Precision contact of the fingertip reduces postural sway of individuals with bilateral vestibular loss

1999 ◽  
Vol 126 (4) ◽  
pp. 459-466 ◽  
Author(s):  
J. R. Lackner ◽  
Paul DiZio ◽  
John Jeka ◽  
F. Horak ◽  
David Krebs ◽  
...  
Keyword(s):  
Postural Sway ◽  
Vestibular Loss ◽  
Bilateral Vestibular Loss

scholarly journals Velocity dependence of vestibular information for postural control on tilting surfaces

2016 ◽  
Vol 116 (3) ◽  
pp. 1468-1479 ◽  
Author(s):  
Fay B. Horak ◽  
JoAnn Kluzik ◽  
Frantisek Hlavacka
Keyword(s):  
Visual Information ◽  
Postural Sway ◽  
Somatosensory System ◽  
The Body ◽  
Velocity Range ◽  
Vestibular Loss ◽  
Bilateral Vestibular Loss ◽  
Eyes Closed ◽  
Vestibular Information ◽  
Wide Range

Vestibular information is known to be important for postural stability on tilting surfaces, but the relative importance of vestibular information across a wide range of surface tilt velocities is less clear. We compared how tilt velocity influences postural orientation and stability in nine subjects with bilateral vestibular loss and nine age-matched, control subjects. Subjects stood on a force platform that tilted 6 deg, toes-up at eight velocities (0.25 to 32 deg/s), with and without vision. Results showed that visual information effectively compensated for lack of vestibular information at all tilt velocities. However, with eyes closed, subjects with vestibular loss were most unstable within a critical tilt velocity range of 2 to 8 deg/s. Subjects with vestibular deficiency lost their balance in more than 90% of trials during the 4 deg/s condition, but never fell during slower tilts (0.25–1 deg/s) and fell only very rarely during faster tilts (16–32 deg/s). At the critical velocity range in which falls occurred, the body center of mass stayed aligned with respect to the surface, onset of ankle dorsiflexion was delayed, and there was delayed or absent gastrocnemius inhibition, suggesting that subjects were attempting to actively align their upper bodies with respect to the moving surface instead of to gravity. Vestibular information may be critical for stability at velocities of 2 to 8 deg/s because postural sway above 2 deg/s may be too fast to elicit stabilizing responses through the graviceptive somatosensory system, and postural sway below 8 deg/s may be too slow for somatosensory-triggered responses or passive stabilization from trunk inertia.

scholarly journals Vibrotactile feedback improves balance and mobility in patients with severe bilateral vestibular loss

2018 ◽  
Vol 266 (S1) ◽  
pp. 19-26 ◽  
Author(s):  
Herman Kingma ◽  
Lilian Felipe ◽  
Marie-Cecile Gerards ◽  
Peter Gerits ◽  
Nils Guinand ◽  
...  
Keyword(s):  
Vibrotactile Feedback ◽  
Vestibular Loss ◽  
Bilateral Vestibular Loss

scholarly journals Finding a Balance: A Systematic Review of the Biomechanical Effects of Vestibular Prostheses on Stability in Humans

2020 ◽  
Vol 5 (2) ◽  
pp. 23
Author(s):  
Felix Haxby ◽  
Mohammad Akrami ◽  
Reza Zamani
Keyword(s):  
Vestibular System ◽  
Postural Sway ◽  
Vestibular Function ◽  
Vestibular Stimulation ◽  
Significant Heterogeneity ◽  
Vestibular Loss ◽  
Ocular Reflex ◽  
Gait Characteristics ◽  
Vestibulo Ocular Reflex ◽  
Meta Analyses

The vestibular system is located in the inner ear and is responsible for maintaining balance in humans. Bilateral vestibular dysfunction (BVD) is a disorder that adversely affects vestibular function. This results in symptoms such as postural imbalance and vertigo, increasing the incidence of falls and worsening quality of life. Current therapeutic options are often ineffective, with a focus on symptom management. Artificial stimulation of the vestibular system, via a vestibular prosthesis, is a technique being explored to restore vestibular function. This review systematically searched for literature that reported the effect of artificial vestibular stimulation on human behaviours related to balance, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) technique. A total of 21 papers matched the inclusion criteria of the literature search conducted using the PubMed and Web of Science databases (February 2019). The populations for these studies included both healthy adults and patients with BVD. In every paper, artificial vestibular stimulation caused an improvement in certain behaviours related to balance, although the extent of the effect varied greatly. Various behaviours were measured such as the vestibulo-ocular reflex, postural sway and certain gait characteristics. Two classes of prosthesis were evaluated and both showed a significant improvement in at least one aspect of balance-related behaviour in every paper included. No adverse effects were reported for prostheses using noisy galvanic vestibular stimulation, however, prosthetic implantation sometimes caused hearing or vestibular loss. Significant heterogeneity in methodology, study population and disease aetiology were observed. The present study confirms the feasibility of vestibular implants in humans for restoring balance in controlled conditions, but more research needs to be conducted to determine their effects on balance in non-clinical settings.

scholarly journals Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss

2019 ◽  
Vol 25 (Suppl. 1-2) ◽  
pp. 79-90 ◽  
Author(s):  
Angel Ramos Macias ◽  
Angel Ramos de Miguel ◽  
Isaura Rodriguez Montesdeoca ◽  
Silvia Borkoski Barreiro ◽  
Juan Carlos Falcón González
Keyword(s):  
Electrical Stimulation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Clinical Test ◽  
Otolith Organ ◽  
Bilateral Vestibulopathy ◽  
Vestibular Loss ◽  
Bilateral Vestibular Loss ◽  
Chronic Electrical Stimulation ◽  
Stimulation Of

Introduction: Bilateral vestibulopathy is an important cause of imbalance that is misdiagnosed. The clinical management of patients with bilateral vestibular loss remains difficult as there is no clear evidence for an effective treatment. In this paper, we try to analyze the effect of chronic electrical stimulation and adaptation to electrical stimulation of the vestibular system in humans when stimulating the otolith organ with a constant pulse train to mitigate imbalance due to bilateral vestibular dysfunction (BVD). Methods: We included 2 patients in our study with BVD according to Criteria Consensus of the Classification Committee of the Bárány Society. Both cases were implanted by using a full-band straight electrode to stimulate the otoliths organs and simultaneously for the cochlear stimulation we use a perimodiolar electrode. Results: In both cases Vestibular and clinical test (video head impulse test, videonistagmography cervical vestibular evoked myogenic potentials, cVEMP and oVEMP), subjective visual vertical test, computerized dynamic posturography, dynamic gait index, Time UP and Go test and dizziness handicap index) were performed. Posture and gait metrics reveal important improvement if compare with preoperartive situation. Oscillopsia, unsteadiness, independence and quality of life improved to almost normal situation. Discussion/Conclusion: Prosthetic implantation of the otolith organ in humans is technically feasible. Electrical stimulation might have potential effects on balance and this is stable after 1 year follow-up. This research provides new possibilities for the development of vestibular implants to improve gravito-inertial acceleration sensation, in this case by the otoliths stimulation.

Idiopathic Bilateral Vestibular Loss: Diagnosis and Management

1995 ◽  
Vol 113 (2) ◽  
pp. P154-P154
Author(s):  
Eric W. Sargent ◽  
Joel Goebel ◽  
Jason Hanson ◽  
Douglas Beck
Keyword(s):  
Vestibular Loss ◽  
Diagnosis And Management ◽  
Bilateral Vestibular Loss

scholarly journals Effects of Device on Video Head Impulse Test (vHIT) Gain

2017 ◽  
Vol 28 (09) ◽  
pp. 778-785 ◽  
Author(s):  
Kristen L. Janky ◽  
Jessie N. Patterson ◽  
Neil T. Shepard ◽  
Megan L. A. Thomas ◽  
Julie A. Honaker
Keyword(s):  
Normal Control ◽  
Vestibular Function ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Vestibular Loss ◽  
Directional Bias ◽  
Horizontal Canal ◽  
Head Impulse ◽  
Control Subjects ◽  
Bilateral Vestibular Loss

AbstractNumerous video head impulse test (vHIT) devices are available commercially; however, gain is not calculated uniformly. An evaluation of these devices/algorithms in healthy controls and patients with vestibular loss is necessary for comparing and synthesizing work that utilizes different devices and gain calculations.Using three commercially available vHIT devices/algorithms, the purpose of the present study was to compare: (1) horizontal canal vHIT gain among devices/algorithms in normal control subjects; (2) the effects of age on vHIT gain for each device/algorithm in normal control subjects; and (3) the clinical performance of horizontal canal vHIT gain between devices/algorithms for differentiating normal versus abnormal vestibular function.Prospective.Sixty-one normal control adult subjects (range 20–78) and eleven adults with unilateral or bilateral vestibular loss (range 32–79).vHIT was administered using three different devices/algorithms, randomized in order, for each subject on the same day: (1) Impulse (Otometrics, Schaumberg, IL; monocular eye recording, right eye only; using area under the curve gain), (2) EyeSeeCam (Interacoustics, Denmark; monocular eye recording, left eye only; using instantaneous gain), and (3) VisualEyes (MicroMedical, Chatham, IL, binocular eye recording; using position gain).There was a significant mean difference in vHIT gain among devices/algorithms for both the normal control and vestibular loss groups. vHIT gain was significantly larger in the ipsilateral direction of the eye used to measure gain; however, in spite of the significant mean differences in vHIT gain among devices/algorithms and the significant directional bias, classification of “normal” versus “abnormal” gain is consistent across all compared devices/algorithms, with the exception of instantaneous gain at 40 msec. There was not an effect of age on vHIT gain up to 78 years regardless of the device/algorithm.These findings support that vHIT gain is significantly different between devices/algorithms, suggesting that care should be taken when making direct comparisons of absolute gain values between devices/algorithms.

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