Game-based at-home vestibular rehabilitation tailored for military service members

Vestibular conditions are common among civilians and service members. These conditions limit activities of daily living and can reduce readiness and delay return to duty. Vestibular rehabilitation is effective at resolving symptoms, but adherence to at-home exercises is critical to achieving successful outcomes. Lack of engagement and incorrect performance of prescribed exercises limits compliance and greatly reduces the effectiveness of traditional vestibular rehabilitation programs. Thus, there is a strong need for rehabilitation approaches which can improve engagement, accuracy, and compliance.   Exercise gamification has been shown to be an effective approach to improving rehabilitation compliance. The research team has previously utilized a user-driven design approach to develop VestRx™, a novel at-home vestibular rehabilitation system targeted for older adults. The system consists of a smartphone/tablet app and a web-based clinician interface. The application includes rehabilitation games that are controlled using state-of-the-art motion capture algorithms leveraging the front facing camera on the mobile device. Using the same motion capture data, the app uses machine learning models to identify movement errors and provide feedback to ensure the exercises are performed safely and effectively. The clinician interface can be accessed on a PC or mobile device through a secure web portal and allows for changes to prescription and tracking of the rehabilitation program.   The proposed project will leverage a user-driven design approach to tailor the existing VestRx™ system to the specific needs and preferences of the military population (VestRX-MIL). As part of this effort we will: 1) develop new games based on military clinician recommended exercises and military-relevant themes and gameplay, 2) update the clinician interface to meet the specific needs of military clinicians, 3) improve the motion capture capabilities to work with the more complex and dynamic movements, and 4) develop machine learning algorithms to detect movement errors while completing the exercises.   To accomplish this project, we will develop VestRX-MIL in three phases. We will first identify user needs and preferences by demonstrating the existing VestRx™ for military patients and clinicians and collecting both quantitative and qualitative feedback. This initial feedback will establish the initial design parameters for our prototype development. We will conduct prototype testing to identify areas to further refine prior to final end-user in-lab and take-home testing. By conducting multiple rounds of development and testing in addition to engaging stakeholders throughout the entire development process, we will ensure that the final product meets the unique requirements of service members and improve the likelihood for future adoption.