Postural Response to Unexpected Changes

Abstract

Objective: 1) Determine the characteristics of postural responses to unexpected changes in the support-surface in patients with unilateral peripheral vestibular deficit and analyze differences between patients achieving a clinical compensated status and those without. 2) Find out which is the best clinical data to predict the vestibular compensation status.

Method: Twenty-seven adults suffering unilateral peripheral vestibular deficits (vestibular neuritis, Ménière’s disease, neurinoma, trauma and benign recurrent vertigo) were included. Neurocom equipment was used to create pulses unexpectedly. Sway Star system was used to measure the angle and the angular velocity of the body during the stimulus.

Results: The range of peak to peak excursion, the area of the displacement angle, the range of peak to peak velocity excursion in pitch and roll directions and the mean path velocity were studied. When using the caloric test results to classify the patients as compensated or not compensated significant differences (p minor to 0.001) of the body angle in the roll direction were found, although all the stimuli were made in the pitch direction. However, when using the caloric test, the cardiovascular risk or the patient’s clinical course to classify the groups, no differences were found.

Conclusion: The rotatory test is the best diagnostic method to predict vestibular compensation status of patients with vestibular deficits. Patients suffering vestibular deficit with an uncompensated status, have more difficulties to give an appropriate postural response in the roll direction to unexpected support-surface movements.