Device could aid those with balance problems

To stand, walk, run or ride a bike, people rely greatly on the sensory apparatus of the vestibular system located in the inner ears. The vestibular system allows people to determine the position of their heads and bodies and to keep their balance.

Two million people in the United States live with chronic imbalance as the result of vestibular system malfunction. Imbalance interferes with daily life and increases the risk of falls, which can be deadly in those who are frail.


Joel Goebel, M.D., director of the Dizziness and Balance Center at the School of Medicine, wanted to help people with vestibular malfunction better navigate through their surroundings. So he collaborated on building a device, worn on the head, that alerts wearers that they are leaning so they can upright themselves. The device could benefit people with partial or complete loss of their vestibular function.

Goebel, along with two researchers at Princeton University and two technical experts from Barron Associates Inc., a research and development company, outlined a proposal that won a small business innovation research grant from the NIH, a type of award that backs research with commercial potential. They put together a prototype device based on the theory that a tactile sensation, a touch, could become a substitute for the unconscious senses that normally keep people from falling over.

The early version of the device consists of headgear wired to a computer. The headgear senses how many degrees from vertical the wearer’s head inclines and a connected computer communicates with four mechanical tappers on the sides, front and back of the head. The tappers very gently strike the wearer’s head, tapping slowly for one degree of tilt, fast for two degrees and very fast for three degrees.

In a clinical study conducted by Goebel, the device worked very well. Patients who wore the device were able to avoid falling more often than patients without the device. When device-wearers did fall, it was after a longer time on the platform, and they were better able to use corrective movements of their ankles and hips to remain standing.

The company is now building a more compact version of the device, and Goebel has received funding for a second, more extensive testing phase, which will include patients with a wider range of balance disorders. This study will determine whether performance improves over time and whether the benefit continues after patients stop using the device. Goebel believes a marketable product, a device incorporated into a hat or scarf, could be ready within the next two years.

Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.