Influence of sensory information on static balance in older patients with
               vestibular disorder

Macedo, Camila; Gazzola, Juliana Maria; Ricci, Natalia Aquaroni; Doná, Flávia; Ganança, Fernando Freitas

doi:10.1016/j.bjorl.2014.11.004

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Brazilian Journal of Otorhinolaryngology

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Original Articles • Braz. j. otorhinolaryngol. 81 (1) • Jan-Feb 2015 • https://doi.org/10.1016/j.bjorl.2014.11.004 copy

Influence of sensory information on static balance in older patients with vestibular disorder^☆ ☆ Please cite this article as: Macedo C, Gazzola JM, Ricci NA, Dona F, Ganança FF. Influence of sensory information on static balance in older patients with vestibular disorder. Braz J Otorhinolaryngol. 2015;81:50-7.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction:

With aging, the sensory systems suffer an accumulation of degenerative, infectious and/or traumatic processes that may hinder the body balance maintenance.

Objective:

To assess the influence of sensory information on static body balance of elderly individuals with vestibular disorders.

Methods:

Cross-sectional study of elderly individuals with vestibular disorders. The Clinical Test of Sensory Interaction and Balance and posturography integrated with virtual reality (Balance Rehabilitation Unit^TM) were used. Posturography parameters analyzed included center of pressure and velocity of body sway.

Results:

123 individuals with mean age of 73.11 were assessed. Worst performance was observed in the Clinical Test of Sensory Interaction and Balance condition of visual dome-unstable surface. Differences between conditions were: firm surface-open eyes/firm surface-closed eyes, unstable surface-open eyes/unstable surface-closed eyes (p < 0.001), and unstable surface-closed eyes/unstable surface-visual dome. Considering center of pressure and velocity of body sway, significant differences were observed between the following conditions: firm surface-open eyes/firm surface-closed eyes: firm surface-saccadic stimulus/firm surfacevertical optokinetic stimulus; firm surface-optokinetic stimuli/firm surface-visual-vestibular interaction; and firm surface-visual-vestibular interaction/unstable surface. Worse performances were observed in conditions firm surface-closed eyes, firm surface-vertical optokinetic stimulus, F-visual-vestibular interaction, and unstable surface-closed eyes. There was a difference in the center of pressure between firm surface-closed eyes/firm surface-saccadic stimulus, with a worse performance in the condition of firm surface-closed eyes, and of velocity of body sway, between firm surface-saccadic stimulus/firm surface-horizontal optokinetic stimulus (p < 0.001).

Conclusion:

Static body balance in elderly individuals with vestibular disorders is worse when the sensory conditions are more challenging, i.e. stable and unstable surfaces, visual stimuli, such as optokinetic and visual-vestibular interaction, and with the eyes closed.

Aged; Postural balance; Rehabilitation; Dizziness; Vestibular diseases

Conditions	BRU™ conditions	Conditions	BRU™ conditions regrouped and renamed for the study
1	No stimulus, FS, OE	1	No stimulus, FS, OE
2	No stimulus, FS, CE	2	No stimulus, FS, CE
3	No stimulus, foam surface, OE	6	No stimulus, foam surface, CE
4	Saccadic, FS, OE	3	Saccadic, FS, OE

5	Optokinetic, Bars (to the right), FS, OE	4 horizontal	Arithmetic mean Optokinetic, Bars (to the right), FS, OE and Optokinetic, Bars (to the left); FS, OE
6	Optokinetic, Bars (to the left); FS, OE

7	Optokinetic, Bars (downward): FS, CE	4 vertical	Arithmetic mean Optokinetic, Bars (downward), FS, OE and Optokinetic, Bars (upward); FS, OE
8	Optokinetic, Bars (upward): FS, OE

9	Vestibular–visual interaction, Circular, Bars (horizontal direction), FS, OE	5 horizontal	Vestibular–visual interaction, Circular, Bars (horizontal direction), FS, OE
10	Vestibular–visual interaction, Circular, Bars (vertical direction), FS, OE	5 vertical	Vestibular–visual interaction, Circular, Bars (vertical direction), FS, OE

CTSIB conditions	Cases	Mean (SD)	95% CI
I	N	119 (96.7%)	29.44 (3.26)	28.86–30.0
A	4 (4.3%)

II	N	107 (87.0%)	28.11 (5.73)	27.09–29.13
A	16 (13%)

III	N	104 (84.6%)	27.28 (7.26)	25.99–28.58
A	19 (15.4%)

IV	N	109 (88.6%)	27.56 (7.04)	26.30–28.82
A	14 (11.4%)

V	N	91 (74.0%)	25.01 (9.42)	23.32–26.69
A	32 (26.0%)

VI	N	82 (62.7%)	22.99 (10.11)	21.08–24.90
A	41 (33.3%)

BRU™ conditions		VBS (cm/s)		COP area (cm²)
		Mean (SD)	95% CI	Mean (SD)	95% CI
1	FS/OA	1.01 (0.40)	0.94–1.08	3.88 (3.80)	3.20–4.56
2	FS/OF	1.34 (0.57)	1.23–1.44	4.90 (5.96)	3.83–5.97
3	FS/saccadic	1.34 (0.50)	1.25–1.43	2.93 (2.23)	2.53–3.32

4	Horizontal	1.23 (0.44)	3.69 (3.53)	3.69 (3.53)	3.05–4.32
	Vertical	1.31 (0.69)	3.96 (3.47)	3.96 (3.47)	3.24–4.48

5	Horizontal	1.75 (0.74)	6.07 (4.87)	6.07 (4.87)	5.20–6.94
	Vertical	1.74 (0.62)	6.41 (4.10)	6.41 (4.10)	4.68–6.15

6	Foam/OF	3.01 (1.24)	15.00 (12.25)	15.00 (12.25)	12.78–17.22

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] ^∗Corresponding author. E-mail:camila mace@yahoo.com.br (C. Macedo).