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

Korak Sarkar; Kathleen Delpy; Summer Skelton; Alec Slayden; Nicole R Villemarette-Pittman

doi:10.3389/fmed.2026.1766706

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

Front Med (Lausanne). 2026 Mar 4:13:1766706. doi: 10.3389/fmed.2026.1766706. eCollection 2026.

Authors

Korak Sarkar^{1

2

3

4

5

6

7}, Kathleen Delpy^{1

2}, Summer Skelton^{1

3

4}, Alec Slayden^{1

3

4}, Nicole R Villemarette-Pittman^{1

2

3

4

6

7}

Affiliations

¹ Ochsner Clinic Foundation, New Orleans, LA, United States.
² Ochsner Neuroscience Institute, New Orleans, LA, United States.
³ Ochsner Academics & Research, New Orleans, LA, United States.
⁴ Ochsner Biodesign Lab, New Orleans, LA, United States.
⁵ Physical Medicine and Rehabilitation Service Southeast Louisiana Veterans Health Care System, New Orleans, LA, United States.
⁶ University of Queensland School of Medicine, Brisbane, QLD, Australia.
⁷ Xavier Ochsner College of Medicine, New Orleans, LA, United States.

Abstract

Background: 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.

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

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: medical extended reality; neurology; physical therapy; vestibular; virtual reality.