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Application of Vibrotactile Feedback of Body Motion to Improve Rehabilitation in Individuals With Imbalance

Wall, Conrad III PhD

Journal of Neurologic Physical Therapy: June 2010 - Volume 34 - Issue 2 - pp 98-104
doi: 10.1097/NPT.0b013e3181dde6f0
Articles

Background and Purpose: Balance rehabilitation and vestibular or balance prostheses are both emerging fields that have a potential for synergistic interaction. This article reviews vibrotactile prosthetic devices that have been developed to date and ongoing work related to the application of vibrotactile feedback for enhanced postural control. A vibrotactile feedback device developed in the author's laboratory is described.

Methods: Twelve subjects with vestibular hypofunction were tested on a platform that moved randomly in a plane, while receiving vibrotactile feedback in the anteroposterior direction. The feedback allowed subjects to significantly decrease their anteroposterior body tilt but did not change mediolateral tilt. A tandem walking task performed by subjects with vestibulopathies demonstrated a reduction in their mediolateral sway due to vibrotactile feedback of mediolateral body tilt, after controlling for the effects of task learning. Published findings from 2 additional experiments conducted in the laboratories of collaborating physical therapists are summarized.

Results: The Dynamic Gait Index scores in community-dwelling elderly individuals who were prone to falls were significantly improved with the use of mediolateral body tilt feedback.

Discussion and Conclusions: Although more work is needed, these results suggest that vibrotactile tilt feedback of subjects' body motion can be used effectively by physical therapists for balance rehabilitation. A preliminary description of the third-generation device that has been reduced from a vest format to a belt format is described to demonstrate the progressive evolution from research to clinical application.

Department of Otolology and Laryngology, Harvard Medical School, and Jenks Vestibular Diagnostic Laboratory, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts.

Supported by the National Institutes of Health (in part).

Correspondence: Conrad Wall, E-mail: cwall@mit.edu.

© 2010 Neurology Section, APTA