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Braz J Otorhinolaryngol. 2019 Apr 22. pii: S1808-8694(19)30031-X. doi: 10.1016/j.bjorl.2019.03.001. [Epub ahead of print]

A quantitative analysis of postural control in elderly patients with vestibular disorders using visual stimulation by virtual reality.

Author information

1
Universidade Federal de São Paulo, Departamento de Otorrinolaringologia e de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil; Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Natal, RN, Brazil.
2
Universidade Federal de São Paulo, Departamento de Otorrinolaringologia e de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
3
Universidade Federal de São Paulo, Departamento de Otorrinolaringologia e de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil. Electronic address: fgananca@terra.com.br.

Abstract

INTRODUCTION:

Postural instability is one the most common disabling features in vestibular disorders.

OBJECTIVE:

This study aimed to analyze the limit of stability and the influence of manipulation of visual, somatosensorial and visual-vestibular information on postural control in older adults with vestibular disorder, with and without a history of falls.

METHODS:

Cross-sectional study. Participants - 76 elderly patients with vestibular disorder (G1, without falls; G2, with falls) and 41 healthy elderly subjects (Control Group; CG). Using posturography, analyzed were limit of stability area, body center of pressure, and velocity of oscillation in the standing position in 10 conditions, including open/closed eyes, unstable surface with eyes closed, saccadic and optokinetic stimuli, and visual-vestibular interaction.

RESULTS:

Limit of stability area in CG was better compared with G1-2, and center of pressure values were worse in G1 than in CG. Center of pressure area in all conditions and velocity of oscillation in the following conditions: open/closed eyes, optokinetic stimulation, and visual-vestibular interaction showed worse values in G2 than in CG. Center of pressure area in the following conditions: open/closed eyes, saccadic and optokinetic stimuli, visual-vestibular interaction, and unstable surface with eyes closed showed worse values in G2 than in G1.

CONCLUSION:

Older adults with vestibular disorder presented reduced limit of stability and increased postural sway in the following conditions: conflict between visual and somatosensory information and visual-vestibular interaction. Deterioration in postural control was significantly associated with history of falls.

KEYWORDS:

Accidental falls; Aging; Doenças vestibulares; Envelhecimento; Equilíbrio postural; Postural balance; Quedas acidentais; Vestibular diseases

PMID:
31175041
DOI:
10.1016/j.bjorl.2019.03.001
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