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Extended Reality-Based Proof-of-Concept for Clinical Assessment Balance and Postural Disorders for Personalized

Fabiano Bini1, Michela Franzò2, Alessia Finti1

  • 1Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy.

Bioengineering (Basel, Switzerland)
|August 28, 2025
PubMed
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This study shows a new mixed reality (MR) system using advanced technology for balance assessment. The multimodal framework effectively measures postural control in healthy individuals, showing potential for clinical balance disorder evaluation.

Area of Science:

  • Biomedical Engineering
  • Human Movement Science
  • Virtual Reality in Healthcare

Background:

  • Traditional balance and postural disorder assessments include Subjective Visual Vertical (SVV) and Limit of Stability (LOS) tests.
  • Extended Reality (XR) offers advanced technological solutions for enhanced stability evaluation.
  • Current methods highlight the need for innovative tools in clinical balance assessment.

Purpose of the Study:

  • To assess the feasibility and clinical utility of a novel Mixed Reality (MR)-based framework for multimodal balance assessment.
  • To introduce and evaluate an Innovative Dynamic Balance Assessment (IDBA) test.
  • To integrate HoloLens 2, Wii Balance Board, and Azure Kinect for comprehensive balance evaluation.

Main Methods:

  • Development of an MR-based framework integrating HoloLens 2, Wii Balance Board, and Azure Kinect.
Keywords:
balance assessmentbalance disordersextended realityrehabilitationvestibular pathology

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  • Introduction of the Innovative Dynamic Balance Assessment (IDBA) test.
  • Administration of an MR version of the Subjective Visual Vertical (SVV) test to healthy individuals.
  • Main Results:

    • Participants' SVV deviations were within the accepted clinical range (±2°).
    • The IDBA demonstrated consistent sway and angular profiles, with significant differences in posture control between directions.
    • The integrated system provided consistent outputs and a comprehensive view of postural strategies.

    Conclusions:

    • The MR-based framework successfully provided integrated, multimodal measurements of postural control.
    • Findings support the framework's potential for clinical applications in balance disorder assessment.
    • The system shows promise for personalized rehabilitation strategies in patients with balance impairments.