Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-28T14:31:44.804Z Has data issue: false hasContentIssue false
  • English
  • Français

Sensory interaction testing in platform posturography

Published online by Cambridge University Press:  29 June 2007

Marcel E. Norré
Marcel E. Norré*
Affiliation:
Department of Otoneurology, University Hospitals, University of Leuven
*
Professor M. Norré, Otoneurology and Equilibriometry, Schotstrasse 2, 3020 Herent, Belgium
Get access Rights & Permissions [Opens in a new window]

Abstract

Mostly techniques measuring the vestibulo-ocular reflex (VOR) have been used for the evaluation of patients with dizziness problems. Some investigators, however, have also tried to take into account the vestibulospinal reflex (VSR). So recording techniques for the Romberg-test have been proposed and called posturography (PG). By interfering with the visual and proprioceptive sensory inputs during this PG-testing one tries to find out how ‘sensory interaction’ is organized in the balance performance of the patient examined. To interfere with vision, closure of the eyes has been commonly used and to interfere with proprioception, the patient can be put on foam-rubber, which makes the contribution of the foot-ankle proprioception less adequate. These interferences are applied once separately and once combined. The degree of ‘abnormality’ is assessed by a score-system for parameters surface (S) and velocity (V), which measure the postural sway. A comparison of tests with and without influence on the sensory inputs gives an idea of the sensory interaction. Patients with peripheral vestibular disorders were examined: patients with BPPV, with spontaneous vertigo attacks and with a sudden vestibular deficit.

When applying this evaluation technique different formulae or patterns can be found. Firstly complete normal evaluation, which means that there is no influence of the vestibular disturbance upon the PG results. Secondly a normal balance when using all available sensory information, but disturbed balance as soon as one of the sensory inputs is influenced by the test conditions. Thirdly striking destabilization when closing the eyes. Fourthly striking destabilization when misleading the ankle and foot proprioceptor. Fifthly a combined effect, when the vestibular input is the only one not influenced by the test conditions and sixthly no specific effect, no complementary compensatory effect of this sensory interaction.

In the group of patients with peripheral vestibular disorders, no special pattern linked to a peripheral syndrome could be found. Not only in the acute stage could abnormal PG be found: in fact, PG provides ‘functional’ data, which are complementary to the ‘classical’ evaluation and subdivide the patients into other sub-categories. The sensory interaction testing points to some conditions where balance will be more inclined to be troubled.

Keywords

Vestibular function testsposturography
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 6 , June 1993 , pp. 496 - 501
Copyright
Copyright © JLO (1984) Limited 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alford, B. R. (1972) Committee on hearing and equilibrium. Ménièr's disease: criteria for diagnosis and evaluation of therapy for reporting. Transactions of the American Academy of Ophthalmology and Otology 76: 1462–1464Google Scholar
Baloh, R. W., Honrubia, V. (1979).Clinical Neurophysiology of the Vestibular system, F. A. Davis & Co, Philadelphia.Google ScholarPubMed
Black, F. O. (1985) Vestibulospinal function assessment by moving platform posturography. American Journal of Otolaryngology (suppl): 39–46.Google ScholarPubMed
Black, F. O., Nashner, L. M. (1984) Vestibulospinal control differs in patients with reduced and distorted vestibular function. Acta Otolaryngologica (Stockholm) 406 (suppl): 110–114.Google ScholarPubMed
Brandt, T., Krafczyk, S., Malsbenden, I. (1981) Postural imbalance with head extension: improvement by training as a model for ataxia therapy. Annals of the New York Academy of Sciences 374: 636–649CrossRefGoogle Scholar
Booth, J. B., Stockwell, C. W. (1986) A method for evaluating vestibular control of posture. Transactions of the American Academy of Ophthalmology and Orology 86: 93–97Google Scholar
Dix, M. R., Hallpike, C. (1952) The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Annals of Otology, Rhinology-Laryngology 61: 987–1016CrossRefGoogle ScholarPubMed
Fetter, M., Diener, H. C., Dichgans, J. (1991) Recovery of postural control after an acute unilateral vestibular lesion in humans. Journal of Vestibular Research 1: 373–383CrossRefGoogle Scholar
Flohr, H., Bienhold, H., Abeln, W., Macskovics, A. (1981) Concepts of vestibular compensation. In Lesion-Induced neuronal plasticity in sensorimotor systems. (Flohr, H., Precht, W., eds.), Springer-Verlag, Berlin, pp 153–172.CrossRefGoogle Scholar
Igarashi, M., Kato, Y. (1975) Effect of different vestibular lesions upon body equilbrium function in squirrel monkeys. Acta Otolaryngologica (Stockholm) 330 (suppl): 91–99.CrossRefGoogle Scholar
Llinas, R., Walton, K. (1979) Vestibular compensation: a distributed property of the central nervous system. In Integration in the nervous system. (Asunama, H., Wilson, V. J., eds.), Ishuon Shoin, Tokyo, pp 145–166.Google Scholar
Henriksson, N. G., Dolowitz, D. A., Forssman, B. (1962) Studies on cristospinal reflexes. Acta Orolaryngologica (Stockholm) 55: 33–40, 116–127 and 496–504.CrossRefGoogle ScholarPubMed
Henriksson, N. G., Johansson, G., Olsson, L. G., Ostlund, H. (1967) Electric analysis of the Romberg test. Acta Otolaryngologica (Stockholm) 224 (suppl): 272–279.CrossRefGoogle Scholar
Mittermaier, R. (1950) Uber die Ausgleichsvorgange im Vestibularapparat. Zeitschnft für Laryngologie Rhinologie Otologie 29: 487–495 and 585–592.Google Scholar
Norré, M. E. (1990) Posture in Otoneurology. Acta Otorhinolaryngologica Belgica 44: 355–364Google ScholarPubMed
Norré, M. E. (1992) Contribution of a posturographic six-test-set to the evaluation of patients with peripheral vestibular disorders. Journal of Vestibular Research 2: 159–166Google Scholar
Norré, M. E., Forrez, G., Beckers, A. (1987 a) Vestibulospinal function in two syndromes with spontaneous attacks of vertigo: evaluation by posturography. Clinical Otolaryngology 12: 215–220CrossRefGoogle ScholarPubMed
Norré, M. E., Forrez, G., Beckers, A. (1987 b) Vestibularcompensation evaluated by rotation tests and posturography. Archives of Otolaryngology, Head and Neck Surgery 113: 533–535CrossRefGoogle Scholar
Precht, W., Dieringer, N. (1985) Neuronal events paralleling functional recovery (compensation) following peripheral vestibular lesions. In Adaptive mechanisms in gaze control. Reviews in oculomotor research. vol. 1. (Berthoz, A., Melvill-Jones, G., eds.), Elsevier, Amsterdam, pp 251–268.Google Scholar
Putkonen, P. T. S., Courjon, J. H., Jeannerod, M. (1977) Compensation of postural effects of hemilabyrinthectomy in the cat. A sensory substitution process? Experimental Brain Research 28: 249–257Google Scholar
Roberts, T. D. M. (1978) Neurophysiology of Postural mechanisms 2nd edn., Butterworths, London.Google Scholar
Shumway-Cook, A., Horak, F. B. (1986) Assessing the influence of sensory interaction on balance. Physical Therapy 66: 1548–1550CrossRefGoogle Scholar
Taguchi, K. (1977) Spectral analysis of body sway. Journal of Otorhinolaryngology and Related Specialities 39: 330–337CrossRefGoogle ScholarPubMed
Takagi, A., Fujimura, E., Suehiro, S. (1985)A new method of statokinesigram area measurement: application of a statistically calculated ellipse. In Vestibular and visual control on posture and locomotor equilibrium. (Igarashi, M., Black, F. O., eds.), Karger, Basel, pp 74–79.Google Scholar