Spinoff is NASA’s annual publication featuring successfully commercialized NASA technology. This commercialization has contributed to the development of products and services in the fields of health and medicine, consumer goods, transportation, public safety, computer technology, and environmental resources.

Based on a new technique pioneered in Johnson Space Center’s Neurosciences Laboratory, the Zibrio balance scale assesses balance by applying algorithms to changes in pressure distribution over the course of a minute. The company found it could even predict a subject’s likelihood of experiencing a fall.

The inside of the International Space Station (ISS) is designed to give astronauts the illusion of verticality in the weightlessness of orbit. The “floors” are relatively uncluttered and lighting runs along the opposite “ceilings,” with most of the monitors, cables, and frequently used equipment packed onto the “walls.” Astronauts learn to use their eyes rather than their inner ears to establish their orientation. It’s an illusion that’s easily broken, often resulting in confusion, nausea, and vertigo but this happens less with time.

The return to Earth results in a similar adjustment period. Shuttle crewmembers typically made a full recovery in anywhere from 12 hours to two or three days but it’s not unusual for astronauts who spend months on the ISS to take more than a week to fully readjust to gravity.

To observe space-induced balance disorders, NASA uses a technique called computerized dynamic posturography (CDP), a technique developed by Massachusetts Institute of Technology (MIT) that tests a subject’s balance in a controlled environment, moving a platform and visual cues to challenge the subject’s equilibrium. It’s a standard diagnostic technique today and flight doctors at Johnson still use it to determine when returned astronauts are ready to go back to their normal duties. About the size of a phone booth, the system would not be practical for a lunar or Martian surface mission, so researchers began to look for an alternative.

As the team of MIT colleagues worked to gain a better understanding of how the brain controls balance, they discovered a lot of patterns of the brain searching for information from the bottom of the feet. Using multiple pressure sensors under a subject’s feet to passively monitor pressure distribution was simple; known algorithms were applied to those pressure distributions over time to quantify postural stability, with no need to challenge the vestibular system. In 2008, Zibrio Inc. was founded to turn the technique into a commercial product.

For decades, NASA flight doctors have used a technique called computerized dynamic posturography to assess astronauts’ balance after stays in space. Moving visual cues and a shifting platform challenge the subject’s equilibrium. A system of this size wouldn’t be practical for a mission to the Moon or Mars. (Image courtesy of the U.S. Army)

The team realized that the ability to detect patterns of balance instability could have wide applications in preventing falls among the elderly. They designed a product that looks like a bathroom scale that assigns users a fall-risk score between 1 and 10, with 7 and up indicating low risk and 1 to 3 meaning high risk. Zibrio released a commercial version — called SmartScale — in 2019.

A person’s balance is by no means fixed and can be influenced by anything from balance exercises to changes in medication, sleep, diet, mood, and activity level. An app for the SmartScale lets users explore possible causes and solutions for balance issues. It provides a score and then, through the Zibrio app or with a physician, users can deep-dive into what’s helping and hurting their balance. The app generates a personalized plan for improvement.

The balance scale isn’t just for the elderly; it can be useful to anyone trying to improve their physical performance. Balance indicates the functioning of not just the vestibular system but also the overall nervous and musculoskeletal systems. The clinical version provides an even larger package of information to guide physicians’ recommendations.

The simplicity that lets it test balance without provoking a fall has also helped make it affordable, with the consumer version running $249 and the clinical scale priced at $499.

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