; COVID-19 years; Cell Phone; Cellular Phone; Cellular Telephone; Clinic; Clinical; Clinical Trials; Clinical assessments; Complex; Computer Vision Systems; Conduct Clinical Trials; Data; Devices; Dizziness; Equilibrium; Excision; Extirpation; Eye; Eye Movements; Eyeball; Foundations; Friends; Goals; Head; Head Movements; Health system; Home; Human; Human Subject Research; Institution; Measurement; Measures; Medical Rehabilitation; Methods; Mobile Health App; Mobile Health Application; Mobile Phones; Modeling; Modern Man; Monitor; Motion; Msec; Musculoskeletal Equilibrium; On-Line Systems; Online Systems; Outcome; Patient Care; Patient Care Delivery; Patients; Performance; Peripheral; Phase; Physiatric Procedure; Physical Medicine Procedure; Physical Therapeutics; Physical therapy; Physiotherapy; Postural Balance; Postural Equilibrium; Practice Guidelines; Process; Protocol; Protocols documentation; Psychophysics; Qualifying; Recommendation; Rehabilitation; Rehabilitation therapy; Removal; Reporting; Research; Research Resources; Resources; Role; SARS-CoV-2 epidemic; SARS-CoV-2 global health crisis; SARS-CoV-2 global pandemic; SARS-CoV-2 pandemic; SARS-coronavirus-2 epidemic; SARS-coronavirus-2 pandemic; Secondary to; Self Administered; Self Administration; Severe Acute Respiratory Syndrome CoV 2 epidemic; Severe Acute Respiratory Syndrome CoV 2 pandemic; Severe acute respiratory syndrome coronavirus 2 epidemic; Severe acute respiratory syndrome coronavirus 2 pandemic; Sight; Structure; Surgical Removal; System; Technology; Testing; Time; Universities; Vestibular; Vestibular Diseases; Vestibular Neurilemmoma; Vestibular System Function; Vestibular System Impairment; Vestibular defect; Vestibular disorder; Vestibular dysfunction; Vestibular function; Vestibular loss; Vestibular problems; Vestibular system disorder; Vestibulopathy; Virginia; Vision; Visual Acuity; Visualization; adulthood; balance; balance disorder; balance function; balance impairment; care for patients; care of patients; caring for patients; clinical efficacy; clinical outcome measures; computer human interaction; computer vision; computerized; computerized data processing; coronavirus disease 2019 crisis; coronavirus disease 2019 epidemic; coronavirus disease 2019 global health crisis; coronavirus disease 2019 global pandemic; coronavirus disease 2019 health crisis; coronavirus disease 2019 pandemic; coronavirus disease 2019 public health crisis; coronavirus disease crisis; coronavirus disease epidemic; coronavirus disease pandemic; coronavirus disease-19 global pandemic; coronavirus disease-19 pandemic; cost; cost effective; data management; data processing; design; designing; disturbed balance; equilibration disorder; equilibrium disorder; eye tracking; fall risk; falls; gaze; handheld mobile device; homes; human subject; iPhone; instrumentation; m-Health; m-Health app; m-Health application; mHealth; mHealth app; mHealth application; man-machine interaction; microphone; millisecond; mobile device; mobile health; novel; oculovestibular reflex; online computer; post-operative recovery; postoperative recovery; postural control; posture instability; processing speed; psychophysical; recovery after surgery; recovery following surgery; recruit; rehab therapy; rehabilitative; rehabilitative therapy; resection; sensor; severe acute respiratory syndrome coronavirus 2 global health crisis; severe acute respiratory syndrome coronavirus 2 global pandemic; shared decision making; smart phone; smartphone; social role; software as a medical device; software as medical device; telehealth; telerehab; telerehabilitation; tool; usability; user-friendly; vestibo-ocular reflexes; vestibular Schwannoma; vestibular deficit; vestibular impairment; vestibular system; vestibular system dysfunction; vestibulo-occular system; vestibulo-ocular reflex; vestibulo-oculomotor reflex; vestibuloocular reflexes; virtual reality; visual function; visual process; visual processing; visual tracking; web based