Use of Virtual and Augmented Reality Devices in Vestibular Physical Therapy for mTBI

Description

Rapidly evolving virtual reality (VR) and augmented reality (AR) technologies are being incorporated by many large-scale industries, and the medical field is no exception. One area that has gained significant attention in recent years is virtual rehabilitation which allows physical therapists to leverage state-of-the-art immersive virtual environments to uniquely address functional deficits in patients who are unresponsive to conventional treatment techniques. Advanced VR and AR technologies are now available in commercially available small-scale, mobile head-mounted displays which can be readily used in outpatient clinic settings and possibly at home. The aim of this study is to determine whether advanced VR- and AR-based physical therapy improves functional status and reduces self-reported symptoms in individuals experiencing vestibular disorders secondary to mild traumatic brain injury (mTBI). Study participants will be randomized into treatment groups: 1) conventional therapy, 2) therapy performed using a large-scale VR system (the Computer Assisted Rehabilitation Environment or CAREN), 3) therapy performed using a mobile AR. Upon completion of treatment, groups will be compared to determine functional outcome improvements with respect to static and dynamic balance as well as reduction of vestibular symptoms.

Conditions

MTBI - Mild Traumatic Brain Injury, Dysfunction of Vestibular System

Study Overview

Study Details

Study overview

Rapidly evolving virtual reality (VR) and augmented reality (AR) technologies are being incorporated by many large-scale industries, and the medical field is no exception. One area that has gained significant attention in recent years is virtual rehabilitation which allows physical therapists to leverage state-of-the-art immersive virtual environments to uniquely address functional deficits in patients who are unresponsive to conventional treatment techniques. Advanced VR and AR technologies are now available in commercially available small-scale, mobile head-mounted displays which can be readily used in outpatient clinic settings and possibly at home. The aim of this study is to determine whether advanced VR- and AR-based physical therapy improves functional status and reduces self-reported symptoms in individuals experiencing vestibular disorders secondary to mild traumatic brain injury (mTBI). Study participants will be randomized into treatment groups: 1) conventional therapy, 2) therapy performed using a large-scale VR system (the Computer Assisted Rehabilitation Environment or CAREN), 3) therapy performed using a mobile AR. Upon completion of treatment, groups will be compared to determine functional outcome improvements with respect to static and dynamic balance as well as reduction of vestibular symptoms.

Use of Virtual and Augmented Reality Devices in Vestibular Physical Therapy for mTBI

Use of Virtual and Augmented Reality Devices in Vestibular Physical Therapy for mTBI

Condition
MTBI - Mild Traumatic Brain Injury
Intervention / Treatment

-

Contacts and Locations

San Diego

Naval Health Research Center, San Diego, California, United States, 92106

San Diego

Naval Medical Center San Diego, San Diego, California, United States, 92134

Bethesda

Walter Reed National Military Medical Center (WRNMMC), Bethesda, Maryland, United States, 20889

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Men and women, active duty SMs between 18 and 65 years of age and enrolled in Defense Enrollment Eligibility Reporting System (DEERS)
  • * History of mTBI based on the Ohio State University Traumatic Brain Injury Identification (OSU TBI-ID)
  • * Require vestibular physical therapy as determined by a PT
  • * Normal or corrected vision based on the Snellen Eye Chart of at least 20/40
  • * Able to consistently follow verbal and written instructions and observe safety precautions
  • * Able to tolerate up to 60 minutes of physical therapy exercise, with breaks
  • * Able to ambulate with contact guard assistance or less, and to walk unassisted over ground or on a treadmill for 10 minutes at a time
  • * Able to tolerate wearing a full body safety harness
  • * Able to tolerate wearing a head mounted display weighing up to 3 pounds for up to 60 minutes
  • * History of a moderate or severe TBI (OSU TBI-ID; or DVBIC TBI Screening Tool)
  • * Under care of a physician for a neurodegenerative diagnosis
  • * History of seizures or syncope
  • * Clinical determination of Benign Paroxysmal Positional Vertigo (BPPV)
  • * Diagnosis of any of the following visual impairments: field cuts, macular degeneration, retinal detachment, diplopia, limited peripheral or central vision, or require prism lenses
  • * Unable or unwilling to use contacts for corrected vision
  • * Require a medical device that can be affected by radio waves such as a pacemaker, defibrillator, or hearing devices (implantable or air conduction)
  • * Medications with significant sedating side effects that could impact safety (i.e., Phenobarbital, Ativan, etc.)
  • * Women who are more than 4 months pregnant may not participate in this study due to the effects advanced pregnancy can have on balance and vision. Note: Women who choose to participate will be informed up front that there are risks associated with pregnancy including decrements in postural control and falls. Additionally, changes in hormones, metabolism, fluid retention, and blood circulation during pregnancy can affect the eyes and eyesight. Women who become pregnant during the intervention should inform their PT immediately to determine if continued participation is possible.
  • * Concurrent participation, either clinically and/or as a part of another research study, in vestibular physical therapy and/or PTSD treatment
  • * Unable to consent for any reason

Ages Eligible for Study

18 Years to 65 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Naval Health Research Center,

Pinata Sessoms, PhD, PRINCIPAL_INVESTIGATOR, Naval Health Research Center

Sarah Kruger, MS, PRINCIPAL_INVESTIGATOR, Walter Reed National Military Medical Center

Kerry Rosen, PhD, PRINCIPAL_INVESTIGATOR, Walter Reed National Military Medical Center

Study Record Dates

2024-12