At Maastricht UMC+, ENT specialist Dr. Raymond van de Berg has been working for years with patients suffering from severe balance disorders. “In the Netherlands, we’re basically the ‘last resort’ for people with complex balance problems,” he explains. “Patients come to us from all over the country, and even from abroad, because the expertise is concentrated here.”
Alongside his clinical work, Van de Berg is deeply involved in research on vestibular disorders, from diagnostics to innovative treatments such as the artificial balance organ and the BalanceBelt.
The power of interdisciplinary thinking
What drives him in this field? “Balance disorders are incredibly fascinating because they sit at the crossroads of ENT, neurology, ophthalmology, psychiatry, and even physics,” says Van de Berg enthusiastically. “It’s an area where logical reasoning, technology, and clinical experience all come together.”
The BalanceBelt: from idea to impact
Van de Berg became involved with the BalanceBelt through Prof. Herman Kingma, a pioneer in balance research and the inventor of the technology behind the belt.
“In the beginning it was still a university project, but since the collaboration with Elitac-wearables, it has become truly professional,” he says.
The initial experiences with the BalanceBelt were very promising. “Some patients were absolutely ecstatic; others noticed less difference. But what stood out most is that there’s a group of patients who continue using the belt consistently, even after two years. That says something about the value they experience.”
According to Van de Berg, the BalanceBelt works particularly well for patients with severe bilateral vestibular loss, people who have literally lost their sense of balance. “In addition, there seems to be a subgroup of patients with an oversensitive balance system, such as those with 3PD (Persistent Postural-Perceptual Dizziness). For them, the belt mainly helps to restore confidence in their own balance system.”
Challenges and improvements
While he is enthusiastic, Van de Berg also sees challenges ahead. “The biggest one remains distinguishing the true medical effect from the placebo effect. That’s important for recognition, reimbursement, and further scientific validation.”
He also sees room for technical improvement: “The price is still a barrier. And beyond that, we could think of faster feedback, lighter materials, and more individualized settings for each patient.”
The Vestibular Implant (VI): taking the next step
In addition to research on the BalanceBelt, Maastricht UMC+ is also developing the Vestibular Implant (VI), an artificial balance organ. “It’s an implant that, just like a cochlear implant for hearing — electrically stimulates the vestibular nerve,” Van de Berg explains. “In that way, we aim to partially restore the reflexes of the balance organ.”
The potential is huge, but the road is long. “Ten years ago, we thought: within five to ten years this will be ready for patients. And now we’re still saying the same, mainly because of European regulations. The technology is there, the doctors are ready, the patients are ready, but the administrative barriers are enormous.”
Two technologies, each with its own role
How does Van de Berg see the relationship between the BalanceBelt and the Vestibular Implant? “The main difference is that the VI primarily restores reflexes, while the BalanceBelt supports balance. For many patients, that distinction is crucial: those who mainly suffer from balance instability can already benefit greatly from the BalanceBelt. The VI is a surgical option, something for later, or for patients with very severe loss.”
He even sees potential synergy between the two technologies in the future. “Who knows, they might complement each other. The BalanceBelt could be the first step, and the implant the second.”
Raising awareness is key
According to Van de Berg, there’s still much to be gained by improving awareness and diagnosis of balance disorders. “There are still many people walking around with bilateral vestibular loss without realizing it. Doctors and patients often don’t consider the balance system as the root cause. Greater awareness among general practitioners, ENT specialists, neurologists, and patients themselves is crucial.”
“Every step forward counts”
Van de Berg concludes on an optimistic note: “Whether it’s with an implant or with the BalanceBelt, every step that helps people with balance disorders move with confidence again is a victory. And that’s what we work on every day here in Maastricht.”