Leveraging virtual reality for vestibular testing: Clinical outcomes from tests of dynamic visual acuity

BACKGROUND: Virtual reality (VR) use as a platform for vestibular rehabilitation is widespread. However, the utility of VR based vestibular assessments remains unknown. OBJECTIVE: To compare dynamic visual acuity (DVA) scores, perceived balance, and perceived dizziness when using traditional versus VR environments for DVA testing among healthy individuals. METHODS: DVA testing occurred for both a traditional clinical protocol and in a VR variant. Horizontal, vertical, and no head motion conditions were conducted for both clinical and VR test protocols. DVA scores, balance ratings, and dizziness ratings were obtained per condition. Two-way ANOVAs with repeated measures were used to assess differences in DVA scores, balance, and dizziness ratings. RESULTS: No differences in DVA results, balance or dizziness ratings were observed when comparing traditional clinical protocol versus the VR variant. Differences across head motion conditions were observed, with no motion trials exhibiting significantly higher DVA scores and perceived balance, and lower perceived dizziness compared to vertical and horizontal head motion. Vertical head motion exhibited this same trend compared to horizontal. CONCLUSION: DVA testing conducted in VR demonstrated clinical utility for each measure. Effects of head motion were similar across test variants, indicating DVA testing in VR produces similar effects on vestibular function than traditional clinical testing. Additional research should be conducted to assess the feasibility of VR assessment in individuals with vestibular disorder.