A virtual reality head stability test for patients with vestibular dysfunction

BACKGROUND: The contribution of visual information to standing balance in patients with vestibular dysfunction varies between patients. Sensitive tools to detect kinematic response to visual perturbation are needed to individualize treatment. OBJECTIVE: Using the Oculus Rift headset and sensors, we developed a novel virtual reality (VR) test of head stability (HST) in response to visual perturbation. During the test, head movements were tracked in six degrees-of-freedom. The purpose of this pilot study was to test the sensitivity of the VR_HST to differences between patients with vestibular dysfunction and controls. METHODS: Seventeen patients and 16 controls performed static balance tasks with eyes closed (feet together or tandem on floor and foam) and observing 'moving stars' (amplitude 32mm, frequency 0.2 Hz) via the Oculus (tandem). Directional Path and Root Mean Square Velocity were calculated for postural and head oscillations. RESULTS: Postural sway differed significantly between groups when standing on foam with feet together and on floor while observing the 'moving stars' task. Head oscillations were larger among patients, primarily in pitch, yaw, and roll rotation. CONCLUSIONS: The VR_HST was found to be sensitive to differences between small and diverse groups. Its clinical utility should be studied in larger samples of patients with vestibular dysfunction.