Advancing Remote Vestibular Assessment Technology to Improve the Health of Service Members

Naval service members experience a range of atypical exposures to the vestibular system (a.k.a. “equilibrium” organs). Some of these exposures are known to cause injury (e.g., blast- related overpressure), while others are more poorly understood but have been linked to diminished vestibular performance (e.g., exposure to high accelerations—up to 7x Gravity—in flight). Of particular relevance to the Naval aviator and flight crew, vestibular performance influences head-eye coordination, spatial orientation, and resistance to motion sickness, among other key functions. Unfortunately, optimization of vestibular performance through specific training has remained largely unexplored in Naval aviators, largely because there is a lack of remote-capable or field-based vestibular assessments to inform decisions regarding periodicity of training or prescription of specific vestibular exercises. Moreover, to date, vestibular training approaches have not been designed for optimization within high-demand environments (i.e., naval aviation). Instead, vestibular training has historically been reserved only for those with profound vestibular impairment. Overall, there is a lack of understanding of how routine Naval vestibular exposures alter head-eye coordination, spatial orientation, or other key aspects of warfighter/aviator performance, and there is also poor understanding of how to mitigate subclinical deficits or optimize vestibular performance through training. Therefore, this proposal was developed to enhance the Navy’s vestibular training capabilities, by 1) better understanding vestibular exposures incurred during training and the impact on vestibular performance, 2) advancing technology for precise and routine assessments of vestibular exposures as well as vestibular performance, and 3) developing vestibular training programs aimed at mitigating motion sickness.