Vestibular rehab lab 2-compressed

1. Vestibular Rehab Lab Cutting-edge technology for diagnosis and treatment of Vertigo, Dizziness, and Balance Disorders

2. Vestibular Rehabilitation Recommended in the following diseases • Vestibular Neuritis (Acute Unilateral Vestibulopathy) • Labyrinthitis • Unilateral Peripheral Vestibulopathy • Bilateral Peripheral Vestibulopathy • Ototoxicity • Labyrinthine Concussion • Functional Dizziness • PPPD • Otolith disorders • VOR dysfunction • Vestibulospinal dysfunction • Post - BPPV Dizziness • Risk of Fall • Presbyastasis Computerized Dynamic Posturography (CDP) Computerized Dynamic Posturography is an objective and functional evaluation of the postural control system. It determines deficits in balance strategies and helps customize rehabilitation according to the patient’s requirements. It comprises of the following standard tests for assessment and treatment of patients with balance disorders : Tests Included Sensory Organization Test (SOT) : It objectively identifies abnormalities in the patient’s use of the three sensory systems that contribute to postural control - somatosensory, visual and vestibular. Motor Control Test (MCT) : Measures motor responses to unexpected perturbation. Quantification of motor strategies used to prevent falls. Adaptation Test (ADT) : Measures ability to regain balance on disruption of somatosensory input. Useful to teach stabilization strategies to prevent falls. Features Platform with 4 load cells, forward-backward toe-up, and toe-down movement. Automatic storage of data on the cloud. Customized reports with charts for easy viewing and understanding. Integrated with virtual reality. Includes 3 rehabilitation modules.

3. Virtual Reality Based Vestibular Rehabilitation State-of-the-art Rehab Protocols Vestibular Rehabilitation Therapy (VRT) is essential for treatment of various vestibular disorders. NeuroEquilibrium has pioneered Virtual Reality-based VRT exercise protocols designed to help in: • Gaze stabilization • Sensory reorganization • Desensitization and development of alternative compensatory pathways The NeuroEquilibrium VRT suite includes exercises for - • Acrophobia (fear of heights) • Visual vertigo/Agoraphobia • Gaze stabilization • Sea sickness • Motion sickness • VOR & VOR supression exercises • Head & eye coordination The VR-based VRT advantage • Ability to simulate real life dynamic situations • Interactive and engaging • Gamification of exercises improves compliance and helps in quantifying the improvement based on scores • Head movements can be tracked in VR • Immersion therapy for certain phobic and psychogenic disorders • Patient improvement is accelerated Computerized Stabilometry (Posturography) To evaluate postural control Stabilometry is an objective and functional evaluation of the postural control system in its steady-state behaviour. It is also a very good evaluation tool to measure the outcome of vestibular rehabilitation. It consists of the following tests: • Modified Clinical Test of Sensory Interaction of Balance (mCTSIB) • Limits of Stability (LOS) • Rhythmic Weight Shift (RWS) Rehab modules for Limits of stability, Rhythmic weight shift, Balance, Sensory organization etc.

4. GAIT Lab Human gait depends on a complex interplay of diferent systems, including the CNS, vestibular, and musculoskeletal systems. The unique NeuroEquilibrium Gait Lab harnesses the power of computer vision to analyse gait patterns. It helps in devising strategies for rehabilitation and provides an objective tool to follow up on the outcome of rehabilitation. The Gait lab accurately tracks the following parameters: • Step Length • Stride Length • Gait Cycle Duration • Double Support (% of Gait Cycle) • Gait Speed • Cadence • Step Duration • Stance (% of Gait Cycle) • Arm Swing (per cycle) The deficit causing the impairment in gait can be quantified and the rehab outcome can be measured. This helps the clinician & therapist plan rehabilitation strategies. • Swing (% of Gait Cycle) Useful in • Vestibular Disorders • Stroke • Sensory Ataxia • Unsteadiness • Cerebellar Ataxia • Gait Disorder Analysis • Parkinson’s Disease • Fall Risk Assessment Features • 3D reconstruction of patient's gait (sagittal plane) is generated without using markers • Two wide angle cameras with FOV of minimum 80 degrees, 60 fps • Patient's video is recorded in both frontal and sagittal plane with help of a front camera and a side mounted camera • Final video is created by concatenating input frame from both side camera and front camera Advanced Video Nystagmography (VNG) NeuroEquilibrium VNG is the most advanced technology to evaluate the vestibular and oculomotor systems in a non-invasive, accurate and afordable way. This cutting-edge equipment eliminates contamination by myogenic and electrical noise seen in ENG. NeuroEquilibrium Video Nystagmography evaluates peripheral and central vestibular functions through the following protocols: • Spontaneous nystagmus - with & without optic fixation • Gaze evoked nystagmus • Saccades – Random Target Movement • Smooth tracking - with varying frequencies • Optokinetic test • Head shaking test • Caloric test • Positional testing, Dix–Hallpike, Supine Head Roll and Deep Head Hanging • Valsalva and Hyperventilation induced nystagmus • Skew deviation

5. BPPV Maneuver Guidance System Canalith repositioning maneuvers (CRM) are highly efective in the treatment of BPPV. For each involved canal, the appropriate repositioning maneuvers should be performed. For posterior canal BPPV, maneuvers like Epley or Semont are recommended; for horizontal canal BPPV, 360⁰ Roll, Zuma or Gufoni Maneuver are recommended; for anterior canal, BPPV Modified Yacovino maneuver is used. The BPPV Maneuver Guidance System provides information to the clinician about the angle and plane of the head at each step of the repositioning maneuver. The guidance system gives visual feedback about the head angulation and allows the clinician to proceed to the next step only after achieving the desired head position. Each step of the BPPV maneuvers is displayed on a screen, using a 3D model of the human body. Head Orientation is measured with a head band with custom-made sensors (the “tracker”). The system is configured with a waiting period of 30 seconds between each step of the maneuver. This waiting period ensures that the debris reach the desired position in the canal before proceeding to the next step. • BPPV Maneuver Guidance system provides a step-by-step visual guidance for the care giver to carry out the maneuvers for BPPV. The device calculates the angle at each step. Maneuvers Features ? Posterior canal a) Epley Maneuver b) Semont Maneuver c) Semont Plus Maneuver ? Lateral Canal a) 360 Degree Roll Maneuver b) Gufoni Maneuver c) Zuma Maneuver ? Anterior Canal a) Modified Yacovino Maneuver • An animated model of human body which shows the desired head and body movement for each step. • The device visually indicates the head movement and indicates that each step was done correctly with less than +/- 4 degree variation. • The inner ear labyrinth is shown on the screen which moves with the actual head movement. • Adjustable timer for each step.

6. Video Head Impulse Test (VHIT) The VHIT tests function of all 6 semi-circular canals at high frequency. Features • Quick test : 10 minutes to independently test the 6 semi-circular canals • The motion sensor accurately measures head movement allowing for simultaneous comparison of head and eye movement • High frame rate camera (200fps) allows precise tracking of eye movements during head impulse • Lightweight goggle design to reduce slippage (Maximum weight 250 grams) • Built-in lasers that provide stimulus for calibration Dynamic Visual Acuity (DVA) For screening of Vestibular impairment Dynamic Visual Acuity is used for: • Evaluation of the Vestibulo-Ocular Reflex (VOR) • Early detection of Vestibulotoxicity • Detection of Bilateral Peripheral Vestibulopathy • Rehabilitation tool • Assessing outcome of rehabilitation How it works: DVA assesses the function of VOR in maintaining the image, on the fovea of the retina during head movement. Defective VOR results in slippage of the image resulting in blurring of vision.

7. Subjective Visual Vertical (SVV) For detection of abnormal subjective tilt Subjective Visual Vertical (SVV) is an investigation to evaluate the otolith system, which is responsible for perception of verticality. Static and dynamic SVV are important to: • Assess otolithic disorders • Assess chronic dizziness • Decide side of peripheral vestibular insult during the acute stage. • Diagnose compensated vestibular disorders. • Assess efect of rehabilitation Product Specifications • Tubular vision goggle with IMU • Measurment of head angle during testing to ensure correct head position Tests Conducted • Static SVV, head vertical • Static SVV, head inclined at 30 degrees • Dynamically moving background, head vertical Craniocorpography (CCG) Fast and simple investigation NeuroEquilibrium Craniocorpography (CCG)evaluates the vestibulospinal reflex, which is responsible for maintenance of balance during gait testing. The protocols evaluated by CCG include: • Romberg Test • Tandem Walking • Unterberger’s / Fukuda Test

8. Vestibular Assessment Platform Comprehensive and robust The NeuroEquilibrium Vestibular Assessment Platform is the most comprehensive vertigo and balance assessment platform. The platform integrates various diagnostic tests on one platform and helps doctors diagnose and treat vertigo & balance disorders through comprehensive evaluation, customized reporting, one-click patient data retrieval, rehabilitation, and patient monitoring modules. Cloud integration for anywhere access Product Specifications • Comprehensive history module • All reports on one platform • Automatically generates graphs of all parameters with easy visual comparison with normative data • Patient scheduling with SMS reminders, etc. • Data from the tests is automatically and seamlessly saved on the cloud and can be accessed over the internet anywhere in the world. • Allows for easy restoration of data in case the local system crashes. Corporate Ofce : 255 SriGopal Nagar Gopalpura Bypass Road Jaipur 302015 info@neuroequilibrium.in www.neuroequilibrium.in India