Balance Rehabilitation: The Latest Innovations

4 April 2021

Balance is a fundamental component of human movement and a critical aspect of overall health and well-being. For physical therapists, understanding balance rehab is essential for helping patients regain independence and improve their quality of life.
This blog will explore the latest innovations from Interacoustics for effective balance rehabilitation, including diagnosis, assessment, and training.

What is Balance Rehabilitation?

Balance rehabilitation is a specialized area of physical therapy aimed at assessing, diagnosing, and treating individuals who experience difficulties with balance and stability. This type of rehabilitation focuses on improving a patient’s ability to perform daily activities safely and independently, thereby enhancing their overall quality of life.

Balance rehab uses various methods such as strength training, balance exercises, and walking practice. Innovative technology like virtual reality and computerized dynamic posturography is aiding data-driven rehabilitation, and keeping patients engaged and motivated.

Balance rehabilitation addresses the reasons for balance problems like neurological issues or aging. It helps prevent falls, improve independence, and make patients feel more confident in their daily activities.

Common Causes of Balance Impairments

Balance impairments can arise from various conditions, including:
Neurological Disorders: Stroke, Parkinson’s disease, multiple sclerosis, and traumatic brain injury.
Musculoskeletal Issues: Arthritis, joint replacements, and muscular weakness.
Vestibular Disorders: Benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and Meniere’s disease.
Age-Related Changes: Decreased proprioception, muscle strength, and reaction time in older adults.

Virtual Reality-Based Rehabilitation

Virtual reality (VR) is revolutionizing balance rehab by offering an innovative and engaging approach to delivering personalized training. Virtualis, a leading VR-based rehabilitation system, empowers clinicians to tailor training programs objectively to address each patient’s specific daily living challenges. With Virtualis, clinicians can promptly receive feedback and adjust training sessions as needed, ensuring efficient use of clinic time, and optimizing patient outcomes.

In Virtualis VR, patients immerse themselves in simulated real-life environments mirroring their daily activities, fostering relatability and motivation in the rehabilitation process. Recent research indicates that VR in rehabilitation significantly boosts patient motivation by 73%, with an impressive 98.4% completion rate for a 4–6-week training program using VR [1].

Furthermore, Virtualis enables seamless sharing of data among modules and sessions, enhancing clinician efficiency and the overall rehabilitation process. Research also demonstrates that patients undergoing physical therapy within 3 months of dizziness onset experience 86% fewer falls over the subsequent 9 months [2].

These findings underscore Virtualis VR’s potential to revolutionize balance rehabilitation, making it more personalized, motivating, and efficient.

Balance Assessment using Virtual Reality

Training with VR offers a fully immersive experience by eliminating visual references in the peripheral view, deeply engaging patients in their rehabilitation process. Virtualis provides simulated real-life training modules that promote adaptation, substitution, and habituation, thereby enhancing the effectiveness of balance rehabilitation.

When integrated with the MotionVR dynamic platform, which includes Computerized Dynamic Posturography (CDP), patients undergo a comprehensive functional balance assessment. This platform can move in all directions to simulate real-life surfaces, engaging the entire balance system, including the otoliths, for a comprehensive evaluation and training experience.

Alternatively, the StaticVR platform offers static posturography for basic functional balance assessment. It features portable platforms that provide objective balance control data, allowing for tailored and precise balance training, whether in the clinic or on the go. This versatility makes VR a powerful tool in balance rehabilitation.

Training the Balance System using Virtual Reality

Training to enhance a patient’s function in daily activities is a crucial component of Interacoustics’ comprehensive approach. Balance VR and PhysioVR platforms offer extensive, personalized balance training tailored to each patient’s unique needs.

For dynamic and immersive balance exercises, MotionVR provides training using 360-degree dynamic platforms, challenging, and improving the patient’s stability in various scenarios.
The StaticVR platform offers portable static balance training for flexible and accessible sessions.

Physical therapists can use innovative technologies to provide better, personalized care. This helps patients become more independent and improve their quality of life.

Vestibular Disorders: From Diagnosis to Treatment

When it comes to comprehensive solutions for your clinic, Interacoustics offers a complete range of tools for diagnosing and treating vestibular disorders. Their advanced diagnostic arsenal includes VisualEyes™ and EyeSeeCam vHIT.

VisualEyes™ employs videonystagmography to differentiate between peripheral and central vestibular dysfunction, ensuring accurate diagnosis. Meanwhile, the EyeSeeCam vHIT evaluates the vestibulo-ocular reflex (VOR), providing crucial insights into the patient’s condition.

There are two separate packages, which use the VORTEQ™ inertial measurement unit (IMU), that can be added on to VisualEyes™. These are VORTEQ™ Diagnostic and VORTEQ™ Assessment.

The VORTEQ™ Diagnostic package features vHIT and active head rotation (AHR) tests, enabling binocular vHIT with VNG goggles. During the AHR test, patients move their heads to a metronome beat while the software measures gain, phase, and symmetry of eye and head movements.

Additionally, passive head rotation tests are available. The VORTEQ™ Assessment package includes advanced Dix-Hallpike, lateral head roll, and dynamic visual acuity (DVA) tests.

These are ideal for testing benign paroxysmal positional vertigo (BPPV), featuring a 3D head model, maneuver guides, and torsional eye tracking. The DVA test is valuable for functional VOR assessment, offering objective data in response to rotational or functional head-movement stimuli.

For targeted treatment, the Interacoustics TRV Chair is an invaluable tool for diagnosing and treating BPPV.

Additionally, the Interacoustics Orion Chair enhances diagnostic capabilities by diagnosing bilateral vestibular losses and evaluating central compensation. This comprehensive approach ensures that clinicians have access to the necessary tools for thorough assessment and treatment of vestibular disorders.

Understanding how a patient functions in their daily activities post-diagnosis is crucial for effective treatment planning. Interacoustics designed their assessment tools to provide comprehensive insights into their functional capabilities.

Whether you are seeking guidance on selecting the right balance equipment for your clinic or looking to integrate balance rehab into your practice, don’t hesitate to connect with your local e3 Diagnostics expert.

Reach out today to explore how we can support your clinic’s needs and enhance your patient care experience.
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**Sources: **
[1] Heffernan, A., Abdelmalek, M., & Nunez, D. A. (2021). Virtual and augmented reality in the vestibular rehabilitation of peripheral vestibular disorders: Systematic Review and meta-analysis. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-97370-9.
[2] Marmor S, Karaca-Mandic P, Adams ME. Use of Physical Therapy and Subsequent Falls Among Patients with Dizziness in the US. JAMA Otolaryngol Head Neck Surg. 2023;149(12):1083–1090. doi:10.1001/jamaoto.2023.2840