Optokinetic (OPK) Stripes Exposure

A web-based application to treat rocking sensations or Persisting Symptoms of Self-motion (PSS-m) related to Mal de DeBarquement (MdDS). Exposure to OPK stripes with head roll (side-to-side, or lateral, head tilts) was originally introduced by Dr. Dai (2014) and has been shown to reduce, if not alleviate, symptoms associated with MdDS. This application is based on the most current available research. The cause and mechanism(s) of recovery remain poorly understood, and more research is needed.

A special thanks to the late Mingjia Dai, Ph.D., and Bernard Cohen, MD, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY. We also thank their colleagues, Dr. Yakushin and Maruta, for their continued efforts in the research of the Dai Protocol for MdDS. You can read the entirety of Dr. Cohen’s dedication to Dr. Dai and Dr. Murat’s dedication to Dr. Cohen by clicking on their names.

We want to thank all the stakeholders dedicated to better understanding MdDS and vestibular-related disorders resulting in PSS-m. Please note this website was replicated per the software app designed by Anton Yakushin, as noted in the License section below. The only modifications to the original software app are (1) the number of stripes across the screen at any given time defaults to 20, (2) the stripe color defaults to black and white, (3) the speed of the stripes has four dropdown options (20, 15, 10, and 7), (4) the metronome defaults to “on,” (5) the metronome frequency defaults to 0.2 Hz, and (6) the full-screen mode defaults to “on.” Despite these defaults, the clinician can manually enter their preferred options. The reasoning is 2-fold: (1) to ease the burden of entering information when prescribing the Dai Protocol to a patient as part of their home program and (2) to streamline the process amongst clinicians in the clinic.

Also of note is that this protocol is used in patients with MdDS-related symptoms but with no identifiable trigger (e.g., prolonged passive motion). Researchers have referenced this as Spontaneous Onset (SO) MdDS (Mucci et al., 2020). It is used with individuals reporting relief of rocking or PSS-m when in motion. It is not used with those who report increased symptoms during movement. Although the Dai protocol has either resolved or decreased symptoms associated with MdDS, it does not work for everyone. The addition of other therapeutic interventions as deemed appropriate may improve outcomes.

Disclaimer

Some individuals may experience visually induced dizziness, photosensitivity, and nausea when exposed to certain patterns, especially optokinetic patterns. Watching this video should not be done without guidance and clearance from a healthcare provider who has training in MdDS and other vestibular-related conditions.

The defaults within the web application were made specifically to meet the needs of the staff at 360 Balance & Dizziness. The supervising healthcare provider can manually enter the specifications as deemed appropriate. This web application is not intended to be used without supervision.

License

360 Dizziness & Balance Center©, 2022. Note: This software app has been redesigned and modified based on the original work of Anton Yakushin©. Per his MIT License Agreement: Permission is granted, free of charge, to any person obtaining a copy of his software and associated documentation files (the “Software”), to deal in the Software without restriction, including without limitation the rights to use, copy, modify, merge, publish, distribute, sublicense, and/or sell copies of the Software, and to permit persons to whom the Software is furnished to do so, subject to including the copyright and permission notice is included in all copies or substantial portions of the Software. His code is open-source and available to everyone on GitHub under the MIT License by Anton Yakushin©.

THE 360 BALANCE & DIZZINESS SOFTWARE IS PROVIDED “AS IS, ” WITHOUT WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT. IN NO EVENT SHALL THE AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES, OR OTHER LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT, OR OTHERWISE, ARISING FROM, OUT OF, OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN THE SOFTWARE.

System Requirements

This application supports the latest versions of browsers on Windows and Mac: Google Chrome, Mozilla Firefox, Internet Explorer 10+, Safari, Opera, and Microsoft Edge. Mobile device support varies by device and vendor (the latest versions of major mobile browsers are typically supported). This application works in browsers that support HTML5 Canvas and requestAnimationFrame(). This application also uses cookies and local browser storage to save settings.

Support

Please report issues and feature requests here If you are reporting a bug, please provide enough information for us to reproduce the issue (a detailed description, screenshot, or screen recording is preferred). Please also indicate your device or operating system.

Terms of Use

By using and/or accessing this web application, you acknowledge and agree that the web application provided is not certified as a medical device and is not intended for any diagnostic use. You further acknowledge and agree that at all times you will use and access such tools solely in connection with your clinical training; (xi) in compliance with all applicable laws and regulations; and (xii) in accordance with any user documentation we provide to you.  At no time shall this web application be used to (xii) diagnose; (xiii) be a substitute for professional medical advice, diagnosis or treatments, or (ix) replace any diagnosis, recommendation, advice, treatment or decision by another appropriately trained and licensed provider. The use of this web application should fall within the scope of practice of the provider/user. 

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