Retrospective Outcomes Analysis

Clinical Outcomes from 250+ Users

Anonymized, aggregate symptom improvement data from users of the EyeRehab vestibular rehabilitation app. All data is collected during normal use through pre-exercise symptom assessments.

Last updated: February 2026. This is an observational analysis, not a clinical trial. See methodology and limitations below.

Key Findings

Among users who completed at least six exercise sessions — enough for a meaningful baseline-to-final comparison — the following outcomes were observed.

70%

Reported Improvement

Of qualified users showed net reduction in overall symptom burden

33%

Average Reduction

Mean decrease in combined symptom scores from baseline to final

4.4

Weeks Average

Mean duration of active use among qualified users

5,500+

Total sessions recorded

50

Avg sessions per user

20

Avg unique active days

10

Exercise types available

Per-Symptom Improvement

Five symptoms are tracked on a 0–10 scale before every exercise session. Baseline is the average of the first five PRE-exercise scores; final is the average of the most recent five. Higher reduction percentages indicate greater improvement.

Dizziness

Primary complaint in vestibular disorders

24% reduction
Baseline: 3.4/10 Final: 2.0/10

Brain Fog

Cognitive cloudiness and difficulty concentrating

40% reduction
Baseline: 2.8/10 Final: 1.3/10

Headache Strongest improvement

Post-concussion and exertional headaches

42% reduction
Baseline: 2.4/10 Final: 1.1/10

Eye Strain

Visual fatigue from oculomotor dysfunction

33% reduction
Baseline: 2.7/10 Final: 1.5/10

Nausea

Motion-induced nausea and stomach discomfort

34% reduction
Baseline: 1.1/10 Final: 0.5/10

Note on baseline severity: Average baseline scores range from 1.1 to 3.4 out of 10, indicating the population skews toward mild-to-moderate symptom severity. Users with higher baseline severity may see different absolute reductions. PRE-exercise scores are collected before each session and reflect resting symptom levels, not exercise-provoked symptoms.

Outcomes by Duration of Use

Longer engagement correlates with higher improvement rates. Users who remained active for four or more weeks showed the strongest outcomes, consistent with vestibular rehabilitation literature recommending 4–12 weeks of structured exercise.

4+

4+ Weeks Active

~62 users in cohort

67%

showed improvement

35%

average symptom reduction

8+

8+ Weeks Active

~21 users in cohort

50%

showed improvement

25%

average symptom reduction

12+

12+ Weeks Active

Insufficient data

Not enough users have reached 12 weeks of consistent use to report meaningful cohort data. This section will be updated as the user base matures.

Interpreting the 8+ week cohort: The lower improvement rate (50% vs. 67% at 4+ weeks) likely reflects survivorship bias in the opposite direction — users with more severe or persistent symptoms tend to use the app longer, while users who improve quickly may stop before reaching 8 weeks. This does not mean longer use produces worse outcomes.

Exercise Usage Distribution

Users self-select exercises through an adaptive daily routine. The distribution below reflects natural usage patterns across 5,500+ recorded sessions.

VOR x1 (Gaze Stabilization)

Head rotation with fixed target — foundational vestibular exercise

27%

1,485 sessions

Saccades

Rapid eye movements between targets for visual tracking

25%

1,375 sessions

Convergence

Near-point focus training for depth perception

18%

990 sessions

VOR x2 (Advanced)

Head and target moving in opposite directions

17%

935 sessions

Smooth Pursuits

Following smoothly moving targets

11%

605 sessions

Other (5 types)

Optokinetic, Brandt-Daroff, Cawthorne-Cooksey, Imaginary Target, Static Balance

2%

110 sessions

VOR x1 and saccades account for 52% of all sessions, consistent with their role as first-line exercises in vestibular rehabilitation protocols. The five less-used exercise types (optokinetic, Brandt-Daroff, Cawthorne-Cooksey, imaginary target, static balance) were added more recently and are expected to grow as users progress to advanced routines.

Methodology

Transparency in how this data was collected and analyzed.

Data Collection

Symptom data is collected passively during normal app use. Before each exercise session, users rate five symptoms — dizziness, brain fog, headache, eye strain, and nausea — on a 0–10 scale. These PRE-exercise scores serve as the primary outcome measure, reflecting the user's resting symptom state independent of exercise-induced provocation. All data is stored with HIPAA-grade AES-256-GCM field-level encryption and analyzed only in anonymized, aggregate form.

Inclusion Criteria

  • Completed at least 6 exercise sessions with PRE-exercise symptom assessments
  • Sufficient symptom data for non-overlapping baseline and final comparison windows
  • Approximately 42% of total users met these criteria

Improvement Calculation

Baseline = average of first 5 PRE-exercise symptom scores

Final = average of last 5 PRE-exercise symptom scores

Per-symptom improvement = (baseline - final) / baseline × 100

Overall improvement = mean of per-symptom improvements across all 5 symptoms

Non-overlapping windows prevent the same data points from appearing in both baseline and final calculations. For users with 10+ symptom assessments, the window size is 5. For users with 6–9 assessments, the window is half the total, rounded down.

Clinical Foundation

EyeRehab's exercise protocols are based on published vestibular rehabilitation guidelines (Herdman & Clendaniel, 2014). The app's sensor-based approach measures head velocity and movement accuracy in real-time via the device gyroscope, enabling adaptive difficulty progression that mirrors the graded exposure principles used in clinical vestibular rehabilitation.

Limitations

This data has meaningful limitations that should be considered when interpreting the results.

No control group

Improvement cannot be attributed solely to the app. Users may have been receiving concurrent professional therapy, natural recovery, or placebo effects.

Self-reported scores

Symptom ratings are subjective 0–10 scales, not clinician-administered validated instruments like the Dizziness Handicap Inventory (DHI) or Activities-specific Balance Confidence (ABC) Scale.

Survivorship bias

Users who abandoned the app before completing 6 sessions are excluded. Those who stayed may be systematically different (more motivated, less severe symptoms, or finding the app helpful).

No demographic data

This aggregate analysis does not stratify by age, sex, injury type, injury severity, or time since injury. Individual outcomes will vary based on these factors.

Small qualified cohort

While 250+ users have sessions, the qualified analysis cohort (~104 users with 6+ sessions) is relatively small. Cohort subgroups (8+ weeks) are even smaller.

No long-term follow-up

Data reflects active use periods only. Whether improvements persist after users stop exercising is not captured in this analysis.

Planned Improvements

Future analyses will incorporate validated clinical outcome measures (DHI, ABC Scale, VVAS), demographic stratification, and a prospective study design with a waitlist control group. Integration of these instruments into the app is currently in development. We are also exploring partnerships with academic vestibular rehabilitation programs for independent validation.

References

  1. 1. Herdman, S.J. & Clendaniel, R.A. (2014). Vestibular Rehabilitation (4th ed.). F.A. Davis Company. — Standard reference for VOR exercise protocols and graded vestibular rehabilitation.
  2. 2. Hillier, S.L. & McDonnell, M.N. (2016). Is vestibular rehabilitation effective in improving dizziness and function after unilateral peripheral vestibular hypofunction? An abridged version of a Cochrane Review. European Journal of Physical and Rehabilitation Medicine, 52(4), 541–556. — Cochrane systematic review establishing moderate-to-strong evidence for vestibular rehabilitation.
  3. 3. Klatt, B.N., et al. (2022). Clinical Practice Guideline: Vestibular Rehabilitation for Peripheral Vestibular Hypofunction. Journal of Neurologic Physical Therapy, 46(2). — APTA-endorsed clinical practice guideline supporting VOR and gaze stabilization exercises as Level A evidence.
  4. 4. Schneider, K.J., et al. (2023). Consensus statement on concussion in sport — the 6th International Conference on Concussion in Sport. British Journal of Sports Medicine, 57(11), 695–711. — Recommends controlled sub-symptom threshold exercise as part of concussion management.

Frequently Asked Questions

Common questions about this outcomes data and the EyeRehab app.

How is symptom improvement measured in EyeRehab?
Users rate five symptoms (dizziness, brain fog, headache, eye strain, nausea) on a 0–10 scale before each exercise session. Improvement is calculated by comparing the average of the first five PRE-exercise scores (baseline) against the average of the most recent five PRE-exercise scores (final). This non-overlapping window method reduces noise from day-to-day variation and reflects genuine trend changes rather than single-session fluctuations.
What does '70% of users report symptom improvement' mean?
Among users who completed at least six exercise sessions — enough data for a meaningful baseline-to-final comparison — 70% showed a net reduction in their overall symptom burden. This means their combined dizziness, brain fog, headache, eye strain, and nausea scores were lower at the end of their tracked period than at the start. The remaining 30% either maintained stable symptoms or experienced increases, which can occur with more severe injuries or inconsistent adherence.
Why is headache the symptom with the strongest improvement?
Across the user population, headache showed a 42% average reduction from baseline to final scores — the largest improvement among the five tracked symptoms. This is consistent with vestibular rehabilitation literature, where post-concussion headaches often respond well to structured gaze stabilization and oculomotor exercises that reduce visual-vestibular mismatch. Dizziness, despite being a primary complaint, showed 24% improvement — still meaningful, but vestibular symptoms typically resolve more gradually.
How many exercise sessions are needed to see improvement?
Users in the analysis completed an average of 50 sessions over approximately 20 active days. However, improvement timelines vary significantly. Cohort analysis shows that users active for four or more weeks had a 67% improvement rate with an average 35% symptom reduction, suggesting that consistent practice over at least one month is a reasonable expectation for noticeable results. The app requires a minimum of six sessions before generating any outcome data.
Is this a clinical trial?
No. This is a retrospective analysis of anonymized, aggregate user data collected through the EyeRehab app during normal use. It is not a randomized controlled trial and does not include a control group. The data reflects real-world outcomes from self-directed users, some of whom were also receiving professional vestibular rehabilitation therapy. A prospective clinical study with validated outcome measures is planned.
What exercises does EyeRehab include?
EyeRehab offers 10 exercise types based on published vestibular rehabilitation protocols: VOR x1 (gaze stabilization), VOR x2 (advanced gaze stabilization), saccades (rapid eye movements), convergence (near-point focus), smooth pursuits (tracking), imaginary target, Brandt-Daroff, optokinetic, Cawthorne-Cooksey, and static balance. VOR x1 and saccades are the most frequently used, accounting for approximately 52% of all sessions.
How does the adaptive difficulty system work?
After each session, the app analyzes the user's last 5–7 sessions, examining symptom trends, pre-to-post changes, consistency, and stability. If symptoms spike above 6/10 in any session, difficulty decreases immediately. Advancement requires at least 80% of recent sessions showing controlled symptoms. Users see a plain-language explanation after each exercise explaining why their difficulty changed or stayed the same.
Can these outcomes be compared to traditional vestibular rehabilitation?
Direct comparison is not possible from this data alone, as there is no control group and many users may have been concurrently receiving professional therapy. Published meta-analyses of vestibular rehabilitation (Hillier & McDonnell, 2016) report moderate-to-strong evidence for symptom improvement, with typical DHI score reductions of 10–20 points over 4–12 weeks. Our data is consistent with these timelines and magnitudes, though measured with a different instrument (0–10 symptom scales rather than standardized questionnaires like the DHI).
What are the limitations of this data?
Key limitations include: (1) no control group, so improvement cannot be attributed solely to the app; (2) self-reported symptom scores rather than clinician-administered outcome measures; (3) survivorship bias — users who stopped using the app early are underrepresented; (4) no demographic or injury-severity data is included in this aggregate analysis; (5) symptom scores are encrypted at rest for HIPAA compliance, which limits some query flexibility. Future studies will incorporate validated instruments (DHI, ABC Scale) and prospective study designs.
Is user data protected?
All health data is encrypted at rest using AES-256-GCM field-level encryption across 80+ database fields (HIPAA-compliant). This outcomes report uses only anonymized, aggregate statistics — no individual user data, emails, or identifiable information is included. The app maintains HIPAA-grade audit logging with 7-year retention for all data access events.

Related Resources

VOR Exercise Guide

Step-by-step instructions for all 10 vestibular rehabilitation exercises included in the app.

Concussion Recovery

How vestibular rehabilitation fits into the broader concussion recovery timeline.

For Physical Therapists

Clinical information, evidence basis, and professional tools for vestibular rehabilitation specialists.

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