Use of Technology for Exercise Prescription Among Persons With Dizziness: A Mixed-Methods Study.

Area of Science:

• Vestibular Rehabilitation
• Digital Health Technology
• Clinical Decision Support

Background:

• Dizziness and vestibular disorders significantly impact quality of life.
• Vestibulo-ocular reflex (VOR) exercises are crucial for managing dizziness.
• Current VOR exercise progression relies on subjective clinical judgment.

Purpose of the Study:

• To assess the consistency of clinical decisions made by physical therapists (PTs) using VestAid's exercise performance report (EPR) versus video recordings.
• To evaluate the influence of clinical experience on PTs' decision-making agreement regarding VOR exercise progression.
• To determine if the VestAid EPR provides sufficient information for clinical judgment on exercise advancement.

Main Methods:

• Thirty PTs with varying experience levels viewed 12 videos and corresponding EPRs of patients performing VORx1 exercises.
• EPRs included gaze fixation, symptom reports, and head speed compliance data.
• PTs decided whether to progress, regress, or maintain the current exercise program.

Main Results:

• Agreement among PTs was higher using the EPR (71.1%) compared to video alone (60%).
• No significant differences in agreement were found across different levels of clinical experience.
• PTs with <5 years of experience unanimously found the EPR sufficient for exercise progression, unlike more experienced PTs (67%).

Conclusions:

• VestAid's EPR provides objective data comparable to video for clinical decision-making in VOR exercise management.
• The technology enhances insights into gaze fixation and head speed, aiding clinical judgment.
• Further research is needed to validate the impact of objective VOR outcome metrics on patient recovery and establish clear progression guidelines.