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At least 127 records · Page 7Linked to original sources
PubMed2006

Virtual reality in posturography.

Balance dysfunctions are common, especially among elderly people. Present methods for the diagnosis and evaluation of severity of dysfuntion have limited value. We present a system that makes it easy to implement different visual and mechanical perturbations for clinical investigations of balance and visual-vestibular interaction. The system combines virtual reality visual stimulation with force platform posturography on a moving platform. We evaluate our contruction's utility in a classification task between 33 healthy controls and 77 patients with Ménière's disease, using a series of tests with different visual and mechanical stimuli. Responses of patients and controls differ significantly in parameters computed from stabilograms. We also show that the series of tests achieves a classification accuracy slightly over 80% between controls and patients.

Artificial Intelligence↗
PubMed1996

Balance after stapedectomy: the measurement of spontaneous sway by posturography.

Sway was measured by static posturography in 25 patients undergoing stapedectomy, 16 first-side and nine second-side operations. Measurements were taken pre-operatively and at 1 week and 6 months after surgery, 25 age-matched controls were also tested. In both the first and second side groups, sway was greater at 1 week after surgery than pre-operatively when relying on vestibular function alone (P = 0.01 first-side, 0.05 second-side, 0.01 both sides taken together). By 6 months, sway measurements were no longer significantly different from pre-op or control values. Thus, it appears that there is a measurable increase in patients' sway following stapedectomy but this is well compensated by visual and proprioceptive information, and resolves fully with time. Patients undergoing a second side stapedectomy do not appear to fare worse than those undergoing first-side surgery.

Humans↗
PubMed2005

Interobserver reliability in evaluating postural stability between clinicians and posturography.

OBJECTIVES: To assess the interobserver reliability in assessing postural stability and to compare with results obtained by computerized posturography. DESIGN: Cross-sectional study. SETTING: Balance clinic, teaching hospital. PARTICIPANTS: 81 patients attending with a primary complaint of imbalance. MAIN OUTCOME MEASURES: Inter-rater reliability between two clinicians and the modified Clinical Test for the Sensory Interaction on Balance (mCTSIB) as assessed by the Neurocom VSR Balance Master platform. RESULTS: Inter-rater reliability scores were high (0.53-0.81) for all conditions of the mCTSIB except for the easiest, i.e. firm surface eyes open, where concordance levels were poor to fair. CONCLUSIONS: Overall there was good agreement between observers and the computerized mCTSIB.

Adult↗
PubMed1993

Evaluation of postural stability by computerised posturography following outpatient paediatric anaesthesia. Comparison of propofol/alfentanil/N2O anaesthesia with thiopentone/halothane/N2O anaesthesia.

Simple clinical tests, like Romberg's test or a walking test, have proved to be inadequate guidelines for safe discharge after outpatient anaesthesia. A randomised study was therefore planned to compare postural stability measured by computerised posturography in 31 oral midazolam-atropine premedicated children aged 6.9 (s.e. 0.4) years who had been anaesthetised with either propofol/alfentanil/N2O or thiopentone/halothane/N2O. The sway velocity of the children was measured before premedication and 1, 2 and 3 h after the end of anaesthesia. Results show that sway velocity had returned to baseline values 3 h after the end of anaesthesia in all children who had received propofol/alfentanil/N2O and in 12 of the 15 children who had received thiopentone/halothane/N2O. The quantified version of the Romberg test performed with eyes open or closed was not impaired after anaesthesia, compared with the control values, indicating that in children poor equilibrium is not compensated by vision. The clinical recovery with respect to the times to eye opening, to responding to command or to being fully awake did not differ between the two anaesthesia methods. On the basis of recovery assessed by postural stability, propofol/alfentanil/N2O anaesthesia was not preferable to thiopentone/halothane/N2O anaesthesia after minor paediatric otolaryngological surgery.

Alfentanil↗
PubMed1998

A prospective study of posturography in normal older people.

OBJECTIVE: To follow posturographic measurements over time in a group of normal older subjects to see if sway increases with aging and if sway is greater in those with deteriorating balance and falls. SUBJECTS: Seventy-two community-dwelling older people (age range 79-91 years), who initially had normal neurological evaluations, were followed with three yearly follow-up examinations. MEASUREMENTS: Amplitude and velocity of sway on static and dynamic posturography, Tinetti gait and balance score, reports of falls. RESULTS: Velocity of sway on dynamic tests increased significantly during the 3 years of follow-up. The percentage increase in sway was about the same in the anterior-posterior and medial-lateral directions and with eyes open and eyes closed. Subjects with low Tinetti scores had higher sway amplitude and velocity, particularly on dynamic tests, but no measure of sway was significantly different in those who reported falls compared with those who did not report falls. CONCLUSIONS: Sway increases in normal subjects over time, and sway is greater in older subjects with deteriorating balance compared with those with normal balance. Sway was not greater in those who fell compared with those who did not fall, probably because falls are highly dependent on individual behavior.

Accidental Falls↗
PubMed2001

What can posturography tell us about vestibular function?

Patients with balance disorders want answers to the following basic questions: (1) What is causing my problem? and (2) What can be done about my problem? Information to fully answer these questions must include status of both sensory and motor components of the balance control systems. Computerized dynamic posturography (CDP) provides quantitative assessment of both sensory and motor components of postural control along with how the sensory inputs to the brain interact. This paper reviews the scientific basis and clinical applications of CDP. Specifically, studies describing the integration of vestibular inputs with other sensory systems for postural control are briefly summarized. Clinical applications, including assessment, rehabilitation, and management are presented. Effects of aging on postural control along with prevention and management strategies are discussed.

Posture↗
PubMed1999

Stereotactic posterioventral pallidotomy improves balance control as assessed by computerized posturography.

Postural instability is arguably the most debilitating symptom of Parkinson's disease (PD). Recently, posterioventral pallidotomy/pallidoansotomy (PVP) has been advocated to improve a multitude of symptoms associated with PD. Dyskinesias, rigidity and bradykinesia are the most talked about improved symptoms, but posture and gait are also affected after PVP. To analyze the effect of PVP on postural control, 14 patients with PD were prospectively studied using a computerized dynamic posturography machine. Seven males and 7 females underwent a total of 18 procedures, 6 left PVP, 6 right PVP, 2 bilateral and 2 had Vim thalamotomies in addition to PVP. Data were collected pre- and postoperatively after a 12-hour drug-free interval ('off' period) and 1-2 h after medications ('on' period). Postoperative analyses were performed between 1 and 3 months postoperatively. As a group, patients' balance, in the off period, improved after surgery in a dynamic setting. Prior to surgery, patients' anterior-posterior sway exceeded their stability limits (patient fell) on 31% of the trials. After surgery, the fall rate decreased to 23%. Anterior-posterior sway decreased significantly (p < 0.05) postoperatively when the platform was sway referenced. In comparing the effect of surgery in decreasing sway with that of medication preoperatively, improvement after surgery (off period) was better than the preoperative on period (p < 0.05). Patients also improved in ostoperative off state when compared to preoperative off state with the platform sway referenced (p < 0.05), controlling for improvement in dyskinesia-induced imbalance. In conclusion, PVP improves standing balance performance better than that achieved with medications preoperatively. Since central input parameters were improved, the mechanism of PVP may be centralized.

Aged↗
PubMedDate not supplied

Postural control measured by visual feedback posturography.

The objective was to study the applicability and repeatability of visual feedback posturography (VFP) in assessing postural control of 23 healthy subjects. The subjects had to move their center of gravity (COG) marker on a computer screen to chosen targets by leaning their body on the platform, and the accuracy, velocity, and side difference of these movements were measured. The intraclass correlation coefficients for all parameters during repeated tests were significant (r = 0.93 - 0.96; p < 0.01). Hold percentage within the targets and COG marker velocity to the targets did not change significantly during repeated tests. Balance index and hit delay were significantly smaller during the 4th and 5th than during the 1st test session (p < 0.05), but they did not change significantly between the other test sessions. The normative limit for side difference in postural control was 22%. VFP can be used to follow active postural control due to its high test-retest repeatability. However, learning effects in some parameters must be taken into account when applying VFP repeatedly in different patient populations to assess the progress in postural control.

Adolescent↗
PubMed2005

Postural control after vestibular schwannoma resection measured with visual feedback posturography.

BACKGROUND: Vestibular symptoms after surgery diminish rapidly, but the simultaneous progress in active postural control has not been fully addressed. OBJECTIVES: The aim was to evaluate the progress in postural control in operated vestibular schwannoma (VS) patients with visual feedback posturography (VFP). METHODS: 36 consecutive patients with unilateral VS were studied with the VFP pre-operatively, 1 month and 3 months after the surgery. The accuracy and velocity of active postural control movements to distant targets in VFP was measured and compared to that of healthy controls. RESULTS: The hold percentage within the targets was significantly reduced in the VS patients compared to the controls (pre-operatively p = 0.005; postoperatively at 1 month p = 0.002 and at 3 months p = 0.017). The sway velocity (SV) within the targets among patients with VS was significantly increased pre-operatively (p = 0.009), at the 1-month (p = 0.004) and at the 3-month follow-up visits (p = 0.016). All the postural control parameters except SV tended to improve slightly postoperatively. The consecutive VFP measurements in individual VS patients correlated statistically significantly (p < 0.001 for all parameters). The abnormality in the pre-operative VFP results correlated statistically significantly with that of postoperative VFP (p = 0.001). CONCLUSIONS: The VFP is an objective and repeatable method, which can be used to assess and follow up the active postural control in individual patients with VS. Persisting abnormality in the VFP seems to be an indication for more aggressive vestibular rehabilitation to normalize the disturbed postural control.

Adult↗
PubMed2006

Preoperative postural control of patients with vestibular schwannoma assessed by visual feedback posturography.

BACKGROUND: The need for an objective method to describe the functional postural control of patients with vestibular schwannoma in agreement with their subjective sensation of balance. OBJECTIVES: The objective was to compare the postural control of 49 patients with unilateral vestibular schwannoma (VS) with that of healthy subjects by using visual feedback posturography (VFP). We aimed to find out if preoperative postural control of the patients correlates with their subjective sensation of balance. METHODS: In the VFP, while standing on the platform, patients were instructed to move their center of gravity (COG) marker to the targets as fast and accurately as possible. Hit delay (HD) to the targets, hold percentage (HP) within the targets, COG marker velocity (CMV) to the targets, and balance index (BI) were calculated. We rated intensity of balance disturbance using a 5-point qualitative scale. RESULTS: Twenty-two (45%) patients had at least one abnormal VFP parameter, and 49% of patients were simultaneously symptomatic. Mean hit delay (HD), hold percentage (HP), and balance index (BI) were significantly worsened in patients with VS (p < 0.05). Increased HD and BI correlated significantly with subjective sensation of imbalance (p = 0.02). CONCLUSIONS: The overall deficit in preoperative postural control of the VS patients was not severe, and this finding agreed well with their subjective sensations.

Adult↗
PubMed2006

Posturography and risk of recurrent falls in healthy non-institutionalized persons aged over 65.

BACKGROUND: A poor postural stability in older people is associated with an increased risk of falling. The posturographic tool has widely been used to assess balance control; however, its value in predicting falls remains unclear. OBJECTIVE: The purpose of this prospective study was to determine the predictive value of posturography in the estimation of the risk of recurrent falls, including a comparison with standard clinical balance tests, in healthy non-institutionalized persons aged over 65. METHODS: Two hundred and six healthy non-institutionalized volunteers aged over 65 were tested. Postural control was evaluated by posturographic tests, performed on static, dynamic and dynamized platforms (static test, slow dynamic test and Sensory Organization Test [SOT]) and clinical balance tests (Timed 'Up & Go' test, One-Leg Balance, Sit-to-Stand-test). Subsequent falls were monitored prospectively with self-questionnaire sent every 4 months for a period of 16 months after the balance testing. Subjects were classified prospectively in three groups of Non-Fallers (0 fall), Single-Fallers (1 fall) and Multi-Fallers (more than 2 falls). RESULTS: Loss of balance during the last trial of the SOT sensory conflicting condition, when visual and somatosensory inputs were distorted, was the best factor to predict the risk of recurrent falls (OR = 3.6, 95% CI = 1.3-10.11). Multi-Fallers showed no postural adaptation during the repetitive trials of this sensory condition, contrary to Non-Fallers and Single-Fallers. The Multi-Fallers showed significantly more sway when visual inputs were occluded. The clinical balance tests, the static test and the slow dynamic test revealed no significant differences between the groups. CONCLUSION: In a sample of non-institutionalized older persons aged over 65, posturographic evaluation by the SOT, especially with repetition of the same task in sensory conflicting condition, compared to the clinical tests and the static and dynamic posturographic test, appears to be a more sensitive tool to identify those at high-risk of recurrent falls.

Accidental Falls↗
PubMed1994

Ageing and balance: the measurement of spontaneous sway by posturography.

Sway was measured by static posturography in 74 healthy subjects. Four age groups were investigated: 20-40, 40-60, 60-70 and over 70 years with equal numbers of males and females in each group. Sway increased linearly with age but was not affected by gender at any age. All age groups were more dependent on proprioception than vision in the maintenance of balance, but when reliable pressoreceptor information was removed, dependence on vision increased. The relative contributions of the sensory systems to balance did not alter with advancing age. The increase in sway demonstrated with normal ageing does not appear due to altered peripheral sensibility. It is more likely that it is due to slowing of central integrative processes.

Adult↗
PubMed1991

Correlation between dynamic posturography, clinical investigation, and neurography in patients with polyneuropathy.

Dynamic posturography (PG) is a new objective method to study functional performance in diseases affecting balance. It measures muscle response latencies and sway angles to standardized alterations of a moveable platform and moveable surroundings. Twenty-eight patients with polyneuropathy (PN) were studied by clinical investigation, vibrametry, neurography, and dynamic PG. The results of dynamic PG and vibrametry were compared with those of 29 healthy controls. In the patients with PN, clinical scores correlated to the latencies of the muscle response when the platform was suddenly moved forward, and to equilibrium performance (sway angles) in dynamic PG test conditions with eyes closed and the platform either stable or 'sway-referenced'. That is, the platform moves in response to the patient's anterior-posterior sway, creating a disturbed proprioceptive input to the brain. Clinical scores also correlated to the equilibrium performance when both platform and surroundings were sway-referenced. In conclusion dynamic PG, in addition to clinical investigations and neurophysiology, is a valuable and objective method for estimating the equilibrium performance in patients with PN.

Aged↗
PubMedDate not supplied

Posturography.

Posturography is a method of measuring a patient's ability to control his balance. Currently available testing techniques may be useful to otologists, although they have not been shown to yield information beyond that obtained from other diagnostic procedures. More powerful techniques are under development, but methodologic problems remain, and none is yet ready for routine clinical use.

Cerebellum↗
PubMed1992

Effect of head orientation on the diagnostic sensitivity of posturography in patients with compensated unilateral lesions.

Patients with compensated unilateral vestibular lesions often have no detectable abnormality on conventional posturography. The purpose of this study was to determine whether a change in head orientation could improve the diagnostic sensitivity of the test for these patients. Twenty-four patients with known unilateral vestibulopathy and twenty-four normal controls were tested on the EquiTest apparatus in four head positions: head centered, head tilted right, head tilted left, and head extended. The sensory organization test was performed for each head position, using a single trial for each sensory condition. The test sequence was randomized to account for simple order effects. The subject's equilibrium was quantified by a performance index and a composite score of all sensory conditions was calculated for each head position. Patients with unilateral vestibulopathy had more postural sway with the head tilted contralateral to the side of lesion. The difference between the mean composite scores for ipsilateral and contralateral head tilts was statistically significant (p less than 0.05). When individual trials were compared, equilibrium scores were significantly different only for sensory conditions that required vestibular input. Head extension increased postural sway in both patients and controls. Equilibrium scores were significantly different for all sensory conditions in which the support was sway-referenced. We suggest that the results of head extension in patients are similar to those found in normal individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Clinical significance of type 5 patterns in platform posturography.

Several abnormal patterns have been identified on the sensory portion of the computerized dynamic posturography test. The vestibular deficit pattern, also known as the "5-6" pattern, is frequently seen in patients with either uncompensated unilateral vestibular lesions, severe bilateral peripheral vestibular loss, or dysfunction involving the vestibular pathways in the brain stem and/or cerebellum. In both sensory conditions 5 and 6, the patient's balance/equilibrium is determined primarily by the vestibular system. A subgroup of the vestibular deficit pattern has been identified, in which only sensory condition 5 is abnormal. This article presents findings in several cases identified with the 5 pattern. Implications for diagnosis and for monitoring the recovery phase after treatment are discussed.

Adolescent↗
PubMed1994

Sensory interaction posturography in patients with peripheral vestibular disorders.

The results of posturography, using all sensory inputs, are compared with recordings when one or more of the sensory inputs are altered by the test conditions. This gives an idea of the sensory interaction in central compensation in the vestibulospinal reflex. Positive and negative effects could be observed in patients with peripheral vestibular disorders.

Female↗
PubMed1993

Vestibular evaluation--electronystagmography, rotational testing, and posturography.

This report describes a battery of tests that is utilized by several clinical laboratories to investigate vestibular and balance function. The electronystagmogram evaluates eye movements, inner ear function, brainstem function and cerebellar function. Sinusoidal vertical axis rotation is a sensitive measure of horizontal semicircular canal function that is often complimentary to the caloric stimulation portion of the electronystagmogram. Visual-vestibular interaction rotation testing is designed to evaluate brainstem, cerebellar and oculomotor function. Dynamic posturography facilitates measurement of standing balance and permits a quantification of the role of proprioception, vision and the vestibular system in the maintenance of standing balance.

Adrenocorticotropic Hormone↗