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Anat V. Lubetzky, Daphna Harel, Helene Darmanin and Ken Perlin

Substantial advances in virtual reality technology open an exciting window toward better understanding of subdomains of balance control. Here, we studied whether a portable virtual reality headset can be used to test sensory integration for balance. Twenty young adults stood on a both-sides-up ball or floor. Moving spheres were projected from an Oculus Development Kit 2 at various amplitudes and frequencies. Participants’ gains indicated visual “weighting” when standing on both-sides-up but not on the floor and “reweighting” with increased visual amplitude. Intraclass correlations showed acceptable to good reliability for all floor conditions and for some of the both-sides-up conditions when we repeated the protocol a week later. Future steps to further develop our paradigm into a clinical assessment of sensory integration for postural control are discussed.

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Anat V. Lubetzky, Bryan D. Hujsak, Gene Fu and Ken Perlin

Postural sway does not differentiate between balance disorders. Head kinematics within a salient, immersive environment could potentially help identifying movement patterns that are unique to vestibular dysfunction. We describe a virtual park scene, where participants are asked to avoid a virtual ball approaching their head, to target dynamic balance and quantify head movement strategy. Sixteen patients with vestibular dysfunction and 16 healthy controls were wearing the Oculus Rift and performed the “park” scene on floor and stability trainers. Significant between-group differences emerged in head path (patients rotated their head sideways more), head acceleration (controls had higher acceleration, especially on translation movements), and peak frequency (controls peaked around the frequency of the ball whereas patients were variable). Those findings demonstrated good to excellent test–retest reliability. There were no significant between-group differences in postural sway parameters. Future studies should establish norms across different levels of balance dysfunction and investigate the underlying mechanism leading to the movement strategy observed.