Lubetzky Anat V, Hujsak Bryan D, Kelly Jennifer L, Fu Gene, Perlin Ken
New York University, Department of Physical Therapy, Steinhardt School of Culture Education and Human Development, 380 2nd Ave, New York, NY 10010(∗).
Vestibular Rehabilitation, The Ear Institute, Hearing and Balance Center, The New York Eye and Ear Infirmary of Mount Sinai, New York, NY(†).
PM R. 2018 Nov;10(11):1223-1236.e2. doi: 10.1016/j.pmrj.2018.07.001.
Deficits in sensory integration and fear of falling in complex environments contribute to decreased participation of adults with vestibular disorders. With recent advances in virtual reality technology, head-mounted displays are affordable and allow manipulation of the environment to test postural responses to visual changes.
To develop an assessment of static and dynamic balance with the Oculus Rift and (1) to assess test-retest reliability of each scene in adults with and without vestibular hypofunction; (2) to describe changes in directional path and sample entropy in response to changes in visuals and surface and compare between groups; and (3) to evaluate the relation between balance performance and self-reported disability and balance confidence.
Test-retest, blocked-randomized experimental design.
Research laboratory.
Twenty-five adults with vestibular hypofunction and 16 age- and sex-matched adults.
Participants stood on the floor or stability trainers while wearing the Oculus Rift. For 3 moving "stars" scenes, they stood naturally. For a "park" scene, they were asked to avoid a virtual ball. The protocol was repeated 1-4 weeks later.
Anteroposterior and mediolateral center-of-pressure directional path and sample entropy were derived from a force plate.
We observed good to excellent reliability in the 2 groups, with most intraclass correlations above 0.8 and only 2 at approximately 0.4. The vestibular group had higher directional path for the stars scenes and lower directional path for the park scene compared with controls, with large variability in the 2 groups. Sample entropy decreased with more challenging environments. In the vestibular group, less balance confidence strongly correlated with more sway for the stars scenes and less sway for the park scene.
Virtual reality paradigms can shed light on the control mechanism of static and dynamic postural control. Clinical utility and implementation of our portable Oculus Rift assessment should be further studied.
II.
感觉统合缺陷以及在复杂环境中对跌倒的恐惧导致前庭疾病成人的参与度降低。随着虚拟现实技术的最新进展，头戴式显示器价格实惠，并且能够操控环境以测试对视觉变化的姿势反应。
使用Oculus Rift开发一种静态和动态平衡评估方法，并（1）评估前庭功能减退和未减退的成年人中每个场景的重测信度；（2）描述方向路径和样本熵随视觉和表面变化的变化情况，并在组间进行比较；（3）评估平衡表现与自我报告的残疾和平衡信心之间的关系。
重测、分组随机实验设计。
研究实验室。
25名前庭功能减退的成年人以及16名年龄和性别匹配的成年人。
参与者佩戴Oculus Rift时站在地面或稳定训练器上。对于3个移动“星星”场景，他们自然站立。对于“公园”场景，要求他们避开一个虚拟球。该方案在1 - 4周后重复进行。
从测力板得出前后和内外侧压力中心的方向路径和样本熵。
我们在两组中观察到了良好到优秀的信度，大多数组内相关系数高于0.8，只有2个约为0.4。与对照组相比，前庭组在星星场景中的方向路径更高，在公园场景中的方向路径更低，两组的变异性都很大。样本熵随着环境挑战性增加而降低。在前庭组中，平衡信心较低与星星场景中更多的摆动以及公园场景中较少的摆动密切相关。
虚拟现实范式可以阐明静态和动态姿势控制的机制。我们便携式Oculus Rift评估的临床实用性和实施应进一步研究。
II级。
