GyroStim Science & Technology
Interactive Multi-sensory Stimulation
Good balance requires the healthy function and integration of sensory systems. Balance treatment strategies that include a multimodal approach with sensory stimulation and dual-tasking challenges at or near the limits of patient capacity improve balance (Conradsson, et al., 2015; McGann 2010). It also requires the ability to perform motor tasks while simultaneously engaged in cognitively demanding tasks (Conradsson, et al., (2015).
Vestibular rehabilitation therapy paradigms that enhance engagement with physical, cognitive, and social stimulation and that include novel and multi-modal stimulation result in better general functional outcomes. (Lacour et al., (2015). Similarly, Wulf et al. (2001) reports improved “motor skill performance and learning when attention is directed to the effect of movement instead of the movement itself.”
McGann (2010) concluded that providing multisensory stimulation during goal-oriented training may help establish sensorimotor contingencies, allowing the learner to be better prepared to process and overcome unfamiliar or unanticipated variables (Maier, 2019), a key component to reducing or eliminating fall risk or injury from a fall.
Ambulating through our world is ‘noisy’ and dynamic, requiring input from multiple sensory systems to maintain balance. “Multisensory reweighting (MSR) is an adaptive process that prioritizes visual, vestibular, and somatosensory inputs to provide the most reliable information for postural stability when environmental conditions change.” (Allison et al., 2006). We “reweight” visual, vestibular, and somatosensory inputs to maintain balance as conditions around us change (Allison, 2018; Nasher et al., 1982, Black et al. 1983, Black et al. 1988).
Impaired multisensory integration can predispose elderly citizens to fall (Yang et al., 2020). In older adults, multisensory reweighting is impaired due to the aging process, especially for fall-prone individuals (Allison, 2018; Horak, 1989, Teasdale et al., 1991; Woolocott, 1986). Research supports that sensory-challenge balance exercises contribute to improved balanced and reduced fall risk (Allison, 2018; Tinetti et al., 1994; Cumming, 2002, Gardner et al., 2000; Sibley et al., 2016). Allison et al. (2018) confirm that MSR impairment in fall-prone elderly adults is reduced following a sensory-challenge balanced-based intervention. Wu et al. (2000) found that goal-oriented movements, such as hitting targets with a laser pointer during 3-dimensional movement through space, improve performance outcomes.
GyroStim is well suited for interactive multi-sensory stimulation therapy. The rotating chair is surrounded by integrated interactive laser detecting targets that may be used for a variety of multisensory stimulation strategies, which is shown to improve balance (Lacour & Bernard-Demanze, 2014). The patient uses a handheld laser pointer to hit stationary targets while the chair is in motion, resulting in dual-tasking challenges that are performed at or near the limits of the patient’s capacity, which is critical for improving balance (Conradsson, et al., (2015).
The laser detecting targets communicate with the system computer to calculate and display a standardized value of hits per minute. Hits-per-minute data provides the clinician with quantifiable information about the patient’s progress and ability to engage with the current level of treatment intensity. The targeting exercise provides interactive visuomotor and visuocognitive exercise, reaction exercise and challenge, spatial awareness and spatial orientation exercise, and a quantifiable measure of target hits-per-minute which can be used for assessing patient progress.
Clinicians may include cognition strategies by instructing the patient to hit as many targets as possible, to hit only specified targets, or to hit targets in a specific sequence --- while the chair is in motion. The laser targets can be strategically marked with numbers, colors, shapes, or other identifiers for added visuocognitive, spatial awareness, and reaction-time exercises. From the patient’s perspective, shooting at targets adds a sense of gamification to the treatment activity. It adds purpose to the treatment, increases patient compliance, and makes GyroStim treatment sessions engaging and fun, all important aspects for improving balance (Birkenmeir et al., 2010).