Exploring the Potentials of Wearable Technologies in Managing Vestibular Hypofunction

Abstract

The vestibular system is dedicated to gaze stabilization, postural balance, and spatial orientation; this makes vestibular function crucial for our ability to interact effectively with our environment. Vestibular hypofunction (VH) progresses over time, and it presents differently in its early and advanced stages. In the initial stages of VH, the effects of VH are mitigated using vestibular rehabilitation therapy (VRT), which can be facilitated with the aid of technology. At more advanced stages of VH, novel techniques that use wearable technologies for sensory augmentation and sensory substitution have been applied to manage VH. Despite this, the potential of assistive technologies for VH management remains underexplored over the past decades. Hence, in this review article, we present the state-of-the-art technologies for facilitating early-stage VRT and for managing advanced-stage VH. Also, challenges and strategies on how these technologies can be improved to enable long-term ambulatory and home use are presented.

Keywords: sensory augmentation; sensory substitution; vestibular hypofunction; vestibular management; vestibular rehabilitation; wearable devices.

Figure 1

Eye and head velocity during head impulses for (a) normal VOR gain and (b) reduced VOR gain for VH patients (image from [17]).

Figure 3

Flow diagram for vestibular perception. (a) Normal subjects with strong vestibular perception (broad feedback arrow). (b) Sensory augmentation using biofeedback devices showing weakened vestibular perception (narrow feedback arrow). (c) Sensory augmentation using nGVS showing weakened vestibular perception (narrow feedback arrow). (d) Sensory substitution using vestibular implant showing severely weakened vestibular perception (unshaded feedback arrow). (e) Sensory substitution using biomimetic hair cells for generating vestibular perception (broad feedback arrow).

Figure 4

GVS with a VR headset for managing cybersickness. Stimulation electrodes are on the right and left mastoid, while ground and neutral electrodes are on the nape (image from [57]).

Figure 2

Summarizing the various wearable technologies for vestibular management.

Figure 5

Summarizing Future Research Directions for Wearable VH Management.