Evaluation of a Sensory Enrichment Multimodal Device (SEMD) on Physical Therapy Patients With Disequilibrium

• Sensory Organization Test (SOT) [ Time Frame: Pre Test to Post Test 1 after two physical therapy sessions (one week) ] [ Designated as safety issue: No ]
  Assessment of the efficacy of the SEMD device in improving vestibular function will be evaluated with pre test to post test 1 Sensory Organization Test (SOT.)
  
  
• Sensory Organization Test (SOT) [ Time Frame: Post Test 1 to Post Test 2 after four physical therapy sessions (two weeks) ] [ Designated as safety issue: No ]
  Assessment of the efficacy of the SEMD device in improving vestibular function will be evaluated with pre test to post test 2, and post test 1 to post test 2 Sensory Organization Test (SOT.)
  
  
• Sensory Organization Test (SOT) [ Time Frame: Post Test 2 to Post Test 3 after eight physical therapy sessions (4 weeks) ] [ Designated as safety issue: No ]
  Assessment of the efficacy of the SEMD device in improving vestibular function will be evaluated with pre test to post test 3, and post test 2 to post test 3 Sensory Organization Test (SOT.)
  
  
• Sensory Organization Test (SOT) [ Time Frame: Post Test 3 to Post Test 4 after twelve physical therapy sessions (6 weeks) ] [ Designated as safety issue: No ]
  Assessment of the efficacy of the SEMD device in improving vestibular function will be evaluated with pre test to post test 4, and post test 3 to post test 4 Sensory Organization Test (SOT.)
  
  

• Functional Gait Assessment [ Time Frame: Pre Test, Post Test 1 after two physical therapy sessions, Post Test 2 after four physical therapy sessions, Post Test 3 after eight physical therapy sessions, and Post Test 4 after twelve physical therapy sessions ] [ Designated as safety issue: No ]
  Measurements of transfer of skill(s) to activities of daily living.
  
  
• Self-report Fall(s) Occurrence and Duty/Work Status [ Time Frame: Pre Test, Post Tests 1-5 as above, Phone Follow-up 1 two weeks post intervention, Phone Follow-up 2 eight weeks post intervention, Phone Follow-up 3 eighteen weeks post intervention ] [ Designated as safety issue: No ]
  Skill retention will be evaluated pre intervention to post intervention with a questionnaire devised for this study.
  
  
• Berg Balance Scale [ Time Frame: Pre Test, Post Test 2, Post Test 4 ] [ Designated as safety issue: No ]
  Measurement of transfer of skills to activities of daily living.
  
  
• Vestibular Rehabilitation Benefit Questionnaire [ Time Frame: Pre Test, Post Test 4 ] [ Designated as safety issue: No ]
  Self rated measurement of perceived quality of life.
  
  
• Head Shake Sensory Organization Test (HS_SOT) [ Time Frame: Pre Test, Post Test 1 and Post Test 4 ] [ Designated as safety issue: No ]
  Secondary outcome measurement of vestibular function.
  
  

This study will compare two approaches of physical therapy intervention within vestibular deficit populations that frequently fall: 1. physical therapy plus SEMD, and 2. conventional physical therapy only.

Multimodal sensory cueing gives additional or enriched information to complement postural and mobility decisions. SEMD displays combine vibrotactile, visual and audio cueing that are intuitive and non-intrusive within a balance training system.

Study intervention will include a maximum of 12 physical therapy intervention sessions, 2 times per week for 6 weeks or normalization of SOT, whichever occurs first. Conventional physical therapy prescriptions are written specific for number of sessions over a specific duration of time. Discharge from physical therapy occurs when number of sessions within a specified period of time is exhausted or goals specified by the physical therapist are met. Data collection includes 1 pre test and 4 post tests at intervals during the weeks of intervention, plus 3 follow-up phone interviews at specified intervals after intervention for maximal study duration of 6 months. A patient must attend at least 4 physical therapy intervention sessions for their data to be used and for the follow-up phone interviews to be initiated.