Vestibular rehabilitation has been proven to be effective in reducing dizziness and falls in elderly, but patient adherence is a major problem. Recent research shows that less than half of patients complete their rehabilitation. Some of the main reasons for this are the numerous visits that are required and accessibility. In particular for elderly who experience dizziness and/or falls, it may be difficult to travel to attend rehabilitation sessions. In addition, rehabilitation programs become expensive in terms of equipment and health professional's time. Programs may also not be available to all that may benefit because of geographical limitations. Previous research has shown that remote monitoring and gaming elements have great potential to solve these issues, even in an elderly population. Current solutions are however generic and effectiveness can be inconsistent. The overall goal of this project is to develop a vestibular rehabilitation app for the elderly that will improve adherence through gaming, self-management, and remote monitoring. Specifically, we will develop games that are controlled by low-cost sensors that are placed on the patients' body (head and waist). This allows simultaneous monitoring of patient progress while performing the exercises. These data can be shared with a clinician via email or the cloud, allowing the patient to perform the rehabilitation at their home. This removes one of the main obstacles to patient adherence. The vestibular rehabilitation components will be packaged in a phone or tablet app that is easy to navigate for elderly and has a modular design that allows individualized rehabilitation. The app will be designed to improve patient engagement with rehabilitation and improve enjoyment with the aim to further improve adherence to rehabilitation. This project will use an approach that is novel in that it develops rehabilitation games that specifically target vestibular rehabilitation and incorporates this in an app that is targeting an elderly population. Current approaches typically use existing or commercial games. The use of sensors for remote monitoring is also novel in this area and allows patients to perform rehabilitation at their home, while being monitored by a clinician. This project is therefore likely to have a high clinical impact. It could advance clinical practice and make vestibular rehabilitation more accessible to elderly and help adherence to programs. On the longer term this will reduce falls and improve quality of life of elderly.
The overall goal of this project is to develop an app for the elderly that will improve accessibility of vestibular rehabilitation and that will improve compliance compared to current rehabilitation programs. We will use a novel approach that will combine low-cost inertial sensors with smart-phone or tablet technology to measure performance and present this in a comprehensible way to the clinician via email or the cloud, removing the patients' need to travel for rehabilitation sessions. This will be packaged in an app that is easy to navigate and will use gaming elements developed for vestibular rehabilitation, and appropriate and appealing to the elderly target group to improve compliance, opposed to current rehabilitation that, if using balance games, uses existing commercial games targeting a younger group.
