Rehabilitation exercises for cognitive, oculomotor, and vestibular recovery (recover)

The National Institute of Child Health and Human Development awarded Charles River Analytics, Inc. $1.256 million on September 15, 2025, under the Child Health and Human Development Extramural Research program (CFDA 93.865) to develop RECOVER, a virtual reality–based rehabilitation system for traumatic brain injury recovery.

RECOVER addresses a critical gap in accessible, affordable, and effective TBI rehabilitation platforms. The system delivers adaptive rehabilitation exercises targeting cognitive, oculomotor, and vestibular deficits that commonly persist after concussion and traumatic brain injury. The platform combines robust rehabilitation tasks with an easy-to-use interface supporting both in-person and remote therapeutic administration. RECOVER builds on Charles River Analytics' prior work on ADVISOR, a diagnostic VR tool with integrated eyetracking that assesses vestibular and oculomotor function in TBI patients. The new system aims to accelerate recovery and reduce functional impairments by providing controlled, immersive, ecologically valid stimuli that promote sensorimotor adaptation and neural plasticity.

Charles River Analytics, Inc., an employee-owned small business based in Cambridge, Massachusetts, received the award. The company performs the work at its Cambridge location. The project period runs from September 15, 2025, through April 30, 2026. This is a Phase I Small Business Innovation Research award under the NICHD's SBIR program, as reflected in the $1.256 million obligated amount.

Abstract

Over the last 20 years, traumatic brain injury (TBI) has been increasingly recognized as a significant health problem that can result in acute, subacute, and chronic neurological deficits. Individuals with concussions can display a wide array of symptoms, including physical (e.g., headache, nausea, vomiting), behavioral and emotional (e.g., drowsiness, irritability, sleep problems), and cognitive (e.g., attention or memory) deficits. Commonly, vestibular and oculomotor deficits occur. Interventions can reduce the amount of time needed to return to activity after TBI but a major obstacle to the real-world implementation of TBI rehabilitation is the lack of affordable, accessible, and effective platforms that are adaptable to the wide individual variability of symptoms associated with TBI. A virtual reality (VR)-based rehabilitation system with multidomain and adaptive rehab protocols could accelerate recovery and reduce functional impairments after TBI by providing highly controlled, immersive, and ecologically valid stimuli that promote sensorimotor adaptation and neural plasticity. Such a system must deploy robust rehabilitation tasks coupled with an easy-to-use user interface (UI) that allows for both in-person and remote administration of therapeutic tasks. To solve this problem, charles river analytics will develop a TBI rehabilitation system called recover (rehabilitation exercises for cognitive, oculomotor, and vestibular recovery). Recover is a robust, adaptive, and effective tool for providing sensory, motor, and cognitive rehabilitation after TBI. Charles river has previously developed a diagnostic tool for TBI called assessment and diagnosis of vestibular indicators of soldiers' operational readiness (advisor) that uses a VR headset with integrated eyetracking to assess vestibular and oculomotor function (VOF) associated with TBI. While advisor is designed as a diagnostic tool, under this award we will develop recover to extend the advisor platform to focus on rehabilitation. We will develop an intuitive and highly usable web application UI to enable clinicians to configure and administer rehab tasks and track patient progress in both in-person and telehealth settings. Recover can both stand alone as a therapeutic tool and be used as a supplement to advisor to create a single integrated system capable of both diagnosis and assisting with rehabilitation of TBI.