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Sozzi S, Ghai S, Schieppati M. The 'Postural Rhythm' of the Ground Reaction Force during Upright Stance and Its Conversion to Body Sway-The Effect of Vision, Support Surface and Adaptation to Repeated Trials. Brain Sci 2023; 13:978. [PMID: 37508910 PMCID: PMC10377030 DOI: 10.3390/brainsci13070978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 07/30/2023] Open
Abstract
The ground reaction force (GRF) recorded by a platform when a person stands upright lies at the interface between the neural networks controlling stance and the body sway deduced from centre of pressure (CoP) displacement. It can be decomposed into vertical (VGRF) and horizontal (HGRF) vectors. Few studies have addressed the modulation of the GRFs by the sensory conditions and their relationship with body sway. We reconsidered the features of the GRFs oscillations in healthy young subjects (n = 24) standing for 90 s, with the aim of characterising the possible effects of vision, support surface and adaptation to repeated trials, and the correspondence between HGRF and CoP time-series. We compared the frequency spectra of these variables with eyes open or closed on solid support surface (EOS, ECS) and on foam (EOF, ECF). All stance trials were repeated in a sequence of eight. Conditions were randomised across different days. The oscillations of the VGRF, HGRF and CoP differed between each other, as per the dominant frequency of their spectra (around 4 Hz, 0.8 Hz and <0.4 Hz, respectively) featuring a low-pass filter effect from VGRF to HGRF to CoP. GRF frequencies hardly changed as a function of the experimental conditions, including adaptation. CoP frequencies diminished to <0.2 Hz when vision was available on hard support surface. Amplitudes of both GRFs and CoP oscillations decreased in the order ECF > EOF > ECS ≈ EOS. Adaptation had no effect except in ECF condition. Specific rhythms of the GRFs do not transfer to the CoP frequency, whereas the magnitude of the forces acting on the ground ultimately determines body sway. The discrepancies in the time-series of the HGRF and CoP oscillations confirm that the body's oscillation mode cannot be dictated by the inverted pendulum model in any experimental conditions. The findings emphasise the robustness of the VGRF "postural rhythm" and its correspondence with the cortical theta rhythm, shed new insight on current principles of balance control and on understanding of upright stance in healthy and elderly people as well as on injury prevention and rehabilitation.
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Affiliation(s)
| | - Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, 65188 Karlstad, Sweden
- Centre for Societal Risk Research, Karlstad University, 65188 Karlstad, Sweden
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van der Waal C, Embrechts E, Loureiro-Chaves R, Gebruers N, Truijen S, Saeys W. Lateropulsion with active pushing in stroke patients: its link with lesion location and the perception of verticality. A systematic review. Top Stroke Rehabil 2023; 30:281-297. [PMID: 35102816 DOI: 10.1080/10749357.2022.2026563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Lateropulsion with active Pushing (LwP) is characterized by impairments in postural control. Previous research suggests an association between LwP, lesion location and verticality misperception. This first-ever systematic review evaluates the association between LwP, lesion location and the perception of verticality (PROSPERO: CRD42020159248). METHODS PubMed, Web of Science, REHABDATA, Embase, Cochrane Library and PEDro were systematically searched on December 16, 2021. Studies were included when examining lesion location or perception of verticality (Subjective Haptic, Visual or Postural Vertical) in supratentorial stroke patients showing LwP. Two reviewers independently screened and assessed risk of bias using the Newcastle Ottawa Scale. Data were qualitatively analyzed and extracted. RESULTS Nineteen studies were included, examining a total of 340 LwP patients. Lesions in: the thalamus, internal capsule, inferior parietal lobule at the junction of the postcentral gyrus, the posterior insula and the superior temporal gyrus, were associated with LwP. Whereas all studies examining the Subjective Postural and Haptic Vertical (haptic only examined once) reported a significant increased deviation in LwP patients, inconsistent results were found for the Subjective Visual Vertical. Furthermore, the Subjective Visual and Postural Vertical showed inconsistent results for magnitude, direction and variability of this deviation. DISCUSSION A complex brain network, rather than only one brain region, seems responsible for body control with respect to gravity. A disruption within this network might lead to a bias in the construction of a correct internal reference frame, crucial for perceiving verticality. There was an association of LwP with verticality misperception in all three modalities.
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Affiliation(s)
- Charlotte van der Waal
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Elissa Embrechts
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Renata Loureiro-Chaves
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Nick Gebruers
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Steven Truijen
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.,Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Mikami K, Shiraishi M, Kamo T. Effect of subjective vertical perception on lateral flexion posture of patients with Parkinson's disease. Sci Rep 2022; 12:1532. [PMID: 35087194 PMCID: PMC8795259 DOI: 10.1038/s41598-022-05587-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/14/2022] [Indexed: 11/09/2022] Open
Abstract
In a retrospective study we tested our hypothesis that the subjective postural vertical ratio (SPV ratio), i.e., the subjective postural vertical measured in relation to the lateral flexion axis, is predictive of lateral trunk flexion in patients with Parkinson's disease (PD). Twenty-five patients were included. The SPV angle, i.e., the subjective perception of a vertical position with reference to the vertical axis, and the SPV ratio, i.e., the SPV angle with reference to the axis of lateral flexion, were calculated. The SPV ratio (r = 0.698, P = 0.001) and LTF angle (r = - 0.601, P = 0.001) correlated with change in the LTF angle at 1 year. The SPV ratio was significantly smaller in patients for whom lateral trunk flexion improved (n = 12) than in those for whom it did not improve (n = 13) (0.99 ± 0.78 vs 1.66 ± 0.71, P = 0.011). The AUC under the ROC curve of the SPV ratio for discrimination of improvement was 0.795 (95% confidence interval: 0.61-0.98). We found that the SPV ratio is associated with change in the LTF and that it can conceivably be used to predict the likelihood of improvement in PD-associated lateral trunk flexion.
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Affiliation(s)
- Kyohei Mikami
- Department of Rehabilitation, Noborito Neurology Clinic, Kawasaki, Japan.
| | - Makoto Shiraishi
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tsutomu Kamo
- Department of Neurology, Noborito Neurology Clinic, Kawasaki, Japan
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Nedelkou A, Hatzitaki V, Chatzinikolaou K, Grouios G. Does somatosensory feedback from the plantar foot sole contribute to verticality perception? Somatosens Mot Res 2021; 38:214-222. [PMID: 34256655 DOI: 10.1080/08990220.2021.1949977] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM OF THE STUDY In upright standing, the human foot sole is the only point of contact with the ground conveying information about the pressure distribution under the feet. We examined how the altered somatosensory input from the plantar foot receptors, when standing on a soft surface, affects the subjective estimation of the earth vertical in different sensory contexts. MATERIALS AND METHODS Twelve (12) healthy young females (mean age: 21.8 ± 2.4 years) adjusted the orientation of a visual line (35 × 1.5 cm) representing the roll orientation of a hand-held (attached on a 24.9 × 4 cm cylinder) or head-attached electromagnetic tracking sensor (Nest of Birds, Ascension Technologies Inc., VT. USA, 60 Hz) under two visual conditions (eyes open, eyes closed) while standing on a soft or firm surface. The mean absolute (accuracy) and variable (precision) error in the verticality estimate was depicted in the sensor's roll deviation from the gravitational vertical. RESULTS The accuracy and the precision of the estimate decreased in the absence of vision, while standing on the soft surface and when the estimate was provided by an active hand rather than head rotation. The surface effect was significant only in the absence of vision and when the estimate was provided by the hand. CONCLUSIONS The contribution of the plantar foot mechanoreceptors to gravity perception is sensory context dependent. Perception of the earth vertical is more accurate when estimated by active head rotation due to the integration of the vestibular and neck proprioceptive afferents.
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Affiliation(s)
- A Nedelkou
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Hatzitaki
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Chatzinikolaou
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Grouios
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Bergmann J, Krewer C, Müller F, Jahn K. The Scale for Retropulsion: Internal consistency, reliability and construct validity. Ann Phys Rehabil Med 2021; 65:101537. [PMID: 33933692 DOI: 10.1016/j.rehab.2021.101537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/28/2021] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Retropulsion is an impairment of body orientation against gravity in the sagittal plane. In a Delphi study, the Scale for Retropulsion (SRP) was developed with a high level of expert agreement. OBJECTIVE To assess the clinimetric properties of the German SRP in patients with neurological disorders. METHODS The SRP was applied to 70 hospitalized patients with neurological disorders (stroke, critical illness neuropathy and/or myopathy, Parkinson syndromes). Internal consistency was determined with the Cronbach ɑ. Test-retest and interrater reliabilities were evaluated with the weighted kappa, intraclass correlation coefficient (ICC), and Bland-Altman plots. The construct validity was evaluated with Spearman correlation. RESULTS The median (interquartile range) SRP score was 5 (3-8) and ranged from 0 to 22 (total scale range: 0 to 24). The SRP had excellent internal consistency (Cronbach ɑ = 0.875) and good to excellent test-retest reliability (weighted kappa = 0.957, ICC = 0.957) and interrater reliability (weighted kappa = 0.837, ICC = 0.837). Analysis of construct validity resulted in good correlations with other clinical balance scales (rSp > 0.80), and fair to moderate correlations with posturographic measures (rSp = 0.27-0.56) and the subjective postural vertical error in the sagittal plane (rSp = -0.325, p = 0.012) as well as the range in the frontal plane (rSp = 0.359, p=0.007). The SRP discriminated between patients classified with and without retropulsion by an independent clinical expert (p<0.001). CONCLUSION The SRP provides a valid and reliable bedside test to quantify retropulsion in individuals with neurological disorders.
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Affiliation(s)
- Jeannine Bergmann
- German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich, Marchioninistraße 15, 81377 Munich, Germany; Schoen Clinic Bad Aibling, Kolbermoorer Straße 72, 83043 Bad Aibling, Germany.
| | - Carmen Krewer
- Schoen Clinic Bad Aibling, Kolbermoorer Straße 72, 83043 Bad Aibling, Germany; Chair of Human Movement Science, Department of Sports and Health Sciences, Technical University of Munich, Germany
| | - Friedemann Müller
- German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich, Marchioninistraße 15, 81377 Munich, Germany; Schoen Clinic Bad Aibling, Kolbermoorer Straße 72, 83043 Bad Aibling, Germany
| | - Klaus Jahn
- German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich, Marchioninistraße 15, 81377 Munich, Germany; Schoen Clinic Bad Aibling, Kolbermoorer Straße 72, 83043 Bad Aibling, Germany
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Comparison of two methods based on one psychophysical paradigm to measure the subjective postural vertical in standing. Neurosci Lett 2020; 742:135541. [PMID: 33278509 DOI: 10.1016/j.neulet.2020.135541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/16/2020] [Accepted: 11/26/2020] [Indexed: 11/23/2022]
Abstract
The perception of verticality can be altered with age or due to neurological diseases. Different procedures have been described to measure the subjective postural vertical (SPV). A deviation from the earth vertical was either described as a single position or as a sector defined by two positions representing the edges of the perceived verticality. In this study, for the first time, we investigated if these two methods produce equal values, and consequently can be merged to set normative values. SPV in standing was tested in 24 healthy young adults (28.4 (5.2) years of age, 12 women). Each participant performed both methods in the sagittal and the frontal plane. Absolute and constant error values were found to be similar for both methods in both planes with a mean difference of less than 0.3° (p > 0.148). The mean width of the SPV sector was 3.9° (0.9°) in the sagittal and 3.7° (1.4°) in the frontal plane, ranging in the mean from -5.5° to 8.1° in the sagittal and -5.3° to 4.3° in the frontal plane. SPV values significantly differed in range between both methods in both planes with a mean difference of more than 3.1° (p<0.002). Results show that both methods, SPVposition and SPVsector, produce equal error values when applied with otherwise similar methodological settings and can therefore be used alternatively or within the same meta-analysis. The SPVsector, however, led to wider range values and was less frequently rated as the preferred method to represent the participants' subjective verticality.
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Fukata K, Amimoto K, Fujino Y, Inoue M, Inoue M, Takahashi Y, Sekine D, Makita S, Takahashi H. Starting position effects in the measurement of the postural vertical for pusher behavior. Exp Brain Res 2020; 238:2199-2206. [PMID: 32683513 DOI: 10.1007/s00221-020-05882-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 07/10/2020] [Indexed: 11/28/2022]
Abstract
Pusher behavior (PB) is a severe lateral postural disorder that involves a disturbed subjective postural vertical (SPV) in the frontal plane. SPV is measured by determining the mean value and standard deviation of several trials beginning on both the contralesional- and ipsilesional-tilted positions. However, the postural representation, when passively tilted to the contralesional versus ipsilesional position, is different between patients with and without PB. Therefore, we hypothesized that SPV dependence on the starting position will be influenced by PB. For 53 patients with hemispheric stroke enrolled, SPV was measured using a non-motorized vertical board with eyes closed. The mean value (tilt direction) and standard deviation (variability) were calculated in four trials, each from two positions, with the patient tilted to the contralesional position (SPV-CL condition) and then to the ipsilesional position (SPV-IL condition). Patients were categorized into the non-pusher (n = 29) and pusher (n = 24) groups. In the SPV-CL trials, the tilt direction was significantly tilted contralesionally for the pusher group (- 6.3° ± 1.6°) compared with that for the non-pusher group (- 2.2° ± 1.8°; p < 0.001), with no significant difference in variability between the groups. In the SPV-IL trials, the tilt direction was not significantly different between the groups, but the variability was significantly higher in the pusher group (4.8° ± 2.0°) than in the non-pusher group (2.2° ± 1.3°; p < 0.001). The dependence of tilt direction and variability of SPV on the starting position in patients with PB differed from those noted in patients without PB. These results may help explain this abnormal posture and optimize neurological rehabilitation strategies for PB.
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Affiliation(s)
- Kazuhiro Fukata
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Faculty of Human Health Science, Tokyo Metropolitan University, 7-2-10, Higashi-Ogu, Arakawa-ku, Tokyo, 116-8551, Japan.
| | - Yuji Fujino
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, 3-2-12, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Masahide Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
- Department of Physical Therapy, Faculty of Human Health Science, Tokyo Metropolitan University, 7-2-10, Higashi-Ogu, Arakawa-ku, Tokyo, 116-8551, Japan
| | - Mamiko Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Yosuke Takahashi
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, 3-2-12, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Daisuke Sekine
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
- Department of Physical Therapy, Faculty of Human Health Science, Tokyo Metropolitan University, 7-2-10, Higashi-Ogu, Arakawa-ku, Tokyo, 116-8551, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
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Bergmann J, Bardins S, Prawitz C, Keywan A, MacNeilage P, Jahn K. Perception of postural verticality in roll and pitch while sitting and standing in healthy subjects. Neurosci Lett 2020; 730:135055. [DOI: 10.1016/j.neulet.2020.135055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
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Nakamura J, Shiozaki T, Tsujimoto N, Ikuno K, Okada Y, Shomoto K. Role of somatosensory and/or vestibular sensory information in subjective postural vertical in healthy adults. Neurosci Lett 2020; 714:134598. [DOI: 10.1016/j.neulet.2019.134598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/10/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
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[The subjective perception of the vertical-a valuable parameter for determination of peripheral vestibular disorder in Menière's disease in the chronic phase?]. HNO 2019; 67:282-292. [PMID: 30725124 DOI: 10.1007/s00106-019-0626-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The perception of verticality is mainly based on utricular afferent signals and central processing of the transmitted signals. However, there are also extracranial receptors that make a considerable contribution to the perception of verticality. With the subjective visual vertical (SVV) for the utricle and the subjective trunk vertical (STV), two different parameters are available that are not fully understood in terms of their response to physiologic and pathologic changes. The aim of this work was to determine SVV and STV under certain positions of the head and trunk as well as under the influence of Menière's disease (MD) as a chronic vestibular disease. In a prospective clinical study, 26 patients with MD and 39 healthy volunteers were recruited. Subjects were examined with C‑SVV glasses and with the three-dimensional trunk excursion chair, while head and torso positions were varied. In both groups, SVV determination is clearly more accurate with an earth-vertical head alignment than with a lateral head tilt (right: MM and control group: p = 0.001; left: MM p = 0.001, control group p = 0.000). If the torso is deflected laterally and the head is held straight, the SVV is significantly more accurate (left p = 0.003, right p = 0.015). The SRV was not affected by the presence of unilateral MD, while pathologic SVV values, if present, indicated the affected side. The results of our study support the assumption that in addition to SVV, SRV is an independent parameter for verticality perception and differs from the SVV in terms of lateralizing a peripheral vestibular deficit. These results suggest that the STV may depend not only on utricular function but also on extracranial afferent signals, and not be significantly altered by the presence of a hydropic peripheral vestibular lesion.
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Balance and mobility in geriatric patients : Assessment and treatment of neurological aspects. Z Gerontol Geriatr 2019; 52:316-323. [PMID: 31161336 DOI: 10.1007/s00391-019-01561-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/05/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Personal autonomy in advanced age critically depends on mobility in the environment. Geriatric patients are often not able to walk safely with sufficient velocity. In many cases, multiple factors contribute to the deficit. Diagnostic identification of single components enables a specific treatment. OBJECTIVE This article describes the most common neurological causes of imbalance and impaired gait that are relevant for a pragmatic approach for the assessment of deficits in clinical and natural environments taking into account the physiology of balance and gait control, typical morbidities in older people and the potential of innovative assessment technologies. MATERIAL AND METHODS Expert opinion based on a narrative review of the literature and with reference to selected research topics. RESULTS AND DISCUSSION Common neurological causes of impaired balance and mobility are sensory deficits (reduced vision, peripheral neuropathy, vestibulopathy), neurodegeneration in disorders with an impact on movement control and motoric functions (Parkinsonian syndromes, cerebellar ataxia, vascular encephalopathy) and functional (psychogenic) disorders, particularly a fear of falling. Clinical tests and scores in laboratory environments are complemented by the assessment in the natural environment. Wearable sensors, mobile smartphone-based assessment of symptoms and functions and adopted strategies for analysis are currently emerging. Use of these data enables a personalized treatment. Furthermore, sensor-based assessment ensures that effects are measured objectively.
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Dieterich M, Brandt T. Perception of Verticality and Vestibular Disorders of Balance and Falls. Front Neurol 2019; 10:172. [PMID: 31001184 PMCID: PMC6457206 DOI: 10.3389/fneur.2019.00172] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 02/08/2019] [Indexed: 11/16/2022] Open
Abstract
Objective: To review current knowledge of the perception of verticality, its normal function and disorders. This is based on an integrative graviceptive input from the vertical semicircular canals and the otolith organs. Methods: The special focus is on human psychophysics, neurophysiological and imaging data on the adjustments of subjective visual vertical (SVV) and the subjective postural vertical. Furthermore, examples of mathematical modeling of specific vestibular cell functions for orientation in space in rodents and in patients are briefly presented. Results: Pathological tilts of the SVV in the roll plane are most sensitive and frequent clinical vestibular signs of unilateral lesions extending from the labyrinths via the brainstem and thalamus to the parieto-insular vestibular cortex. Due to crossings of ascending graviceptive fibers, peripheral vestibular and pontomedullary lesions cause ipsilateral tilts of the SVV; ponto-mesencephalic lesions cause contralateral tilts. In contrast, SVV tilts, which are measured in unilateral vestibular lesions at thalamic and cortical levels, have two different characteristic features: (i) they may be ipsi- or contralateral, and (ii) they are smaller than those found in lower brainstem or peripheral lesions. Motor signs such as head tilt and body lateropulsion, components of ocular tilt reaction, are typical for vestibular lesions of the peripheral vestibular organ and the pontomedullary brainstem (vestibular nucleus). They are less frequent in midbrain lesions (interstitial nucleus of Cajal) and rare in cortical lesions. Isolated body lateropulsion is chiefly found in caudal lateral medullary brainstem lesions. Vestibular function in the roll plane and its disorders can be mathematically modeled by an attractor model of angular head velocity cell and head direction cell function. Disorders manifesting with misperception of the body vertical are the pusher syndrome, the progressive supranuclear palsy, or the normal pressure hydrocephalus; they may affect roll and/or pitch plane. Conclusion: Clinical determinations of the SVV are easy and reliable. They indicate acute unilateral vestibular dysfunctions, the causative lesion of which extends from labyrinth to cortex. They allow precise topographical diagnosis of side and level in unilateral brainstem or peripheral vestibular disorders. SVV tilts may coincide with or differ from the perception of body vertical, e.g., in isolated body lateropulsion.
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Affiliation(s)
- Marianne Dieterich
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany.,Department of Neurology, Ludwig-Maximilians University, Munich, Germany.,Munich Cluster for Systems Neurology, Munich, Germany
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany.,Clinical Neuroscience, Ludwig-Maximilians University, Munich, Germany
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Test-retest reliability of and age-related changes in the subjective postural vertical on the diagonal plane in healthy subjects. Atten Percept Psychophys 2018; 81:590-597. [DOI: 10.3758/s13414-018-1627-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Conceição LB, Baggio JAO, Mazin SC, Edwards DJ, Santos TEG. Normative data for human postural vertical: A systematic review and meta-analysis. PLoS One 2018; 13:e0204122. [PMID: 30265701 PMCID: PMC6161851 DOI: 10.1371/journal.pone.0204122] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 09/04/2018] [Indexed: 02/05/2023] Open
Abstract
Perception of verticality is required for normal daily function, yet the typical human detection error range has not been well characterized. Vertical misperception has been correlated with poor postural control and functionality in patients after stroke and after vestibular disorders. Until now, all the published studies that assessed Subjective Postural Vertical (SPV) in the seated position used small groups to establish a reference value. However, this sample size does not represent the healthy population for comparison with conditions resulting in pathological vertical. Therefore, the primary objective was to conduct a systematic review with meta-analyses of Subjective Postural Vertical (SPV) data in seated position in healthy adults to establish the reference value with a representative sample. The secondary objective was to investigate the methodological characteristics of different assessment protocols of SPV described in the literature. A systematic literature search was conducted using Medline, EMBASE, and Cochrane libraries. Mean and standard deviation of SPV in frontal and sagittal planes were considered as effect size measures. Sixteen of 129 identified studies met eligibility criteria for our systematic review (n = 337 subjects in the frontal plane; n = 187 subjects in sagittal plane). The meta-analyses measure was estimated using the pooled mean as the estimator and its respective error. Mean reference values were 0.12°±1.49° for the frontal plane and 0.02°±1.82° for the sagittal plane. There was a small variability of the results and this systematic review resulted in representative values for SPV. The critical analysis of the studies and observed homogeneity in the sample suggests that the methodological differences used in the studies did not influence SPV assessment of directional bias in healthy subjects. These data can serve as a reference for clinical studies in disorders of verticality.
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Affiliation(s)
| | - Jussara A O Baggio
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil.,Federal University of Alagoas, Arapiraca, Alagoas, Brazil
| | - Suleimy C Mazin
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil.,Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Dylan J Edwards
- Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, United States of America.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Taiza E G Santos
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil
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15
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Verticality perception reveals a vestibular deficit in adolescents with idiopathic scoliosis. Exp Brain Res 2018; 236:1725-1734. [DOI: 10.1007/s00221-018-5256-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/07/2018] [Indexed: 10/17/2022]
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16
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Yagci G, Yakut Y, Simsek E. The effects of exercise on perception of verticality in adolescent idiopathic scoliosis. Physiother Theory Pract 2018; 34:579-588. [PMID: 29308950 DOI: 10.1080/09593985.2017.1423429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Visual and proprioceptive cues are important for body orientation to maintain correct posture. This study investigated the effects of exercise training on subjective visual, postural, and haptic perception of verticality in patients with scoliosis. SUBJECTS AND METHODS Thirty-two female adolescents with moderate idiopathic scoliosis were randomly allocated to "Core Stabilization Exercise (CSE)," "Body Awareness," or "Traditional Exercise (TE)" groups. Each group completed a 1-hour supervised program, two days per week for 10 weeks while continuing to wear spinal braces. Perceptual visual, postural, and haptic estimates were assessed before and after treatment. RESULTS Subjective visual vertical perception only improved in the awareness group. Subjective visual horizontal perception, postural vertical perception, total postural perception scores, total haptic perception scores, and haptic perception 45° to the right were significantly improved in the stabilization and awareness groups. For the 60° right and 60° left postural perception parameters, as well as the 45° left haptic perception parameters, perception improved only in the stabilization group. No improvement was observed in the traditional group. CONCLUSION Improvements in visual, postural, and haptic verticality perception within the stabilization exercise training and Basic Body Awareness group treatment suggest the addition of these exercise methods for the treatment of idiopathic scoliosis to improve internal body orientation.
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Affiliation(s)
- Gozde Yagci
- a Hacettepe University, Faculty of Health Sciences , School of Physical Therapy and Rehabilitation Sciences, Samanpazari , Ankara , Turkey
| | - Yavuz Yakut
- b Physiotherapy and Rehabilitation Department, Hasan Kalyoncu University, Faculty of Health Sciences , Altindag Turkey , Turkey
| | - Engin Simsek
- c Dokuz Eylul University, School of Physical Therapy and Rehabilitation Sciences , İzmir , Turkey
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17
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Fukata K, Amimoto K, Fujino Y, Inoue M, Inoue M, Takahashi Y, Makita S, Takahashi H. The effects of aging on the subjective vertical in the frontal plane in healthy adults. J Phys Ther Sci 2017; 29:1950-1953. [PMID: 29200631 PMCID: PMC5702821 DOI: 10.1589/jpts.29.1950] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 08/09/2017] [Indexed: 11/26/2022] Open
Abstract
[Purpose] To determine age-related differences in the subjective vertical in the frontal
plane in healthy adults. [Subjects and Methods] The subjects were 26 healthy adults. For
the subjective visual vertical (SVV), subjects were presented with a visual indicator in
front of them that was rotated. For the subjective postural vertical-eyes open (SPV-EO)
and subjective postural vertical (SPV), subjects sat in a seating device that was tilted
right or left. The subjects gave a signal when they perceived true verticality. Each task
was performed eight times. The items examined were the mean (tilt direction) and standard
deviation (variability) of the eight trials, then the mean of four trials that started
from the right or left side position. These items were compared between the young (age:
22–30 years [range]) and elderly (age: 60–74 years) groups. [Results] As for variability,
the elderly group demonstrated significantly higher values of SPV-EO and SPV. As for the
starting point effect, the elderly group demonstrated greater bias toward the starting
direction than did the young group in SPV-EO and SPV in frontal plane. [Conclusion] The
postural vertical was shown to change with age. Consideration of age-related changes and
the starting point effect was indicated to be important.
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Affiliation(s)
- Kazuhiro Fukata
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan.,Department of Physical Therapy, Tokyo Metropolitan University, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Tokyo Metropolitan University, Japan
| | - Yuji Fujino
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Masahide Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Mamiko Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Yosuke Takahashi
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, Japan
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18
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Sprenger A, Wojak JF, Jandl NM, Helmchen C. Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input. Front Neurol 2017; 8:444. [PMID: 28919878 PMCID: PMC5585141 DOI: 10.3389/fneur.2017.00444] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/14/2017] [Indexed: 02/04/2023] Open
Abstract
Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive deprivation heavily destabilizes BVF, even when visual control is provided.
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Affiliation(s)
- Andreas Sprenger
- Department of Neurology, University of Lübeck, Lubeck, Germany.,Institute of Psychology II, University of Lübeck, Lubeck, Germany
| | - Jann F Wojak
- Department of Neurology, University of Lübeck, Lubeck, Germany
| | - Nico M Jandl
- Department of Neurology, University of Lübeck, Lubeck, Germany
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19
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Mikami K, Shiraishi M, Kawasaki T, Kamo T. Forward flexion of trunk in Parkinson's disease patients is affected by subjective vertical position. PLoS One 2017; 12:e0181210. [PMID: 28700731 PMCID: PMC5507338 DOI: 10.1371/journal.pone.0181210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 06/27/2017] [Indexed: 02/03/2023] Open
Abstract
PURPOSE No method has been established to evaluate the dissociation between subjective and objective vertical positions with respect to the self-awareness of postural deformity in patients with Parkinson's disease (PD). The purpose of this study was to demonstrate, from the relationship between an assessment of the dissociation of subjective and objective vertical positions of PD patients and an assessment based on established PD clinical evaluation scales, that the dissociation regarding vertical position is a factor in the severity of the forward flexion of trunk (FFT). METHODS Subjects were 39 PD patients and 15 age-matched healthy individuals (control group). Posture was evaluated with measurement of FFT angle during static standing and the subjective vertical position (SV) of the patient. For evaluation of motor function, the Modified Hoehn & Yahr scale, Unified Parkinson's Disease Rating Scale (UPDRS), 3-m Timed Up and Go Test (TUG), and Functional Reach Test (FRT) were used. RESULTS In PD patients, FFT angle in the 3rd tertile of patients was 13.8±9.7°, significantly greater than those in the control group and the 1st and 2nd tertiles of PD patients (control group vs 3rd tertile, p = 0.008; 1st tertile vs 3rd tertile, p<0.001; 2nd vs 3rd tertile, p = 0.008). In multiple regression analysis for factors in the FFT angle, significant factors were SV, disease duration, and the standard deviation of each SV angle measurement. CONCLUSION The dissociation between SV and objective vertical position affects the FFT of PD patients, suggesting an involvement of non-basal ganglia pathologies.
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Affiliation(s)
- Kyohei Mikami
- Department of Rehabilitation, Noborito Neurology Clinic, Kawasaki, Kanagawa, Japan
| | - Makoto Shiraishi
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Tsubasa Kawasaki
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University, Urayasu, Chiba, Japan
| | - Tsutomu Kamo
- Department of Neurology, Noborito Neurology Clinic, Kawasaki, Kanagawa, Japan
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20
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Jahn K, Müller F, Koenig E, Krewer C, Tillmann S, Bergmann J. Rehabilitation of verticality perception using a new training method. J Neurol 2017; 264:26-27. [PMID: 28321565 DOI: 10.1007/s00415-017-8435-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 02/21/2017] [Accepted: 02/22/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Klaus Jahn
- German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, University Hospital Grosshadern, Munich, Germany.
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany.
| | - Friedemann Müller
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
| | - Eberhard Koenig
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
| | - Carmen Krewer
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
| | - Susanne Tillmann
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
| | - Jeannine Bergmann
- German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, University Hospital Grosshadern, Munich, Germany
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
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21
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Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus? J Neurol 2016; 263:1819-27. [DOI: 10.1007/s00415-016-8186-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/02/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022]
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22
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Bergmann J, Krewer C, Selge C, Müller F, Jahn K. The Subjective Postural Vertical Determined in Patients with Pusher Behavior During Standing. Top Stroke Rehabil 2016; 23:184-90. [DOI: 10.1080/10749357.2015.1135591] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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