An iPhone stuck to the bottom of a plastic bucket doesn’t sound that techy, but that’s all it takes to cost effectively diagnose vestibular conditions in children, according to physicians at Boston Children’s Hospital who recently validated the technique in a paper published in the International Journal of Pediatric Otorhinolaryngology.
Vestibular conditions can affect children’s sense of balance, though similar symptoms can be caused by the heart, the brain, the eyes, or the inner ear.
The study that tested the app with 39 children with balance problems correctly identified the six patients with inner ear vestibular problems.“One of the toughest things to figure out is, is it a problem with the vestibular system, or is it part of something else, a heart problem or an eye problem?” said Dr. Jacob Brodsky, director of the Balance and Vestibular Program at Boston Children’s Hospital. “Then, the next challenging part is determining whether it is an inner ear problem or a central vestibular disorder – a problem with the brain.”
Traditionally, the test for pinpointing inner ear problems requires putting the patient in a darkened room, to shut out all outside stimuli, and showing them a not-quite-straight line. The patient is then given a remote and asked to adjust the line until it’s straight.
The system involving an iPhone and the bucket, developed by Australian clinician Matthew Holmes, replaces the darkened room with a bucket held up to the patient’s face. The test relies on the phone’s built-in gyroscope, asking the patient to rotate the bucket to straighten the line on the iPhone’s screen. This setup is more portable than the traditional test, allowing pediatricians, neurologists and otolaryngologists to have it on hand, when needed. All they need is a bucket, the iPhone and the app that costs $18.
The study that tested the app with 39 children with balance problems correctly identified the six patients with inner ear vestibular problems. Other pediatric vestibular programs are now evaluating the app for additional use cases, like testing balance in children with concussions.