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The Vestibular System01:29

The Vestibular System

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The vestibular system is a set of inner ear structures that provide a sense of balance and spatial orientation. This system is comprised of structures within the labyrinth of the inner ear, including the cochlea and two otolith organs—the utricle and saccule. The labyrinth also contains three semicircular canals—superior, posterior, and horizontal—that are oriented on different planes.
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Virtual Reality Application for Vestibular/Ocular Motor Screening: Current Clinical Protocol Versus a Novel

Philip Pavilionis1, Isayas Berhe Adhanom2, Ryan Moran3

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Virtual reality (VR) vestibular/ocular motor screening (VOMS) may reduce false positives in concussion assessment. VR VOMS is stable between sexes and may offer standardized administration for sport-related concussion (SRC) evaluations.

Keywords:
VOMSbaselineconcussionvirtual reality

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Area of Science:

  • Sports Medicine
  • Neurology
  • Ophthalmology

Background:

  • Virtual reality (VR) is explored for sport-related concussion (SRC) assessments.
  • Some individuals experience VR-related symptoms, potentially hindering vestibular/ocular motor screening (VOMS) use.
  • Baseline VR VOMS symptomatology can differentiate baseline from overall symptoms.

Purpose of the Study:

  • To compare symptom provocation change score (SPCS) and near point of convergence (NPC) in manual VOMS (MAN), prototype (PRO), and VR.
  • To assess sex differences in VOMS administration across MAN, PRO, and VR methods.

Main Methods:

  • A cohort study involving 688 NCAA Division I student-athletes over three years (2019-2021).
  • Athletes completed VOMS via MAN (N=111), PRO (N=365), and VR (N=212) during annual baseline testing.
  • Exclusion criteria included motion sickness, neurological issues, ADHD, learning disabilities, or uncorrected vision impairment.

Main Results:

  • MAN showed significantly higher baseline and overall SPCS compared to PRO and VR (P < 0.01).
  • VR demonstrated significantly greater NPC average measurements than MAN and PRO (P < 0.01).
  • Female athletes reported greater SPCS with PRO (P < 0.01), but no significant sex differences were found for VR or MAN.

Conclusions:

  • Administering VOMS via VR may not elicit additional symptoms, potentially reducing false positives.
  • VR VOMS administration appears relatively stable between sexes.
  • VOMS standardization and reduction of false positives are potential benefits for concussion assessment.