# Design and preliminary evaluation of a VR-based optokinetic stimuli system for vestibular rehabilitation: insights from clinical end users

## TL;DR

This paper presents a VR-based optokinetic stimuli system for vestibular rehabilitation and gathers feedback from clinicians on its potential use and improvements.

## Contribution

The study introduces a VR-based optokinetic virtual environment and provides insights from clinicians on its usability and areas for improvement.

## Key findings

- Clinicians rated the likelihood of using the OVE highly, with median Likert scores of 9.
- Five key themes for improvement were identified: usability, customization, realism, measurement preferences, and implementation barriers.
- Future studies will test the improved OVE with patients to evaluate its effectiveness.

## Abstract

Vestibular therapy is essential for treating dizziness and balance disorders. There is growing evidence supporting the benefits of incorporating Virtual Reality (VR) into vestibular therapies.

To gather feedback from neuro-rehabilitation specialists on an optokinetic virtual environment (OVE).

An OVE modeled after the traditional optokinetic drum was developed for commercially available VR headsets and tested by practicing vestibular therapists. Participants completed a Likert-based survey and semi-structured interviews to assess their perceptions of the OVE. Qualitative data were analyzed thematically.

Ten therapists with an average of 9 years of clinical experience (range: 3–15 years) participated from October 2024 to March 2025. The likelihood of using the OVE in clinical practice was rated highly, with Likert scores ranging from 6 to10 (median = 9), where 10 indicated a high likelihood. Five key themes emerged for potential improvements: (1) Clinical Usability and Setup, (2) Control and Customization, (3) Immersive Design and Realism, (4) Output and Measurement Preferences, and (5) Implementation Barriers.

Vestibular rehabilitation clinicians expressed strong interest in utilizing VR-based optokinetic stimuli. Feedback from this study will inform iterative, user-focused application improvements. Future studies will test the improved OVE with patients to evaluate tolerance, efficacy, and usability.