Vestibular training promotes adaptation of multisensory integration in postural control

Abstract

BackgroundPostural stability depends on the integration of the multisensory system to produce motor outputs. When visual and somatosensory input is reliable, this reduces reliance on the vestibular system. Despite this, vestibular loss can still cause severe postural dysfunction. Training one or more of the three sensory systems through vestibular habituation and adaptation can alter sensory weighting and change postural behavior. AimThe purpose of this study was to assess sensory reweighting of postural control processing after combined vestibular activation with voluntary weight shift training in healthy adults. MethodsThirty-three healthy individuals (18–35 y.o.) were randomly assigned to one of three groups: No training (control), visual feedback weight shift training (WST) coupled with an active horizontal headshake (HS) activity to elicit a vestibular perturbation, or the same WST without HS (NoHS). Training was performed 2x/day, every other day (M, W, F), totaling six sessions. Pre- and post- assessments on the Sensory Organization Test (SOT) were performed. Separate between- and within- repeated measures ANOVAs were used to analyze the six SOT equilibrium scores, composite scores, sensory ratios and center of pressure (COP) variables by comparing baseline to post-training. Alpha level was set at p < .05. ResultsThere was a significant group x session x condition change (p = .012) in the COP multiscale entropy (MSE) velocity sway in the HS group during SOT conditions 5 and 6. Similarly, COP medio-lateral standard deviation sway (ML Std) showed group x session x visual condition (p = .028), due to HS in condition 6 relative to other two groups. ConclusionPostural training can alter sensory organization after a visual feedback-vestibular activation training protocol, suggesting a possible sensory reweighting through vestibular adaptation and/or habituation. SignificanceTranslating these findings into a vestibular-impaired population can stimulate the design of a rehabilitation balance protocol.