A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises

IntroductionVestibular hypofunction is associated with dizziness, imbalance, and blurred vision with head movement. Vestibular rehabilitation is the gold standard recommendation to decrease symptoms and improve postural stability. The Clinical Practice Guidelines for vestibular hypofunction suggest...

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Main Authors: Linda J. D’Silva, Tarah Phongsavath, Kelly Partington, Nathan T. Pickle, Katherine Marschner, Timothy P. Zehnbauer, Michael Rossi, Karen Skop, Paulien E. Roos
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-11-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2023.1269874/full
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author Linda J. D’Silva
Tarah Phongsavath
Kelly Partington
Nathan T. Pickle
Katherine Marschner
Timothy P. Zehnbauer
Michael Rossi
Karen Skop
Karen Skop
Paulien E. Roos
author_facet Linda J. D’Silva
Tarah Phongsavath
Kelly Partington
Nathan T. Pickle
Katherine Marschner
Timothy P. Zehnbauer
Michael Rossi
Karen Skop
Karen Skop
Paulien E. Roos
author_sort Linda J. D’Silva
collection DOAJ
description IntroductionVestibular hypofunction is associated with dizziness, imbalance, and blurred vision with head movement. Vestibular rehabilitation is the gold standard recommendation to decrease symptoms and improve postural stability. The Clinical Practice Guidelines for vestibular hypofunction suggest home exercises 3–5 times daily, but patient adherence is a problem, with compliance rates often below 50%.MethodsAn app was developed to increase engagement with home exercises by providing exercises as games. This study compared the accuracy of exercise performance in a one-time session using the app versus no-app and gathered participant feedback on using the app for vestibulo-ocular reflex (VOR) and balance exercises. The app was tested with 40 adults (20 women), mean age of 67 ± 5.7 years, with symptomatic unilateral or bilateral vestibular hypofunction. Participants completed VOR exercises in pitch and yaw planes, weight-shift, and single-leg balance exercises using an inertial motion unit to move the character on the tablet screen. Participants were randomly assigned to begin the exercises with or without the app.ResultsResults show that during VOR exercises, participants achieved the prescribed frequency of head motion for the yaw plane (p ≤ 0.001) and reduced variability of head movement frequency in both the yaw (p ≤ 0.001) and pitch plane (p ≤ 0.001) in the app compared to the no-app condition. During weight-shifting exercises, a larger range of body motion was noted in the anteroposterior and mediolateral directions in the app compared to the no-app condition (p < 0.05). During single-leg balance exercises, pelvic motion was lower in the app versus no-app condition (p = 0.02). Participants modified their exercise performance and corrected their mistakes to a greater extent when they used the app during the VOR exercises. Participants agreed that they felt motivated while playing the games (97%) and felt motivated by the trophies (92%). They agreed that the app would help them perform the exercises at home (95%), improve their rehab performance (95%) and that it was fun to do the exercises using the app (93%).DiscussionThe results of this study show that technology that is interactive and provides feedback can be used to increase accuracy and engagement with exercises.
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spelling doaj.art-d1e904df8b1149fd9f7618117d0ae8822023-11-24T08:14:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-11-011010.3389/fmed.2023.12698741269874A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercisesLinda J. D’Silva0Tarah Phongsavath1Kelly Partington2Nathan T. Pickle3Katherine Marschner4Timothy P. Zehnbauer5Michael Rossi6Karen Skop7Karen Skop8Paulien E. Roos9Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas, MO, United StatesDepartment of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas, MO, United StatesDepartment of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas, MO, United StatesBiomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United StatesBiomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United StatesBiomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United StatesBiomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United StatesPhysical Medicine and Rehabilitation Services, Department of Physical Therapy, James A. Haley Veterans’ Hospital, Tampa, FL, United StatesSchool of Physical Therapy, Morsani College of Medicine, University of South Florida, Tampa, FL, United StatesBiomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United StatesIntroductionVestibular hypofunction is associated with dizziness, imbalance, and blurred vision with head movement. Vestibular rehabilitation is the gold standard recommendation to decrease symptoms and improve postural stability. The Clinical Practice Guidelines for vestibular hypofunction suggest home exercises 3–5 times daily, but patient adherence is a problem, with compliance rates often below 50%.MethodsAn app was developed to increase engagement with home exercises by providing exercises as games. This study compared the accuracy of exercise performance in a one-time session using the app versus no-app and gathered participant feedback on using the app for vestibulo-ocular reflex (VOR) and balance exercises. The app was tested with 40 adults (20 women), mean age of 67 ± 5.7 years, with symptomatic unilateral or bilateral vestibular hypofunction. Participants completed VOR exercises in pitch and yaw planes, weight-shift, and single-leg balance exercises using an inertial motion unit to move the character on the tablet screen. Participants were randomly assigned to begin the exercises with or without the app.ResultsResults show that during VOR exercises, participants achieved the prescribed frequency of head motion for the yaw plane (p ≤ 0.001) and reduced variability of head movement frequency in both the yaw (p ≤ 0.001) and pitch plane (p ≤ 0.001) in the app compared to the no-app condition. During weight-shifting exercises, a larger range of body motion was noted in the anteroposterior and mediolateral directions in the app compared to the no-app condition (p < 0.05). During single-leg balance exercises, pelvic motion was lower in the app versus no-app condition (p = 0.02). Participants modified their exercise performance and corrected their mistakes to a greater extent when they used the app during the VOR exercises. Participants agreed that they felt motivated while playing the games (97%) and felt motivated by the trophies (92%). They agreed that the app would help them perform the exercises at home (95%), improve their rehab performance (95%) and that it was fun to do the exercises using the app (93%).DiscussionThe results of this study show that technology that is interactive and provides feedback can be used to increase accuracy and engagement with exercises.https://www.frontiersin.org/articles/10.3389/fmed.2023.1269874/fullvestibular hypofunctionolder adultsrehabilitation gamesmotivationengagement
spellingShingle Linda J. D’Silva
Tarah Phongsavath
Kelly Partington
Nathan T. Pickle
Katherine Marschner
Timothy P. Zehnbauer
Michael Rossi
Karen Skop
Karen Skop
Paulien E. Roos
A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises
Frontiers in Medicine
vestibular hypofunction
older adults
rehabilitation games
motivation
engagement
title A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises
title_full A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises
title_fullStr A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises
title_full_unstemmed A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises
title_short A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises
title_sort gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises
topic vestibular hypofunction
older adults
rehabilitation games
motivation
engagement
url https://www.frontiersin.org/articles/10.3389/fmed.2023.1269874/full
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