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PubMed1990

Dynamic posturography findings in central nervous system disorders.

Dynamic posturography provides functional, selective testing of three sensory modalities for maintenance of balance: vestibular, visual, and somatosensory. Sensory receptors in vertical semicircular canals and utricles, via the vestibulospinal tract, mediate a disconjugate response to the legs, enabling synchronized reciprocal stabilization of the body for control of motion. The patient is systematically exposed to different combinations of useful and conflicting visual, vestibular, and support surface input. The effect of each on stability is appraised. Early posturography reports dealt primarily with sensory organization test (SOT) results. Improved software for movement coordination (MC) tests offer greater identification of problems involving the central nervous system. One hundred fifty-one patients were studied over a 9-month period. Central disorders were present in 31 cases (20.5%) and 90.3% of these were abnormal in sensory organization tests (SOTs). Abnormal movement coordination (MC) results occurred in 80.6% of central nervous system (CNS) disorders. SOTs 4, 5, and 6 in combination were abnormal in 35.5%, and 70% of these cases were also abnormal in MC responses. False-positive responses occurred in less than 4% of cases. Posturography offers a significantly high detection rate in CNS disorders causing dysequilibrium. Long loop latency reflexes, as they relate to maintenance of balance, appear important in the pathophysiology of abnormal SOT and MC responses.

Adult↗
PubMedDate not supplied

Posturography findings in workers exposed to industrial solvents.

Postural control was investigated by static posturography in 18 workers exposed to industrial solvents, 9 patients with psycho-organic syndrome due to industrial solvent exposure, and 52 controls. Both groups of exposed subjects showed larger sway areas with eyes open as well as closed, compared with the controls. No differences were found in the Romberg quotient (the relationship between sway areas with eyes closed/open). The correlation between static posturography and the otoneurological test battery was positive for the visual suppression test in the styrene group. In the industrial solvent group no significant correlations were found. The visual suppression test and some auditory tests were pathological in the exposed groups. The otoneurological test battery--especially the visual suppression test and static posturography--seems to contribute in the assessment of solvent related CNS lesions.

Adult↗
PubMed1993

Effects of increased inertial load in dynamic and randomized perturbed posturography.

Muscular weakness is present in many diseases. The present study attempted to model a relative weakness of postural control muscles by loading the subjects with extra weight, and the effects on EquiTest dynamic posturography and randomized perturbed posturography were assessed. Ten healthy subjects aged 15-39 years (mean 26 years) were used. Their weights ranged 53-82 kg. Equilibrium was measured with and without an extra 20% of body weight attached to the upper part of the trunk by means of pieces of lead metal placed in a specially sewn shirt. Dynamic posturography (EquiTest) comprises a sensory organization test in which the support surface and visual surround are either stable or referenced to the patient's sway, his or her eyes open or closed. In a movement coordination part the platform makes active movements. Antero-posterior sway on a stable support surface with absent or distorted visual cues was marred, and the correction pattern was altered on a movable support surface when the vision was absent. Furthermore, the EquiTest apparatus was driven by special software to produce randomized antero-posterior movements during 45 s. In addition to stable conditions, small and large amplitude perturbations were used. The subject's ability to remain in equilibrium was estimated by the sway velocity and a confidence ellipse sway area during 45 s. During weightbearing, sway areas were larger on the stable support surface both with and without vision. Postural sway velocity was lower when vision was absent both using small and large amplitudes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2003

[Quantified research of measuring postural balance by posturography using inclinometer technique].

OBJECTIVE: To gain the normal values of posturography using inclinometer technique in people, to gain the normal values of posturography using inclinometer technique in people. METHOD: The messages of postural average sway angular velocity (omega) obtained by posturography using inclinometer technique in four various conditions were measured in 167 normal subjects who were grouped by age. RESULT: The normal omega values show that there is no correlation between postural balance with gender, but postural balance is related with age. The postural stability is at its best at the age of 20 to 60 years. The direction of postural sway has a large inter-individual variability, but no significant inclined direction is found. CONCLUSION: The results of individual tests should be compared with match-aged normative data in order to determine abnormal postural balance function. We measured many subjects and grouped by ages in detail. Therefore, the result can be taken as normative data of the measuring system. The omega value of standing on global-ottomed platform with eye closed could distinguish abnormal balance function of vestibo-spinal system accurately.

Adult↗
PubMedDate not supplied

[Posturography as objective evaluation of the balance system in Parkinson's disease patients after neurosurgical treatment. A preliminary report].

BACKGROUND AND PURPOSE: In advanced stages of Parkinson's disease (PD) beside resting tremor, rigidity, and bradykinesia, most patients reveal severe balance instability. The goal of this study is to determine objectively postural control changes using static posturography after neurosurgical treatment (unilateral posteroventrolateral pallidotomy). MATERIAL AND METHODS: 15 patients with advanced idiopathic PD underwent unilateral posteroventrolateral pallidotomy. The study group was composed of 8 men and 7 women. The mean disease duration until operation was 12.5+/-3.5 years, and the mean age of the patients at the time of surgery was 65.8+/-4.1 years. Postural control changes were assessed objectively by static computerized posturography and subjectively according to items of posture, gait and postural stability derived from Part III (motor examination) UPDRS. All evaluations of the balance system were performed preoperatively in the off and on condition, and also two weeks postoperatively in the same conditions. RESULTS: It was found that the majority of posturographic parameters in the off condition were improved after neurosurgical treatment. The improvement in the on condition was less pronounced. For example, the mean path length in the off condition during eyes opened was 318+/-159 mm before pallidotomy, and after surgery it was 240.9+/-119.2 mm in off. The difference was statistically significant (p < 0.005, t=3.11). CONCLUSIONS: Pallidotomy improves postural control changes in the early postoperative period, which can be proved by static computerized posturography.

Aged↗
PubMed2005

Static and dynamic posturography in patients with asymptomatic HIV-1 infection and AIDS.

Alterations of the vestibulo-ocular reflex, optokinetic nystagmus, and visuo-vestibular-ocular reflex, have already been described in patients with AIDS and HIV-1 positive asymptomatic subjects. The introduction to the clinical practice of posturographic techniques allows us to study, with precision, postural perturbation that may be present when performing Romberg's test and to study the vestibulo-spinal reflex as a component of the vestibular system. The relative lack of studies on posturography and AIDS, encouraged us to continue our research on the vestibular system both in asymptomatic HIV-1 seropositive patients and in patients with AIDS (IV stage according to the classification proposed by the Centre for Disease Control). Recordings were made in group 1 (control group, 55 normal subjects), in group 2 (15 asymptomatic HIV-positive subjects), and in group 3 (15 patients with AIDS stage IV). Static and dynamic posturography were carried out using Tonnies platform system (Tonnies GmbH & Co., Wurzburg, Germany) and the data were analysed with Tonnies Posturographic Tübingen (TPOST) software vers. 5.19. In asymptomatic HIV+ subjects, we observed an increase in RW, RA and M3 reflex latency. AIDS patients (stage IV) exhibited significant alterations in almost all the posturographic parameters and the electromyographic potentials. Our results validate static and dynamic posturography as a method for otoneurological investigation and appear to confirm that the entire vestibular system is involved since the earliest stages of the HIV infection. In the HIV+ subjects, a variable dysfunction in the reflex control to long latency was observed, which is correlated with the alteration of the central dopaminergic system; in AIDS patients, the central nervous system damage appears more important, globally distributed and correlated also with immunosuppression.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Posturography classification and clinical application].

W-I computerized posturography system, designed by authors of this article, was introduced. Using this system body sway was measured in 60 normal adults and 484 patients with vertigo. 204 patients with confirmed clinical diagnoses were analyzed. Posturography (PSG) may be classified in 16 composite graphic types. Statistics suggested that PSG of 84.5% patients with unilateral peripheral vestibular dysfunction show that the left-right direction graphic type and of 77.8% patients with front-back direction graphic type. The mechanism of the above-mentioned types of posturography was discussed.

Adult↗
PubMed1993

Dynamic posturography among patients with common neck disorders. A study of 15 cases with suspected cervical vertigo.

We have studied a consecutive series of 15 patients with long-lasting common neck pain combined with vertigo and/or unsteadiness by dynamic posturography with the head in different positions. The evaluation of disturbed equilibrium was done in the anteroposterior direction. Results were compared with 15 sex- and age-matched healthy controls and 10 patients with long-lasting neck complaints without vertigo or unsteadiness. The otoneurological, audiometrical, and electronystagmographical examination was normal in all individuals. The dynamic posturography on a sway-referenced forceplate showed significantly lower equilibrium scores in the patients with vertigo/unsteadiness than in the controls when recorded in neutral position of the head, in rotation and in lateral flexion. The patients with vertigo also had significantly lower equilibrium scores in the position most prone to elicit their vertigo/unsteadiness as compared with the patients with only neck pain. Dynamic posturography was found to be of diagnostic value, indicating the presence of vertigo of cervical origin.

Adult↗
PubMedDate not supplied

[Study of the vestibulospinal reflex. Clinical applications of posturography].

The vestibulo-spinal reflex is of great importance in maintaining balance--hence the interest in evaluating it objectively in patients suffering from vertigo. A review is made of the objective exploratory methods currently available, i.e., static posturography, stimulation posturography, dynamic posturography and craneocorpography. The clinical applications of posturographyare discussed, fundamentally as applied to the diagnosis of central vestibular pathology, treatment planning and evolutive monitoriacion of the patient with vertigo.

Humans↗
PubMed1996

Decision matrix analysis for tonic ocular torsional abnormalities with posturography abnormalities.

Tonic ocular torsions can arise from a variety of central or peripheral, vestibular, and nonvestibular lesions. However, the role of tonic ocular torsions in neurotology has been limited to surgical patients after unilateral vestibular deafferentation. By using 12 patients with a spectrum of well-defined unilateral peripheral vestibular lesions confirmed by electronystagmography (ENG), we identified a link between ipsiversive tonic ocular torsion compensation and vestibulospinal compensation, as measured by computerized dynamic posturography. In the context of ENG findings and posturography, the differential diagnosis of ocular torsions may be localized to the otoliths by using a decision matrix. Specifically, conditions of absent vision and sway-referenced support on computerized dynamic posturography associated with concurrent static ocular torsional abnormalities may suggest an otolith disorder. Furthermore, static ocular torsion assessment provides another important window on central vestibular compensation.

Adult↗
PubMed1997

[Posturography: efficacy and prospects in Otorhinolaryngology].

Static and dynamic computer posturographies are used in diagnosis of vestibular disorders associated with impairment of the equilibrium. Posturography demonstrated high sensitivity and diagnostic abilities. Posturographic correction of the equilibrium defects basing on biological feed-back is successfully tried. Computer posturography is promising for wide medical practice.

Diagnosis, Computer-Assisted↗
PubMed1998

Dynamic and randomized perturbed posturography in the follow-up of patients with polyneuropathy.

BACKGROUND: The purpose of the study was to investigate and follow the equilibrium performance of patients with chronic polyneuropathy using Dynamic Posturography (DP) and Randomized Perturbed Posturography (RPP). METHODS: Fourteen patients with chronic polyneuropathy, aged 53-83 years, were evaluated by clinical investigation, vibrametry, DP and RPP in a six-year follow-up. The patient group was compared to 14 healthy volunteers, aged 63-80 years. The DP comprises a sensory organization (SO) part in which the platform and visual surround are stable or referenced to the patient sway, with eyes open or closed. In a movement coordination (MC) part, the platform makes active movements. In RPP, the platform moves randomly in the anteroposterior direction. RESULTS: Comparison between the first and second study of the patient group showed decreased equilibrium scores under stable conditions and when vision was excluded. Compared with controls, the patients showed significantly lower scores in most of the SO test conditions except when the platform was sway referenced with stable surround; in the MC part, the patients showed prolonged muscular response latencies, and in the RPP, the patients showed increased sway areas. CONCLUSIONS: The results are further evidence that proprioception is probably the single most important sensory input for postural control in humans. Posturography proved to be an objective method to study and follow the equilibrium performance in patients with PN.

Aged↗
PubMed1998

Evaluation of posturography in the detection of malingering subjects.

OBJECTIVE: This study aimed to test the performance of proposed methods for detecting malingering subjects on computerized dynamic posturography using one subject group in three situations (normal, malingering, vestibular weakness). STUDY DESIGN: The study design was a prospective, blinded study. SETTING: The study was conducted at a university hospital. PATIENTS: Volunteer subjects aged 20-59 years of age participated. INTERVENTIONS: Computerized dynamic posturography was performed under three situations: best effort, faking vestibular weakness, and transient induced vestibular weakness with bilateral simultaneous caloric irrigation. MAIN OUTCOME MEASURES: Measured was identification of situation (normal, malingering, induced vestibular weakness) by each of three detection methods: blinded clinical scoring, a set of formulae, and a set of variables (the latter two methods proposed previously by other investigators). RESULTS: Each method performed well. In three-way discrimination, the formulae and clinical scoring each correctly identified approximately 75% of trials. In two-way discrimination (malingering vs. induced vestibular weakness), the best combination of variables slightly outperformed clinical scoring (0.93 vs. 0.88 ROC [receiver operating characteristic] curve area). CONCLUSIONS: Computerized dynamic posturography can distinguish malingering in normal subjects from trials performed with best effort or after binaural simultaneous caloric irrigation. The accuracy of blinded clinical scoring was comparable to that of two objective detection methods.

Adult↗
PubMed1998

Static and dynamic posturography in patients with vestibular and cerebellar lesions.

OBJECTIVE: To assess the diagnostic usefulness of posturography in 2 well-defined patient groups with impaired balance. PATIENTS: Ten control subjects, 10 patients with bilateral vestibular loss, and 10 patients with cerebellar atrophy. OUTCOME MEASURES: Amplitude, velocity, and frequency of sway in the anteroposterior and medial-lateral directions on a static platform, on foam, and on a moving platform. RESULTS: Both patient groups consistently had increased sway compared with controls, particularly when standing on foam or on a moving platform with eyes closed. Sway amplitude and velocity were increased about the same amount. The Romberg ratio (sway with eyes closed/sway with eyes open) did not reliably differentiate patients from controls or the 2 patient groups from each other. Some patients with cerebellar atrophy exhibited a characteristic body tremor at about 3 Hz in the anteroposterior direction. CONCLUSIONS: Although sway amplitude and velocity were consistently increased in patients with bilateral vestibular loss and patients with cerebellar atrophy, none of the posturography measurements reliably distinguished the 2 patient groups. The finding of increased frequency of sway in the anteroposterior direction in patients with cerebellar atrophy was of limited value since the tremor was visible at the bedside.

Adult↗
PubMed2000

[Assessment of routine mobility in geriatrics using static posturography--a population based study].

In a population-based study of 110 women between 53 and 82 years of age (mean age 64.5 +/- 7.9 years) static posturography data were compared to functional items of gait and balance in common geriatric mobility scales. Posturographic data of double-stance with eyes open and eyes closed (DSEO; DSEC) did not differ from those of a group of healthy women previously tested for intact nervous system function. The total neuromuscular score--roughly corresponding to the well-known Tinetti score--did not correlate to the posturographic measures. DSEC correlated with the items "rapid walking" and "single-stance left leg". Age, vision, and neuropsychologic test results correlated with DSEO, "rapid walking", "single-stance right leg", "single-stance left leg", and "walking a figure eight". Multiple linear regression confirmed the impact of age, vision, DSEO, and DSEC on "rapid walking" with a 34% variance explanation. Posturographic parameters did predict other selected gait and balance items. When used in older women living independently in the community, parameters of static posturography reflect to some extent the functional disabilities of gait and balance.

Activities of Daily Living↗
PubMed2006

Posturography frequency analysis of sound-evoked body sway in normal subjects.

Sound-evoked activation of the vestibular system has been suggested for a long time, and myogenic potentials have been recorded at the level of different muscular groups while a high intensity sound was applied. The aim of this study was to analyse sound-evoked postural responses in normal subjects and to correlate them with the activation of the vestibular system. Body sway was measured by posturography and elaborated through spectral frequency analysis in 40 healthy volunteers in the basal condition and after applying a sound stimulus monoaurally. Spectral frequency analysis results showed a significant increase, in presence of stimulus, of body sway at low and middle frequencies only on the lateral plane and in the closed-eyes condition. As it seems that these frequency ranges are mainly under vestibular control, our results suggest that sound activates specifically the vestibular system, and posturography during sound stimulation represents an alternative approach to assess vestibular function.

Adult↗
PubMed2007

Postural stabilizing effect of alfacalcidol and active absorbable algal calcium (AAA Ca) compared with calcium carbonate assessed by computerized posturography.

Sway and postural instability have drawn attention as a risk factor for osteoporotic fracture, in addition to low bone mineral density (BMD) and poor bone quality. In view of the fracture-reducing effect of alfacalcidol and active absorbable algal calcium (AAA Ca) not readily explained by rather mild increases of BMD, attempts were made to evaluate postural stabilizing effect of alfacalcidol, AAA Ca, and calcium carbonate (CaCO(3)) by computerized posturography. Track of the gravity center was analyzed to calculate parameters related to tract length, track range, and track density to express the degree of sway before and after supplementation in 126 subjects ranging in age between 20 and 81 years randomly divided into four groups. Supplementation with AAA Ca containing 900 mg elemental Ca (group A), no calcium (group B), CaCO(3) also containing 900 mg elemental Ca (group C), or alfacalcidol (group D) continued daily for 12 months. For each parameter, the ratio closed eye value/open eye value (Romberg ratio) was calculated to detect aggravation of sway by eye closure. Age, parameters of Ca and P, and proportions of subjects with fracture and those with low BMD showed no marked deviation among the groups. With eyes open, significant decreases of a track range parameter (REC) from group B was noted in groups A (P = 0.0397) and D (P = 0.0296), but not in group C according to multiple comparison by Scheffe, indicating superior postural stabilizing effect of A and D over C. In the first 2 months, a significant fall was already evident in REC from group B in group D (P = 0.0120) with eyes open. Paired comparison of sway parameters before and after supplementation revealed a significant increase of track density parameter (LNGA), indicating sway control efficiency and a significant decrease of REC in groups A and D compared to group B with eyes open. With eyes closed, only group A showed a significant improvement from group B (P = 0.0456; Fig. 1), with a significant shortening on paired After/Before comparison (P = 0.0142; Fig. 2). Computerized posturography appears to be useful in analyzing sway phenomena especially as to the effects of vitamin D and various Ca preparations.

Adult↗
PubMed1996

A comparison of three vibrators in static posturography: the effect of vibration amplitude on body sway.

In static posturography, proprioception is often disturbed using vibrators applied bilaterally to the calf muscles. The effect of vibrator amplitude on body sway was compared in static posturography using bilateral vibrators on the calf muscles of 30 healthy male military conscripts at frequencies of 50 and 90 Hz. Postural stability was measured in terms of BSV (body sway velocity), and maximal displacements of the centre of force (MAXY, MAXX) in the anterio-posterior and lateral directions. In comparing the effects of vibration to base stance without vibration, BSV seemed to be the most sensitive parameter. A vibration of 50 and 90 Hz significantly influenced BSV values with the two most eccentric loads, an effect which could not be confirmed using any other parameter. This result could be obtained even with a small amplitude (around 0.7 mm free/0.3 mm fixed) in our healthy subjects. The BSV effects may be even more pronounced in clinical work with patients and postural disorders. Thus, when proprioceptive stimulations is used in posturographic measurements, differences in the tested magnitude of the stimulation amplitude with a constant frequency will significantly affect postural stability, even in healthy subjects.

Acceleration↗