Usefulness of Mobile Devices in the Diagnosis and Rehabilitation of Patients with Dizziness and Balance Disorders: A State of the Art Review

Abstract

Objective

The gold standard for objective body posture examination is posturography. Body movements are detected through the use of force platforms that assess static and dynamic balance (conventional posturography). In recent years, new technologies like wearable sensors (mobile posturography) have been applied during complex dynamic activities to diagnose and rehabilitate balance disorders. They are used in healthy people, especially in the aging population, for detecting falls in the older adults, in the rehabilitation of different neurological, osteoarticular, and muscular system diseases, and in vestibular disorders. Mobile devices are portable, lightweight, and less expensive than conventional posturography. The vibrotactile system can consist of an accelerometer (linear acceleration measurement), gyroscopes (angular acceleration measurement), and magnetometers (heading measurement, relative to the Earth’s magnetic field). The sensors may be mounted to the trunk (most often in the lumbar region of the spine, and the pelvis), wrists, arms, sternum, feet, or shins. Some static and dynamic clinical tests have been performed with the use of wearable sensors. Smartphones are widely used as a mobile computing platform and to evaluate the results or monitor the patient during the movement and rehabilitation. There are various mobile applications for smartphone-based balance systems. Future research should focus on validating the sensitivity and reliability of mobile device measurements compared to conventional posturography.

Conclusion

Smartphone based mobile devices are limited to one sensor lumbar level posturography and offer basic clinical evaluation. Single or multi sensor mobile posturography is available from different manufacturers and offers single to multi-level measurements, providing more data and in some instances even performing sophisticated clinical balance tests.

Keywords:

• mobile posturography
• dizziness
• imbalance
• clinical tests with sensors
• telephone applications
• older adults

Acknowledgments

This research was funded by NCBiR, STRATEGMED 2/266299/19NCBR/201.

Abbreviations

COP, center of pressure; COM, center of mass; CDP, computerized dynamic posturography; IMU, inertial measurement unit; SP, smartphone; PD, Parkinson disease; MS, multiple sclerosis; BESS, balance error scoring system; iCTSIB, Clinical Test of Sensory Integration for Balance; SOT, sensory organization test; TUG, Timed Up and Go test; BBS, Berg Balance Scale; app, smartphone application.

Disclosure

The authors report no conflicts of interest in this work.