Postural strategies in normal subjects and in patients with instability due to central nervous system diseases after sudden changes in the visual flow

Abstract

Conclusion. The results suggest that after a sudden change in the visual input, postural adaptation is impaired in patients with instability and central nervous system disorders (CNSD). Objective. The aim of this study was the assessment of postural adaptation, as a transient phenomenon, when sudden changes in visual perception occur in normal subjects and in patients with instability due to different CNSD. Subjects and methods. Horizontal optokinetic stimulation (40 s and suddenly stopped) was performed in 16 patients with CNSD, and also in 22 normal subjects. Measurements were made of the body center of pressure area (COP) and the body sway velocity (SV) during 10 s before and after the stop and labeling the COP trajectory. Results. Values of COP and SV (Wilcoxon signed rank test, p=0.979 and 0.496, respectively) in normal subjects did not show any significant change before and after the stop. In 15 of the 16 assessed patients with instability associated with CNSD an increase of the COP and SV values (Wilcoxon signed test, p=0.001 and 0.004, respectively) was observed in the 10 s after the visual stop. COP labeling showed ‘roaming’ of the COP spatial evolution approaching the limits of stability.

• Postural responses
• posturography
• virtual reality
• vestibular rehabilitation
• instability
• falls