Contribution of the Vestibular Apparatus to Postural Control when Rising from a Chair

Abstract

Objective—The everyday act of rising from a chair is known to require the combined angular control of a number of the body's joints, especially those within the pitch plane. Precisely how this control is exerted, however, remains controversial. The aim of this study was to obtain a better understanding of the contribution made by the vestibular apparatus to postural control of the body and head when an individual rises from a chair.Material and Methods—A total of 24 healthy controls and 38 patients with varying degrees of vestibular dysfunction were examined. Electromagnetic motion sensors were used to analyze the angular control of the head and body as subjects rose from a chair with their eyes open or closed.Results—We found that unilateral vestibular dysfunction caused fixation of the head with respect to the body, resulting in a loss of spatial stability of the head which was not compensated for by visual input. Visual input did appear to compensate for bilateral vestibular loss, enabling patients with bilateral vestibular apparatus impairment or central disorders to fix the position of their head in space.Conclusion—The act of rising from a chair is normally controlled by vestibular and proprioceptive input; the head is aligned according to the gravitational reference so as to obtain stable visual information. In patients with unilateral vestibular hypofunction, posture is still controlled by these two inputs, although the ability to align the head is diminished. In patients with bilateral vestibular hypofunction or a central disorder, head alignment is maintained using visual input, although it may not be the sole or predominant stabilizing force.