Wearable Systems for Evaluating Vestibular and Balance Disorders: A Review

The vestibular system regulates gaze stabilization, postural balance, and spatial orientation, which are all essential for daily activities. Vestibular rehabilitation therapy (VRT) helps patients with vestibular hypofunction (VH) compensate for lost function. While existing VRT tests provide valuable functional data, their size and lack of portability limit them to clinical settings. Wearable systems offer a solution by enabling continuous, objective data collection and facilitating personalized home care. Hence, this review examines the current state of wearable systems for assessing and managing VH by synthesizing relevant studies, comparing technologies, and identifying future directions. It outlines key components of wearable vestibular monitoring systems, including eye movement monitoring, body movement tracking and data processing systems. A selection of case studies are used to demonstrate real-world applications of these systems in both clinical and non-clinical settings. The studies are categorized based on methodology and validation depth: single-modality and multimodal sensors, advanced algorithms and clinically validated studies. The reviewed studies were evaluated for methodological rigor and effectiveness through a quality assessment rubric and an effectiveness evaluation framework. The review concludes by highlighting technological gaps and future prospects in wearable vestibular monitoring, emphasizing the potential for improved patient outcomes through more accessible and precise data collection.