{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:39:04Z","timestamp":1792071544998,"version":"4.4.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Vertigo, dizziness, gaze instability and disequilibrium are highly prevalent in people with MS (PwMS) and head movement induced dizziness is commonly reported. Vestibular physical therapy (VPT) is a specialised, non-invasive and effective therapy for these problems but usually involves travel for the person to a specialist center with both personal and carbon costs. The use of wearable sensors to track head movement and smartphone applications to deliver and track programs has potential to improve VPT in MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study investigated the usability and effects of a commercially available digital VPT system (wearable head sensor, smartphone app and clinician software) to deliver VPT to PwMS. A pre\/post treatment design was employed and the primary outcome was the System Usability Scale (SUS). Other patient reported outcomes were the Service User Acceptability Questionnaire (SUTAQ), the Patient Enablement Instrument (PEI) and the Dizziness Handicap Inventory (DHI). Physical outcomes measurements included Mini-BESTest (MB), Modified Dynamic Gait Index (mDGI), Gait Speed (GS), Dynamic Visual Acuity (DVA) and head kinematics and symptoms during exercise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen PwMS (14 female), mean age 44(\u00b114) years were recruited to the study and twelve completed VPT. Mean adherence to exercise, measured digitally was 60% (\u00b118.4). SUS scores were high at 81 (\u00b114) and SUTAQ scores also demonstrated high levels of satisfaction and acceptability of the system. Statistically significant improvements in MB (mean change 2.25; <jats:italic>p<\/jats:italic>\u2009=\u20090.004), mDGI (median change 1.00; <jats:italic>p<\/jats:italic>\u2009=\u20090.008), DVA (median change \u22121.00; <jats:italic>p<\/jats:italic>\u2009=\u20090.004) were found. Head frequencies significantly improved with concurrent decreased intensity of dizziness during head movements (mean change across 4 gaze stabilization exercises was 23 beats per minute; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). Non-significant improvements were seen in DHI (<jats:italic>p<\/jats:italic>\u2009=\u20090.07) and GS (<jats:italic>p<\/jats:italic>\u2009=\u20090.15). 64.5% of follow up visits were conducted remotely (video or phone), facilitated by the system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This study had two main outcomes and benefits for PwMS. Firstly, we showed that the system used was both acceptable and could be used by PwMS. Secondly, we demonstrated an improvement in a range of dizziness, balance and gait metrics with remotely delivered care. This system has the potential to positively impact on MS physiotherapy service provision with the potential to deliver effective remote care.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fresc.2024.1406926","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T13:42:23Z","timestamp":1720618943000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Wearable sensor and smartphone assisted vestibular physical therapy for multiple sclerosis: usability and outcomes"],"prefix":"10.3389","volume":"5","author":[{"given":"D.","family":"Meldrum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Kearney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hutchinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"McCarthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Quinn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"key":"B1","year":"2024"},{"key":"B2","doi-asserted-by":"publisher","first-page":"874388","DOI":"10.3389\/fneur.2022.874388","article-title":"Cerebellar and\/or brainstem lesions indicate poor prognosis in multiple sclerosis: a systematic review","volume":"13","author":"Yang","year":"2022","journal-title":"Front Neurol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e060540","DOI":"10.1136\/bmjopen-2021-060540","article-title":"Effects of multiple sclerosis on the audio-vestibular system: a systematic review","volume":"12","author":"Gur","year":"2022","journal-title":"BMJ Open"},{"key":"B4","first-page":"139","article-title":"Vestibular findings in relapsing, remitting multiple sclerosis: a study of thirty patients","volume":"14","author":"Zeigelboim","year":"2008","journal-title":"Int Tinnitus J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"469","DOI":"10.3233\/VES-160593","article-title":"Gaze stabilization and dynamic visual acuity in people with multiple sclerosis","volume":"26","author":"Manago","year":"2016","journal-title":"J Vestib Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.3390\/brainsci12111519","article-title":"Greater disability is associated with worse vestibular and compensatory oculomotor functions in people living with multiple sclerosis","volume":"12","author":"Grove","year":"2022","journal-title":"Brain Sci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"25","DOI":"10.2147\/dnnd.s135755","article-title":"Spotlight on postural control in patients with multiple sclerosis","volume":"8","author":"Prosperini","year":"2018","journal-title":"Degener Neurol Neuromuscul Dis"},{"key":"B8","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1177\/0269215517730597","article-title":"Falls in people with multiple sclerosis: experiences of 115 fall situations","volume":"32","author":"Carling","year":"2018","journal-title":"Clin Rehabil"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1016\/j.apmr.2015.05.018","article-title":"Systematic review: the effectiveness of interventions to reduce falls and improve balance in adults with multiple sclerosis","volume":"96","author":"Gunn","year":"2015","journal-title":"Arch Phys Med Rehabil"},{"key":"B10","first-page":"466","article-title":"Is customized vestibular rehabilitation effective in patients with multiple sclerosis? 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