Impact of visual signals on axial segmental control during walking in patients with vestibular disorder and healthy persons

Abstract

Head and trunk control during standing in patients with vestibular disorder may depend on intact visual signal to override vestibular disturbance. It is unknown if such process during walking would change. Therefore, the aims of this study were to quantify (1) head and trunk control in healthy participants (HPs) and patients with unilateral vestibular hypofunction (UVH) during walking with and without visual manipulation; and (2) the correlation/association between vestibular function and head/trunk control during walking with visual manipulation in patients. Seventeen UVH patients and 15 HPs completed all the tests. They participated in the caloric test, which was used to examine vestibular function, and walked on a treadmill with and without visual manipulation. Head and trunk angular displacement and velocity were primary outcome measures, deviation of center of mass and step variability were secondary. Head roll angular displacement (7.38° ± 1.38 [mean ± SE] v.s. 12.95° ± 1.48, p = 0.004) and head-trunk correlation (in the pitch/sagittal plane: 0.22 ± 0.05 v.s. 0.38 ± 0.05, roll/frontal plane: 0.35 ± 0.06 v.s. 0.55 ± 0.06, p < 0.05) were significantly lower in patients compared to HPs. Head pitch angular velocity (8.58°/s ± 2.17 v.s. 14.23°/s ± 1.22, p = 0.026) and step width variability (0.075 ± 0.010 v.s. 0.083 ± 0.009, p = 0.04) increased with visual manipulation only in patients. No significant correlation/association was found between vestibular function and head/trunk control. Lower head-trunk correlation in patients suggests an independent head-trunk control strategy in response to vestibular impairment. Visual input could be used by patients to compensate for vestibular disturbance for head control and foot placement. Severe UVH may not lead to worse postural control compared to mild disorder.