Utility of the Novel MediPost Mobile Posturography Device in the Assessment of Patients with a Unilateral Vestibular Disorder

Abstract

Balance disorders are a growing problem worldwide. Thus, there is an increasing need to provide an inexpensive and feasible alternative to standard posturographic platforms (SP) used for the assessment of balance and to provide a possible solution for telemonitoring of patients. A novel mobile posturography (MP) MediPost device was developed to address these issues. This prospective study used a Modified Clinical Test of Sensory Interaction on Balance to evaluate healthy individuals and patients with a unilateral vestibular disorder through SP and MP simultaneously. The control group included 65 healthy volunteers, while the study group included 38 patients diagnosed with a unilateral vestibular deficit. The angular velocity values obtained from both methods were compared by intraclass correlation coefficients (ICC) and Bland–Altman plot analysis. Diagnostic capabilities were measured in terms of sensitivity and specificity. The ICC between the two methods for conditions 2–4 was indicative of excellent reliability, with the ICC > 0.9 (p < 0.001), except for Condition 1 (standing stance, eyes open) ICC = 0.685, p < 0.001, which is indicative of moderate reliability. ROC curve analysis of angular velocity for condition 4 represents the most accurate differentiating factor with AUC values of 0.939 for SP and 0.953 for MP. This condition also reported the highest sensitivity, specificity, PPV, and NPV values with 86.4%, 87.7%, 80%, and 90.5% for SP, and 92.1%, 84.6%, 77.8%, and 94.8% for MP, respectively. The newly developed MediPost device has high sensitivity and specificity in distinguishing between healthy individuals and patients with a unilateral vestibular deficit.

Instrumental and Non-Instrumental Measurements in Patients with Peripheral Vestibular Dysfunctions

“…The instrumental measurement performed using MediPost mobile posturography localized at the L5 level, assessed postural stability in different conditions where the noted grade of improvement varied, as stated in the literature [ 13 , 39 , 40 , 41 ]. The results of condition 4 (standing on foam, eyes closed) were statistically significant for all MediPost measures, which is consistent with other studies [ 5 , 29 , 42 ]. The results of condition 1 (firm surface, eyes open) and condition 2 (firm surface, eyes closed) are clinically unsatisfactory.…”

“…Postural stability was measured using the portable, battery-powered MediPost system with one sensor mounted on the trunk at the L5 level [ 16 ]. Mobile posturography allows for a more direct measurement of COM, which is strongly correlated with the center of pressure (COP) [ 29 ]. The system consisted of the ESP32 system, a Wi-Fi radio module, and the tri-axis inertial measurement unit (IMU; STMicroelectronics LSM9DS1) based on a microelectromechanical system (MEMS) that included an accelerometer, a gyroscope, and a magnetometer (manufactured by University of Technology, Lodz, Poland).…”

Virtual Reality—A Supplement to Posturography or a Novel Balance Assessment Tool?

“…All of the studies report COP measurements from the force plate, with the majority using COP velocity or sway area as the main output parameter. In comparison, the study by Marchetto et al [ 16 ] analyzed the head position with angular velocity values, as in other studies using body-mounted sensors of posture [ 36 ]. The study protocols were different across the manuscripts, as were the VR environments; therefore, a meta-analysis of posturography parameters and VR influence on stability was not attempted in this manuscript.…”

The effect of Immersive Virtual Reality on balance: an exploratory study on the feasibility of head-mounted displays for balance evaluation

“…The study proves a significant effect of the increasing visual disturbance in the virtual environment on sway parameters. We chose angular velocity as the reference parameter, as in our previous research regarding wearable sensors and accelerometry 21 . We found that a static and stable virtual environment has little influence on angular velocity.…”