Rock Steady- A mobile, gamified vestibular rehabilitation tool for olderadults with complaints of dizziness

Project Summary The long-term objective of this SBIR application is to develop and test Rock Steady, a software application for older adults with dizziness. This product is relevant to the mission of the NIDCD because it addresses the request for, “the development of technologies for the study, diagnosis, and treatment of balance disorders, particularly for the elderly”. The envisioned product is an elegantly simple mobile application that is designed to evaluate impairment, track symptoms, and measure adherence to gaze stability home exercise programs which are based on recommendations from the 2016 Clinical Practice Guidelines for Vestibular Rehabilitation. Rock Steady was conceived in response to four main limitations in the current VRT healthcare delivery model: 1) access, 2) the need for developing engaging exercise programs that will improve adherence to VRT, 3) poor performance, and 4) absence of remote monitoring capabilities. This application is very timely given the ever-enlarging older adult population and the ease of dissemination via smart tablets/PCs which are being adopted by older adults at faster rates than ever before. Deploying the app on common digital technology will ensure its widespread adoption. Finally, it will be designed with feedback from all stakeholder groups including people with vestibular dysfunction. The objective of Phase II is to complete the research and development of gamified gaze stability exercises and to conduct an exploratory pilot study to gather data about Rock Steadyandapos;s ability to address current limitations in the standard VRT delivery model; and to gather data that will inform the design of a future randomized clinical trial (RCT). Phase I Progress: We developed the Rock Steady prototype and evaluated its reliability, validity and usability, integrated eye/head tracking, obtained feedback from stakeholders (clinicians and patients) and identified and evaluated content expansions for Rock Steady. Phase 2 Aims. Specific Aim 1: Complete development of Rock Steady based on results from Phase 1, and Specific Aim 2: Conduct an exploratory pilot study to gather data about Rock Steadyandapos;s ability to address current limitations in the standard VRT delivery model; and to gather data that will inform the design of a future randomized clinical trial (RCT). Research Design: The pilot will be a randomized pre- test/post-test parallel group trial; participants will receive either A) standard vestibular rehabilitation (S-VRT) or B) digital vestibular rehabilitation using the Rock Steady app (D-VRT) to use at home for 4 weeks. Outcomes will be collected: pre- and post-test sessions. Outcomes: We will use semi-structured interviews, usability surveys, functional outcomes and game/sensor outcomes to evaluate Rock Steady. Expected Outcomes: We believe that Rock Steady will provide appropriate feedback to patients and clinicians, improve adherence, be usable, enable remote monitoring and be feasibly used as part of a home exercise program that positively impacts function in adults with dizziness.Project Narrative This proposal describes the development of Rock Steady, a novel approach to fall risk reduction through digital assessment and guided exercises for older adults with balance impairments due to dizziness. Rock Steady offers opportunities for improved management of fall risk, improved quality of life, and health care cost containment in elderly populations.