PhysioSensing Otoneuro System: Balance Assessment and Vestibular Rehabilitation With VR

The PhysioSensing Otoneuro System is an all-in-one vestibular rehabilitation and balance assessment system that combines force plate posturography, an inertial sensor, and immersive virtual reality (VR) in one software-driven workflow. It lets clinicians assess the vestibulo-ocular reflex (VOR), visual-vestibular integration, cervical proprioception, and postural control, then deliver targeted, engaging therapy with automated reports to track patient progress, all without switching between separate systems.

The system is a CE-marked Class I medical device under the EU Medical Device Regulation (MDR 2017/745), and ISO 13485, the quality management standard for medical device manufacturers, is applied. It carries a Unique Device Identification (UDI-DI) number and a 2-year warranty.

iHear supplies the Otoneuro System in the UAE for ENT clinics, otoneurologists and neurotologists, audiologists, vestibular physiotherapists, rehabilitation centers, and universities and research groups.

Download the Otoneuro System Brochure (PDF)
Component Key Specifications
Force plate 55 × 55 × 3 cm, 8.5 kg, maximum load 250 kg, 100 Hz sampling rate, 24-bit analog-to-digital conversion
Inertial sensor 3-axis accelerometer, magnetometer, and gyroscope; about 100 Hz sampling rate (around 100 acquisitions per second); USB connection
Virtual reality (VR) headset Meta Quest 3S; 1832 × 1920 resolution per eye; 96° horizontal / 90° vertical field of view; 120 Hz refresh rate; battery life of about 2.5 hours
Screen (Complete configuration) 65-inch 4K Ultra HD (3840 × 2160) display, 144 Hz refresh rate
Minimum PC requirements Intel i5 processor (2.5 GHz, 6 performance cores; avoid "U" and "G7" versions), 16 GB RAM, 8 GB graphics card, Windows 10 or 11 (64-bit)
Regulatory status CE-marked Class I medical device under the EU Medical Device Regulation (MDR 2017/745); ISO 13485 applied
Warranty 2 years

Otoneuro System: An All-in-One Platform for Balance Assessment and Vestibular Rehabilitation With VR

The integrated solution for the diagnosis and treatment of balance disorders is designed for robust clinical decision-making.
An advanced system that combines balance analysis, virtual reality, and sensors to provide an accurate and effective experience in evaluating and treating dizziness and balance problems. Physiosensing Otoneuro combines posture measurement using a force plate, inertial sensor, and immersive virtual reality into a single software-powered workflow. Clinicians assess the vestibulo-visual reflex, visual-vestibular integration, proprioception in the neck, and postural control, then provide targeted, engaging treatment with automated reports to track progress.
The PhysioSensing Otoneuro System represents a new generation of technology to evaluate and rehabilitate the vestibular system, enabling doctors to view balance in a whole new way.
Thanks to the combination of high-precision inertial sensors, a force board, virtual reality technology and intelligent software, the system turns complex postural responses into clear, objective and actionable clinical insights.

PhysioSensing Otoneuro System Balance Assessment and Vestibular Rehabilitation With VR
PhysioSensing Otoneuro System Balance Assessment and Vestibular Rehabilitation With VR

Designed specifically for auditory neurologists, physical therapists, and balance rehabilitation specialists, the Otoneuro System enables accurate assessment of postural control, limits of stability, and dynamic balance in realistic clinical conditions. Its standardized protocols support accurate diagnosis, development of personalized treatment plans, and confident monitoring of patient progress over time.
The system is quick and easy to set up and use, and integrates seamlessly into daily clinical practice, while providing visually attractive reports that enhance clinical decision-making and patient motivation.
By bridging the gap between technology and functional rehabilitation, the PhysioSensing Otoneuro System redefines how balance disorders are assessed, treated and understood.
In this system, we take into account everyone who suffers from balance disorders in the world.

What Is Vestibular Rehabilitation, and How Is VR Used in It?

Vestibular rehabilitation is a specialized, exercise-based form of physical therapy designed to help reduce dizziness, vertigo, and balance and posture problems caused by a disorder of the vestibular system in the inner ear. Through targeted exercises, it helps the brain adapt to and compensate for the problem. If you have these symptoms, see a doctor first for an assessment.

Virtual reality (VR) is increasingly used in rehabilitation. The UAE Ministry of Health and Prevention (MOHAP) has announced plans to introduce VR rehabilitation in physiotherapy, including for patients with balance disorders, and has described VR as a safe, effective alternative to conventional balance therapy. The Otoneuro System offers one VR-enabled approach, combining objective assessment and interactive therapy, with or without VR, in a single platform.

How Does the Otoneuro System Work? Assessment and Rehabilitation in One Platform

In the Complete configuration, the whole system runs from one central software platform that manages two stations:
Patient Station

A force plate inside an adjustable-height frame (65 to 110 cm) with automatic safety bars, an inertial sensor worn on a head strap, a Meta Quest 3S VR headset, and a 65-inch screen on a display cart.

Medical Station (Clinician)

A mobile cart with a desktop PC, a 27-inch screen on a tilt-, rotate-, and height-adjustable mount, and a printer, where the clinician runs the software and reviews results and reports.

Otoneuro System Rehabilitation Modules: Vestibular Therapy With or Without VR

Assessment Module: Objective Measurements to Complement Symptom Reports
Test What It Assesses How
DVA and GST(Dynamic Visual Acuity and Gaze Stabilization Test) Functional vestibulo-ocular reflex (VOR) assessment An inertial sensor on the head tracks head movement. DVA determines the loss of visual acuity at a fixed head speed; GST determines the maximum head movement before visual acuity drops. The workflow also includes a perception time test (PTT) and a static visual acuity baseline.
Optokinetic test(with or without VR) Visual-vestibular integration and visual dependence in postural control Posturography on the force plate with optokinetic bar patterns moving in different directions, creating a visual conflict
Cervical Joint Position Error test(JPE) Cervical proprioception (neck position sense), relevant to cervicogenic dizziness With the inertial sensor, the patient sits with the trunk stabilized and, with eyes closed, returns the head to the neutral position after moving it
Balance assessment protocols Balance in multiple sensory conditions and motor tasks, including fall risk On the force plate: body sway, limits of stability, mCTSIB + Fukuda, Romberg test, Balance Error Scoring System (BESS), fall risk, rhythmic weight shift, and unilateral stance
Rehabilitation Module: Interactive Exercises, With or Without VR
  • VOR and oculomotor exercises: saccades, smooth pursuit, vergence, fixation, and VOR exercises, with or without VR.
  • Balance exercises on the force plate: five groups of exercises targeting postural alignment, weight transfer, directional control, and limits of stability.
  • Cervical proprioception exercises: using the inertial sensor, with figure-and-path, random-point, and visual-stimulus tasks to improve head–neck coordination.
  • Habituation exercises: gradual, controlled exposure to visual and movement stimuli that provoke dizziness, adjusted to the patient's tolerance and designed to reduce symptoms over time. They include optokinetic stimulation (bars and tunnel), and, in VR only, VOR suppression and 360° HD videos of busy real-world environments.
  • Balance and motor-cognitive games: played on the force plate, such as Pong & Ball Balance, BART, Slime Pong & Slime Run, Break Your Balance, Space Sway, and a Memory Game, designed to make sessions more engaging.
  • Coming soon: VR Head Flight (steering an aircraft with head movements to train gaze stability and vestibular adaptation) and HD Busy Environments (high-definition videos of complex visual scenes for habituation).

Clinical Applications of the Otoneuro System: Four Key Areas of Assessment and Training

The system assesses the vestibulo-ocular reflex (VOR) with two functional tests, using an inertial sensor worn on the head:

  • DVA (Dynamic Visual Acuity): determines the loss of visual acuity at a fixed head speed.
  • GST (Gaze Stabilization Test): determines the maximum head movement before visual acuity begins to drop.

The workflow also includes a perception time test (PTT) and a static visual acuity baseline. These tests help identify asymmetries, and clinicians can then use adaptation exercises to improve gaze stability and reduce oscillopsia, the sensation of a blurred or bouncing visual field during head movement. Interpretation and diagnosis remain with the treating clinician.

Using optokinetic stimuli within posturography, with or without VR, the system helps reveal sensory conflict and visual dependence, which can contribute to discomfort in visually busy environments.

After assessment, clinicians can use gradual, safe exposure (habituation) in VR scenarios tailored to motion-provoked symptoms.

With an inertial sensor, the system quantifies cervical joint position error (JPE) to profile deficits in neck proprioception, the sense of neck position.

Clinicians can then tailor head–neck repositioning tasks with real-time feedback. This is relevant when neck problems may contribute to dizziness (cervicogenic dizziness). Dizziness has many possible causes, so a medical assessment comes first.

On the force plate, the system objectively assesses static and dynamic balance using established protocols:

  • Body sway
  • Romberg test
  • mCTSIB with Fukuda
  • Limits of stability
  • Rhythmic weight shift
  • Unilateral stance
  • Balance Error Scoring System (BESS)

It also assesses fall risk, which is particularly relevant for older adults. The results establish a baseline, and training exercises then target postural alignment, weight transfer, directional control, limits of stability, and sensory integration, with or without VR.

What’s Included in the Otoneuro System: Technical Setup and Configurations

Component Key Specifications
Force plate 55 × 55 × 3 cm, 8.5 kg, maximum load 250 kg, 100 Hz sampling rate
Inertial sensor Adjustable head strap (53–63 cm), 3-axis accelerometer, magnetometer, and gyroscope, 200 g (plus 90 g cable)
Virtual reality (VR) headset Meta Quest 3S, 1832 × 1920 resolution per eye, 96° horizontal / 90° vertical field of view, battery life of about 2.5 hours
Screen (Complete configuration) 65-inch, 4K Ultra HD, 144 Hz refresh rate
Minimum PC requirements Intel i5 processor (2.5 GHz, 6 performance cores), 16 GB RAM, 8 GB graphics card, Windows 10 or 11

Otoneuro System Clinical Workflow: From Patient Intake to Progress Report

The system follows an eight-step clinical workflow that repeats from therapy as treatment progresses:
Step 1
Add a patient (Dizziness Handicap Inventory questionnaire)
→
Step 2
Evaluate
→
Step 3
Clinical report
→
Step 4
Establish objective baseline data
→
Step 5
Treat (rehabilitation therapy)
→
Step 6
Re-evaluate
→
Step 7
Progress report (measure intervention results)
→
Step 8
Adjust the intervention, then repeat from Step 5
Automated, comparative reports with one-click summaries and data export help clinicians document outcomes and track progress, so more of their attention goes to clinical decisions rather than manual data collection.

Why Choose the Otoneuro System for Your Clinic?

Once the cause of a patient's dizziness or vertigo has been diagnosed, through tests such as videonystagmography (VNG), the video head impulse test (vHIT), or vestibular evoked myogenic potentials (VEMP), the next step is rehabilitation. Traditional exercise programs, such as the Cawthorne-Cooksey exercises, are well established, but on their own they often provide little objective measurement of progress and rely heavily on the patient's own motivation. The Otoneuro System is designed to address this gap by combining objective measurements (force plate and inertial sensor), engaging therapy with or without immersive VR that is designed to support patient adherence, and automated reports that show progress to both the patient and the clinical team. It complements diagnostic testing and does not replace it.

Why Choose the Otoneuro System for Balance Assessment and Vestibular Rehabilitation, With or Without VR?

A True All-in-One Platform
Assess, treat, and report from one system instead of switching between separate devices, which PhysioSensing says reduces complexity, cost, and staff training time.
Functional VOR Tests
DVA and GST quantify gaze stability, with results that can be compared across sessions to show measurable change.
Optokinetic Tools for Visual Motion Intolerance
Reveal visual dependence, then habituate gradually in controlled VR scenarios.
Cervical Proprioception, Quantified
Measure joint position error with the inertial sensor to target head–neck control, which may contribute to cervicogenic dizziness.
Objective Posturography
Capture sway metrics and document fall risk with clear measures for the patient and the medical record. PhysioSensing describes posturography as having proven clinical utility.
VR Rehabilitation Modules
Engaging, repeatable sessions designed to support patient adherence to the rehabilitation program.
Dizziness Handicap Inventory (DHI) and Clinical History Profiling
Correlate subjective symptoms with objective findings, helping clinicians triage faster and tailor the rehabilitation pathway.
Automated, Comparative Reports
One-click summaries, objective metrics, and data export for clinical follow-up and research.
Why Choose the Otoneuro System for Balance Assessment and Vestibular Rehabilitation, With or Without VR

Otoneuro System vs. Other VR Balance and Vestibular Rehabilitation Systems

Criterion Otoneuro System (PhysioSensing) Bertec Balance Advantage Virtualis (Interacoustics group)
Force plate Static force plate (55 × 55 cm) Static or dynamic dual-balance plate, depending on the package; the dynamic base moves in translation and rotation Static (StaticVR) or dynamic 360° (MotionVR) rehabilitation platforms
Virtual reality Meta Quest 3S headset included in the Base and Complete configurations Immersive VR on a screen (CDP/IVR, Prime IVR) or a wireless head-mounted display VR headset with BalanceVR and PhysioVR modules, used with static or dynamic platforms
Assessment and training VOR (DVA, GST), optokinetic testing, cervical joint position error (JPE), balance protocols, and rehabilitation modules Computerized dynamic posturography protocols, head-shake and visual acuity tests, and balance and mobility training modules Assessment and rehabilitation modules (including DVA rehab and cervical range of motion), plus posturography functions with MotionVR
Configurations Two: Base and Complete Several packages (for example static plate, dynamic plate, portable, and immersive VR) Four solutions that can be combined: PhysioVR, BalanceVR, StaticVR, and MotionVR
Manufacturer PhysioSensing (Portugal); CE-marked Class I medical device under the EU MDR Bertec Corporation (USA) Virtualis (Montpellier, France), part of Interacoustics

Information on Bertec and Virtualis comes from the manufacturers' public websites and may change; check each manufacturer for current specifications. Sources: Bertec CDP/IVR, Interacoustics MotionVR, Virtualis BalanceVR. The right system depends on your clinical needs, space, and budget.

Who Is the Otoneuro System For?

Professional Group How They Can Use It
Otoneurologists and neurotologists Objective, multi-dimensional measurements to support the clinical assessment of dizziness before a rehabilitation plan is set
ENT / otolaryngology clinics Add vestibular assessment and rehabilitation to the clinic in one integrated system
Audiologists Relate vestibular findings to the patient's wider hearing and balance picture
Vestibular physiotherapists and rehabilitation specialists Deliver targeted, measurable rehabilitation programs and track progress with objective data
Rehabilitation medicine and neurology services Track patient progress over time with objective measures
Private clinics and balance centers Offer assessment and rehabilitation in one integrated platform
Universities and research groups A measurable research environment with data export for studies
Fields of application: vestibular assessment and rehabilitation (clinical and research), and balance and fall-risk profiling in neurological and otologic conditions.

Otoneuro System Price and Supply in the UAE: Request a Quote From iHear

The price of the Otoneuro System depends on the configuration you choose: Base (force plate, software, VR headset, inertial sensor, and desktop PC) or Complete (adds automatic safety bars, a 65-inch screen with display cart, and a medical station with a mobile cart, 27-inch screen, and printer). We prepare a quote after we understand your facility's needs.
What the iHear team offers:
The authorized distributor of PhysioSensing and BioMed Jena in the UAE. iHear can supply both diagnostic devices (BioMed Jena) and rehabilitation systems (PhysioSensing), so clinics can build a complete vestibular service with one supplier.
Technical consultation: to help you choose the configuration (Base or Complete) that suits the size and specialty of your facility.
On-site training: for physiotherapists and vestibular specialists on the protocols and on interpreting results.
Local technical support from the iHear team in the UAE.
Otoneuro System as Part of a Vestibular Care Pathway at iHear
A facility that wants to offer vestibular care from diagnostic testing to rehabilitation can combine:
Step 1
BioMed Jena Diagnostic Devices
eVNGUSB (videonystagmography), eHITUSB (video head impulse test), eVEMPUSB (vestibular evoked myogenic potentials), and KALORIstarCT (caloric stimulation), to help clinicians identify the cause of a vestibular problem.
Step 2
Otoneuro System by PhysioSensing
Functional assessment and interactive vestibular rehabilitation, with or without VR, to follow diagnostic testing with objective measurement and targeted exercises.
iHear supplies both diagnostic devices and a rehabilitation system, so a clinic can build a vestibular service from diagnosis to rehabilitation with one supplier, using two specialized brands that complement each other.

Otoneuro System FAQ: Common Questions About VR Vestibular Rehabilitation and Balance Assessment

The Otoneuro System by PhysioSensing (Portugal) is an all-in-one vestibular rehabilitation and balance assessment system. It combines a force plate, an inertial sensor, and a VR headset in one software-driven workflow to help clinicians assess balance and vestibular function and deliver targeted rehabilitation exercises.
iHear (ihear.ae) is the authorized distributor of PhysioSensing devices in the United Arab Emirates, with branches in Al Ain and Abu Dhabi. To request a quote or a consultation, contact iHear on WhatsApp at +971 50 208 4569.
The price depends on the configuration (Base or Complete). Contact iHear for a quote based on your facility's needs.
Two configurations are offered. The Base configuration includes the force plate, software, VR headset, inertial sensor, and a desktop PC. The Complete configuration adds automatic safety bars and a 65-inch screen on a display cart for the patient station, plus a medical station with a mobile cart, desktop PC, 27-inch screen, and printer. PhysioSensing marks the Complete configuration as highly recommended.
The Otoneuro System is designed for otoneurologists and neurotologists, ENT/otolaryngology clinics, audiologists, vestibular physiotherapists and rehabilitation specialists, rehabilitation medicine and neurology services, private clinics and balance centers, and universities and research groups.
Both. The system starts with objective assessment (VOR, balance, visual-vestibular integration, and cervical proprioception), then delivers rehabilitation exercises based on the results, with or without VR. Diagnosis remains with the treating clinician.
The vestibulo-ocular reflex (VOR) moves the eyes in the direction opposite to head movement so that vision stays stable when the head moves. In the Otoneuro System, functional VOR assessment uses an inertial sensor worn on the head. Dynamic Visual Acuity (DVA) determines the loss of visual acuity at a fixed head speed, and the Gaze Stabilization Test (GST) determines the maximum head movement before visual acuity drops. The workflow also includes a perception time test (PTT) and a static visual acuity baseline. These tests help clinicians identify asymmetries and guide adaptation exercises.
The Dizziness Handicap Inventory (DHI) is a 25-item questionnaire in which patients report how dizziness affects their daily life. In the Otoneuro System it is built into the workflow when a patient is added, together with clinical history profiling, so clinicians can correlate subjective symptoms with objective findings, triage faster, and tailor the rehabilitation pathway. The questionnaire does not diagnose a condition.
The Cervical Joint Position Error (JPE) test measures how accurately a patient returns the head to the neutral position after moving it with eyes closed. The patient sits with the trunk stabilized and the inertial sensor tracks the movement. It profiles neck proprioception, the sense of neck position, which can help clinicians identify deficits relevant to cervicogenic dizziness, meaning dizziness attributed to the neck rather than the inner ear. Dizziness has many possible causes, so a medical assessment comes first, and interpretation and diagnosis remain with the treating clinician. Clinicians can then tailor head-neck repositioning exercises with real-time feedback.
Force plate posturography measures how a person stands by recording movement and pressure on a platform, producing sway metrics that help clinicians quantify balance, document fall risk, and track change over time. The Otoneuro System uses a force plate for balance protocols such as body sway, limits of stability, and mCTSIB, and for posturography with optokinetic stimulation. iHear also supplies the PhysioSensing Posturography Station.
The balance assessment protocols include a fall-risk assessment on the force plate, alongside tests such as limits of stability, Romberg, and mCTSIB. Fall risk is particularly relevant for older adults, and the results help clinicians document risk and track change over time. Whether the system suits a particular patient is a clinical decision.
No. Balance assessment on the force plate and cervical proprioception testing with the inertial sensor do not require the headset, and several tests and exercises, such as optokinetic testing and habituation exercises, can be performed with or without VR. Some habituation exercises, such as VOR suppression and 360-degree HD videos of busy real-world environments, are VR-only.
PhysioSensing's brochure does not list benign paroxysmal positional vertigo (BPPV) among the system's applications. BPPV is generally managed by a trained clinician with repositioning maneuvers, which are not among the system's described functions. The system's role is functional assessment and exercise-based rehabilitation, such as VOR, balance, habituation, and cervical proprioception training. A medical assessment should come first to determine the cause of dizziness.
VNG and vHIT devices (such as BioMed Jena's eVNGUSB and eHITUSB) are diagnostic tests that analyze eye movements and head-impulse responses to help clinicians identify the cause of a vestibular problem. The Otoneuro System is for functional assessment and rehabilitation: it quantifies VOR function (DVA and GST), balance, visual-vestibular integration, and cervical proprioception, then delivers rehabilitation exercises. It complements diagnostic testing and does not replace it.
A vestibular service typically combines diagnostic testing, such as videonystagmography (VNG), video head impulse testing (vHIT), vestibular evoked myogenic potentials (VEMP), and caloric testing, with tools for balance assessment and rehabilitation. iHear supplies BioMed Jena diagnostic devices and PhysioSensing systems, including the Otoneuro System for functional assessment and rehabilitation. The right set depends on your clinical scope, patient volume, and staffing, so contact iHear to plan it.
The UAE Ministry of Health and Prevention (MOHAP) has announced plans to introduce VR rehabilitation in physiotherapy, including for patients with balance disorders (see the UAE government portal). This is a general announcement about the technology, not an approval of any specific product, and the Otoneuro System is one VR-enabled option.
Research on VR in vestibular rehabilitation is active and growing. A 2021 systematic review and meta-analysis in Scientific Reports examined VR and augmented reality in the rehabilitation of peripheral vestibular disorders, while other reviews describe the evidence on VR-based balance programs as still limited and varied. Studies commonly measure outcomes with tools such as the Dizziness Handicap Inventory (DHI), the Berg Balance Scale, and the Timed Up and Go (TUG) test. Whether VR rehabilitation suits a particular patient is a decision for the treating clinician.
The Otoneuro System is a CE-marked Class I medical device under the EU Medical Device Regulation (MDR 2017/745). ISO 13485, the quality management standard for medical device manufacturers, is applied, and the device carries a Unique Device Identification (UDI-DI) number and a 2-year warranty. CE marking is a European conformity marking, and use in the UAE is subject to the requirements of the relevant UAE health authority, so ask iHear for the current status.
According to the manufacturer's brochure, the force plate supports a load of 20 kg minimum to 250 kg maximum. The inertial sensor head strap fits head sizes of 53 to 63 cm, and the Meta Quest 3S headset strap fits 48 to 68 cm, with an interpupillary distance (IPD) range of 58 to 68 mm. The brochure does not specify an age range, so use in children is a decision for the treating clinician.
The manufacturer's brochure does not state a minimum room size. The patient station includes a force plate inside an adjustable-height frame (65 to 110 cm) with a 65-inch screen on a display cart in the Complete configuration, and the medical station is a mobile cart with a desktop PC and screen. Ask iHear for the space requirements for your clinic.
The minimum requirements are an Intel i5 processor (2.5 GHz, 6 performance cores; avoid 'U' and 'G7' versions), 16 GB of RAM, an 8 GB graphics card, and Windows 10 or 11 (64-bit). The manufacturer states that meeting them is mandatory for proper functioning.
Yes. PhysioSensing lists universities and research groups among its users, and the fields of application include clinical and research use. The system provides automated, comparative reports and data export.
The manufacturer's brochure lists a 2-year warranty. iHear offers technical consultation, on-site training for physiotherapists and vestibular specialists, and local technical support in the UAE. Ask iHear for the warranty terms and the support scope that apply to your purchase.
PhysioSensing lists vestibular assessment and rehabilitation, and balance and fall-risk profiling in neurological and otologic conditions, as its fields of application. It does not list specific diagnoses, such as concussion, in its brochure. Whether the system suits a particular condition is a decision for the treating clinician, and iHear can discuss your clinical needs.
Several systems combine VR with force-plate-based balance assessment and rehabilitation modules, including offerings from Bertec and Virtualis (part of Interacoustics). They differ in hardware (for example static or dynamic platforms), VR approach, modules, and configurations. See the comparison above, and contact iHear to discuss which approach fits your clinic.
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