Utility of VestAid to Detect Eye-Gaze Accuracy in a Participant Exposed to Directed Energy

Abstract

Introduction The VestAid is a tablet-based application that provides feedback about a patient’s eye/head movements during exercise after concussion. The goal of this case series was to determine if VestAid could be used to detect eye-gaze accuracy in a participant exposed to directed energy (DE). Materials and Methods The VestAid results of a participant with DE were compared to an age- and gender-matched healthy control, a participant post-concussion, and a participant with vestibular neuritis. A tablet with VestAid software was utilized to record eye-gaze accuracy and head speed during VORx1 exercises using eye and facial recognition as participants were exposed to 12 visual scenes. Results The participant with DE consistently had difficulty with eye-gaze accuracy when the head was rotated towards the right for all trials. The participant with DE had poor eye-gaze accuracy during all phases of the head turn cycle compared to the control participant (mean 47.91%, [SD = 7.32%] for the DE participant versus mean 94.28%, [SD = 5.87%] for the control participant). Post-exercise dizziness and perceived difficulty in the 12 exercises completed by the participant with DE were strongly related (Spearman’s rho = 0.7372, P = .0062). The participant with DE had the lowest scores on 10 of the 12 head movement trials. Conclusions VestAid provided unique information about eye-gaze accuracy that detected eye movement abnormalities in the participants with DE exposure, concussion, and vestibular neuritis. The objective metrics of eye-gaze stability correlate with participants’ symptoms and perceived difficulty of the eye/head movements.

Determining the ideal optotype size for pitch plane interventions: an exploratory study (Preprint)

“…The VestAid, as demonstrated in other studies, is a feasible method to attempt clinically quantify VOR impairments 3,9 , and the Clinical Practice Guidelines on vestibular hypofunction and concussion/mild traumatic from the Academy of Neurologic Physical Therapy of the American Physical Therapy Association recommend VOR exercises in the pitch plane when needed for patients with vertical VOR deficits 2,15 . Neither of these documents suggests the size of the target to focus on or if glasses wearers should complete the activity with glasses on or off 2,15 .…”

“…The VOR exercises are lowtech as the patient is often asked to view text on a tongue depressor or post-it note as they move their head while keeping the text in focus. As technology advances, there are now higher-tech applications for monitoring compliance with VOR exercises [3][4][5] . There is no consensus about the correct size optotype for the VOR exercises in these new application-based programs.…”

Smartphone-Assisted Medical Care for Vestibular Dysfunction as a Telehealth Strategy for Digital Therapy Beyond COVID-19: Scoping Review

“…VestAid is an innovative tablet-based system for vestibulo-ocular reflex exercises [ 32 ]. VestAid validated eye-gaze accuracy as part of the study and detected eye movement abnormalities in the participants with directed energy exposure, concussion, and vestibular neuritis [ 33 ]. Although not included in the review as this paper is in the initial evaluation stage of the system, this system is capable of recognizing facial movements and providing rehabilitation for vertigo through games.…”

Leveraging Technology for Vestibular Assessment and Rehabilitation in the Operational Environment: A Scoping Review

“…Whitney et al [20] developed VestAid (BlueHalo, Rockville, MD, USA), a tablet device that utilizes eye and facial recognition software to record head velocities and eyegaze accuracy while patients perform gaze stability exercises. Their small case series demonstrates that advanced technological devices can enhance the precision of clinical measurements for assessment and monitoring of rehabilitation progress.…”