Computerized Dynamic Posturography Research Articles

The decline in postural balance has a negative impact on the performance of functional tasks in individuals with Parkinson's Disease

IntroductionAn accurate assessment of balance problems is critical for decreasing the risk of falling in patients with Parkinson's Disease (PD). Reliable diagnostic tools such as Computerized Dynamic Posturography (CDP) are not feasible for the clinical setting. Therefore, the present study's aim was to assess the correlation between the clinical Balance Evaluation Systems Test (BESTest) and CDP. Methods20 male older adults with Parkinson's Disease (PD) were included in this study. Participants first executed the Sit-To-Stand (STS), Step/Quick turn (SQT), and Step Up and Over (SUO) tests on a Balance Master® force platform, followed by a clinical balance evaluation using the BESTest. ResultsFour outcomes of the CDP were negatively correlated with one or more BESTest domains or total BESTest score: STS sway velocity was negatively correlated with the anticipatory postural adjustment (p = 0.02) and sensory orientation (p = 0.01) domains. SQT turn time was negatively correlated with biomechanical restriction (for turns to the left, p = 0.01, and right, p = 0.03, respectively), postural response (p = 0.01, p = 0.01), dynamic balance during gait (p = 0.007, p = 0.001), and total score (p = 0.02, p = 0.01). Step over time to the right in SUP was negatively correlated with the limits of the stability domain (p = 0.002) and total BESTest score (p = 0.020). SUO impact index was negatively correlated with the anticipatory postural adjustment domain (p = 0.01). ConclusionThis study shows that several BESTest domains are significantly correlated with CDP outcomes, demonstrating that the BESTest can be used as a more clinically feasible alternative for computerized posturography, without loss of information.

THE IMPACT OF VACCINATION AGAINST SARS-CoV-2 INFECTION ON VESTIBULAR FUNCTION AND CENTRAL COMPENSATION

Objective: The aim of this study was to evaluate the effects of SARS-CoV-2 vaccines on vestibular system. In addition, in this study we aimed to investigate the possible protective effects of vaccination on the vestibular system in people who recovered Covid-19. Methods: Totally, 77 subjects were divided into four groups, and evaluated using computerized dynamic posturography (CDP), vestibular evoked myogenic potentials (VEMPs) and video head impulse test (v-HIT). The groups were as follows; Group 1; who had SARS-CoV-2 infection at least one year ago and have not been vaccinated at all. c Group 2; who had SARS-CoV-2 infection at least one year ago and were vaccinated 5 times (2 doses of Sinovac and 3 doses of Biontech). Group 3; who had no known SARS-CoV-2 infection, and were vaccinated 5 times (2 doses of Sinovac and 3 doses of Biontech). Group 4; who had no known SARS-CoV-2 infection, and have not been vaccinated at all. Results: The SOT values of (Covid-Vaccine-) group were better than the (Covid+Vaccine-) group (p=0.001), and no other significant difference was found between the groups (p>0.05). The v-HIT gains of the groups were not significantly different (p>0.05). On o-VEMPs, there was elongation in the N1 and P1 latencies in (Covid+Vaccine-) group compared to (Covid-Vaccine+) group. The amplitudes decreased in (Covid+Vaccine-) compared to (Covid-Vaccine-) (p<0.05). According to c-VEMP results, vaccination lead to elongation in the P1 latencies and increased the P1-N1 amplitudes (p<0.05). Conclusion: Both SARS-CoV-2 viral infection and vaccination may impact on vestibular system. The impact of vaccination seems on the saccule level. However, vaccination may limit or diminish the impact of SARS-CoV-2 on equilibrium, possibly by facilitating the central compensation.

The effect of screen time on hearing and balance in 6–16 aged children

Background The increase in screen time and the decrease in physical- activity cause balance problems as well as many systemic handicaps. Aims/Objectives This study aimed to determine the effect of screen time on balance and the effect of headphone usage time on hearing. Method Thirty-four individuals aged 6–16 years who applied to our clinic with complaints of dizziness and/or balance disorder were included in the study. Participants were divided into 2 groups according to their screen time: Group 1 (4–8 h/day) and Group2(>8 h/day). The other two groups are grouped according to headphone usage time as Group A (2–4 h/day) and Group B (>4hours/day). Pure-tone audiometry, extended high frequency-audiometry, Videonystagmography (VNG) and Computerized Dynamic Posturography (CDP) tests and Pediatric Berg Balance Scale and Visual Analogue Scale were applied to all individuals. CDP scores and pure tone hearing thresholds between groups were compared. Results A significant difference was observed between Group 1 and Group 2 according to the CDP test (visual, vestibular and composite scores), and according to the VAS-dizziness and PBS (p ≤ .05). Pure tone average and pure tone thresholds at high frequencies were compared between Group A and Group B according to headphone usage time. Pure tone thresholds of Group B were worse at high frequencies than Group A (p ≤ .05). Conclusions It has been observed that prolonged screen time may cause balance impairment in children and prolonged use of headphones may affect high-frequency hearing thresholds.

Quantitative Assessment of Balance Function Characteristics in Older Patients with Orthostatic Hypotension.

Orthostatic hypotension (OH) is a common blood pressure abnormality in older adults that makes them prone to balance disorders and falls. The maintenance of balance relies on a complex regulatory system. The use of computerized dynamic posturography (CDP) can provide a quantitative evaluation of balance function. The objective of this study was to utilize CDP to measure balance indicators in older individuals with OH. A total of 303 older adults were divided into an OH group of 91 and a non-OH group of 212. Various factors, including chronic diseases, medication history, laboratory tests, and balance indicators, were compared between the two groups. ① Participants with OH had more chronic diseases, including coronary heart disease (p = 0.049) and a history of falls (p < 0.001), than those without OH. A history of multiple medications in the OH group was significantly more likely than in the non-OH group (p = 0.006). ② There was a significant reduction in the composite equilibrium score (SOT-COM) (p < 0.001), vision ratio score (VIS) (p < 0.001), vestibular ratio score (VEST) (p < 0.001), and directional control (DCL) (p = 0.028) in the OH group. ③ A logistic regression analysis revealed that SOT-COM was a significant independent factor associated with OH. The area under the curve (AUC) of SOT-COM was 0.833 (95% confidence interval: 0.778-0.887, p < 0.001), with a sensitivity of 0.826 and a specificity of 0.759. This study demonstrates that older individuals with OH are more prone to falls, due to decreased sensory integration for balance.

Comparison between the effectiveness of three prophylactic drugs for vestibular migraine; cinnarizine, propranolol, and topiramate: prospective study

BackgroundVestibular migraine (VM) is considered one of the most common causes of episodic vertigo. Acute attacks may interfere or hinder daily activities, and hence decrease the quality of life. Accordingly, this study was designed to evaluate and compare the effectiveness of Cinnarizine, Propranolol, and Topiramate as prophylactic treatment for vestibular migraine, in order to decrease the occurrence of acute attacks. Several medications have been proposed as a prophylactic treatment, but their benefit is still a vast field of study.MethodsForty-five subjects were diagnosed with vestibular migraine. They were divided into 3 groups; each group either received Cinnarzine, Propranolol, or Topiramate. All patients were submitted to thorough history taking for headache and vertiginous attacks, Dizziness Handicap Inventory questionnaire (DHI) -Arabic version, visual analog scale, videonystagmography, and computerized dynamic posturography (CDP) before and after receiving the treatment by 3 months.ResultsTopiramate was significantly superior in reducing the frequency and severity of headache attacks. The three drugs showed improvement but with no significant difference as regards duration and frequency of vertiginous attacks, DHI scores, and CDP. Only 5 patients had non-serious temporary side effects.ConclusionsThe three drugs were effective for ameliorating vertiginous attacks in vestibular migraine patients, but Topiramate was better in the 25 mg twice daily dose.

Evaluation of patients' post-operative results operated for hip fracture with computerized dynamic posturography: Proximal femoral nailing versus hip arthroplasty.

Proximal femoral nailing (PFN) and hip arthroplasty (HA) are the two most often utilized surgical procedures for treating hip fractures in older patients. The post-operative postural balance and functional outcomes of patients may be significantly influenced by the technical distinctions between PFN and HA. This will influence the surgeon's preferred course of therapy. To examine the functional outcomes of patients treated with PFN and HA following a hip fracture, this study used computerized dynamic posturography (CDP). The aim of that study was to evaluate how the two treatment modalities affected patients' post-operative balance, postural stability, and functional rehabilitation. A total of 26 patients who underwent proximal femoral surgery (15 patients PFN [58%] and 11 patients HA [42%]) due to hip fractures were evaluated at least 12 months postoperatively. They were tested by direct radiographs, hip joint examinations, Harris hip score (HHS), and CDP. Twelve (46%) of 26 patients were male and 14 (54%) were female. The mean age of the participants in the study was 67.9±14.2 years. The mean follow-up period was 24 (12-44) months. The average Harris score of PFN group was 79.3 (46.8-100) points and HA group was 83.7 (61.9-99.9) points. There was no significant difference between the groups in terms of Harris Score (P=0.54). The average of the mixed value of the balance results obtained with CDP (the Composite score) for PFN group was 70.5 (56-79) points, and for HA group was 71.9 (56-83) points. There was no significant difference between the groups in terms of the Composite Score (P=0.47). Accordingly, 12 (80%) of the patients who underwent PFN had good results and 3 (20%) of them had bad results. Eight (72.7%) of those who underwent HA had good results and 3 (27.3%) had bad results. There was no statistically significant difference (P=0.66). Comparing the composite score for balance results and HHS results for rehabilitation with the data of the patients who underwent PFN and HA, there was no statistically significant difference between these two techniques in terms of postural stabil-ity and balance as a result of CDP examination.

Quantitative analysis of balance function characteristics in older patients with mild to moderate cognitive impairment

BackgroundCognitive decline in older adults may affect balance function, but the relationship between the two is not fully understood, especially in the early stages of cognitive impairment. Mild to moderate cognitive impairment can be assessed with the Montreal Cognitive Assessment (MOCA). AimThis study quantitatively analyzed balance function in older adults with mild to moderate cognitive impairment using computerized dynamic posturography (CDP) testing. Methods248 older patients were divided into a cognitive impaired group (MOCA <26, n = 126) and a normal group (MOCA ≥26, n = 122) based on the Montreal Cognitive Assessment (MOCA) Beijing Version. Patients underwent CDP testing, which included the sensory organization test (SOT) and the limits of stability test (LOS). ResultsThe cognitive impaired group had significantly lower SOT composite and visual scores, as well as reaction time (RT), movement velocity (MVL), endpoint excursion (EPE), maximum excursion (MXE), and directional control (DCL) of the LOS test. Binary logistic regression analysis revealed that RT and MXE were independent factors significantly associated with MOCA, even after adjustment for age and sex. ConclusionsOlder patients with mild to moderate cognitive impairment may have reduced sensory integration and balance stability limits, mainly manifested as prolonged motor reaction time and shortened maximum movement distance.

Treatment of balance with Computerised Dynamic Posturography therapy in chronic hemiplegic patients.

As patients with hemiplegia have a high risk of falling, it is important to develop a fall rehabilitation plan and/or apply personalised treatment when necessary. We aimed to evaluate the effects of individualised treatment with Computerised Dynamic Posturography (CDP) on balance in patients with and without a history of chronic hemiplegic falls. Forty patients with hemiplegia (time post-stroke: 8-18 months) between 40 and 70 years of age in the Istanbul Yeniyüzyıl University, Gaziosmanpaşa Hospital participated in our study. The patients were divided into two groups: Group 1, falling history (n = 20) and Group 2, no falling history (n = 20). The patients in both groups were included in a traditional rehabilitation programme for 5 weeks, 5 days a week, for 1 h. The group with a history of falls also received individualised CDP treatment for 20 min, 3 days a week, for 5 weeks. Patients were evaluated with a Sensory Organisation Test (SOT) and a Berg Balance Scale (BBS). In Group 1, a significant improvement was determined in the after-treatment SOT 5 values compared with the before treatment SOT 5 values (p = 0.022). Significant improvement was found in BBS (p = 0.003) and SOT 6 (p = 0.022) values in Group 2. There was no statistically significant difference in improvement between the two groups (p ≥ 0.05). Larger samples and longer duration of individualised CDP therapy studies may be required to improve balance with chronic hemiplegia and a history of falls. In addition to traditional therapy, individualised CDP treatment may be beneficial for patients with a history of post-stroke falls.

The acute effect of cervical mobilization on balance in patients with multiple sclerosis: a single-blind, randomized, controlled trial

ABSTRACTThe cervical region plays an important role in providing proprioceptive and vestibular input to the postural control system. Objective. To investigate the effect of cervical mobilization on balance in multiple sclerosis (MS) patients. Methods. The study was undertaken at the neurological rehabilitation unit with 36 MS participants who were assigned randomly to the study (n = 18) and control group (n = 18). While the study group received a single session of 15 minutes of cervical and soft tissue mobilization, no intervention was applied to the control group to investigate the learning effect of the assessment. Patients were evaluated using Computerized Dynamic Posturography (CDP) (Sensory Organization Test (SOT), Limits of Stability (LoS), and Adaptation Test (ADT)), which reflects postural stability. Results. In the study group, a treatment effect was found on the vestibular ratio (VEST) score (p < 0.001) and the composite score of SOT (p = 0.002). Improvements were achieved in all parameters of the LoS and ADT in the study group. There was no statistically significant difference in terms of CDP results in the control group. Conclusion. Cervical mobilization has beneficial effects on balance in MS patients. Our findings support that cervical mobilization can be included in MS balance rehabilitation programs.

Study of Effectiveness of Prophylactic Treatment for Vestibular Migraine Patients

Abstract Objectives To evaluate effectiveness of prophylactic drugs in treatment of VM patients. Second to compare between each drug for its efficacy for treatment of VM patients Subjects and Methods Forty-five subjects divided into 3 groups were included in the present study. Group A, 15 subjects received Cinnarzine with mean age of 37.7 years. Group B, 15 subjects received Inderal with mean age of 38.3 years. Group C, 15 subjects received Topamax with mean age of 39 years diagnosed with vestibular migraine. They were subjected to a Dizziness Handicap Inventory questionnaire (DHI), visual analogue scale (VAS), neurological examination, vestibular office tests, videonystagmography (VNG) and sensory organization test (SOT) of computerized dynamic posturography (CDP) before and after receiving treatment according to grouping. Results 3 months after treatment, the mean number of total vertiginous attacks decreased from (14.5 ±9.2) to (7.3 ± 7.8), from (11.5 ±6.6) to (5.2 ± 4.1) and (13.1 ±8.6) to (4.1 ± 3) in Cinnarzine, Propranolol (Inderal) and topiramate (Topamax) groups respectively. DHI scores decreased from (50 ± 12.7) to (34.7± 12.5), (49.7 ± 11.2) to (32.4± 15.6) and (52.7 ±11.2) to (28.3 ± 9.2) in Propranolol (Inderal) and topiramate (Topamax) groups respectively. Conclusions This study provided that all three drugs are effective for ameliorating vertiginous attacks in VM patients; also, the treatment effects were similar in three groups with no significant difference.

Body Balance in Patients of Vestibular Migraine with and without Visual Vertigo: A study on Computerized Dynamic Posturography (CDP)

Body Balance in Patients of Vestibular Migraine with and without Visual Vertigo: A study on Computerized Dynamic Posturography (CDP)

Audiovestibular Manifestations in Patients with Primary Raynaud's Phenomenon and Raynaud's Phenomenon Secondary to Systemic Sclerosis.

To address the prevalence of audiovestibular disorders in patients with primary Raynaud's Phenomenon (RP). A series of patients with primary RP and secondary RP in the context of systemic sclerosis (SSc) were compared with healthy controls. A prospective multicenter observational cross-sectional study was conducted in several Otolaryngology and Rheumatology Divisions of tertiary referral hospitals, recruiting 57 patients with RP and 57 age- and gender-matched controls. Twenty patients were classified as primary RP when unrelated to any other conditions and 37 patients who met the 2013 ACR/EULAR classification criteria for SSc were classified as having secondary RP associated with SSc. Audiometric and vestibular testing (vHIT), clinical sensory integration and balance testing (CTSIB), and Computerized Dynamic Posturography (CDP) were performed. As significant differences were found in the age of the two study groups, primary and secondary RP, no comparisons were made between both groups of RP but only with their control groups. No sensorineural hearing loss (SNHL) was recorded in any of our patients with primary RP and no differences were found in the voice audiometry tests with respect to controls. Four of 37 (10.8%) secondary RP patients presented SNHL. Those with SNHL were 7.03 times more likely to have a secondary RP than controls (p < 0.001). The audiometric curve revealed high-frequency hearing loss in 4 patients with RP secondary to SSc, and statistically significant differences were achieved when RP secondary was compared to controls in vHIT gain, caloric test, CTSIB, and CDP. Unlike patients with RP secondary to SSc, patients with primary RP do not show audiovestibular abnormalities. Regarding audiovestibular manifestations, primary RP can be considered a different condition than secondary RP.

Sensory organization of postural control after long term space flight.

Alterations in motor control systems is an inevitable consequence of space flights of any duration. After the flight, the crew-members have significant difficulties with maintaining upright balance and locomotion, which last several days following landing. At the same time, the specific mechanisms of these effects remain unclear. The aim of the study was to assess effects of long-term space flight on postural control and to define the changes of sensory organization caused by microgravity. 33 cosmonauts of Russian Space Agency, the members of International Space Station (ISS) flights of duration between 166 and 196 days took part in this study. Computerized Dynamic Posturography (CDP) tests, which include assessment of visual, proprioceptive and vestibular function in postural stability, was performed twice before the flight and on the 3rd, 7th, and 10th days after landing. The video analysis of ankle and hip joints fluctuations was performed to investigate the basis of postural changes. Exposure to long-term space flight was followed by considerable changes of postural stability (-27% of Equilibrium Score value in the most complicated test, SOT5m). Changes in postural strategies to maintain balance were observed in the tests which provide the challenge for vestibular system. In particular, increased hip joint involvement (+100% in median value and +135% in 3rd quartile of hip angle fluctuation RMS in SOT5m) into postural control process was revealed. Decrease of postural stability after long-term space flight was associated with alterations in vestibular system and biomechanically was revealed by increased hip strategy which is less accurate, but simpler in terms of the central control.

Kinesiology tape versus non-standardized tape in the treatment of balance in non-operated anterior cruciate ligament rupture patients: a randomized controlled trial

Purpose/Aim Anterior cruciate ligament injuries are the most common traumatic ligament injuries of the knee, which course with impaired balance. The aim of the present study was to analyse the effect of kinesiology tape on balance in subjects with non-operated anterior cruciate ligament rupture. Materials and Methods 36 subjects were randomly assigned to the kinesiology tape group (KT = 20) and the non-standardized tape group (NST = 16). Balance was assessed in the following 3 conditions: no bandage, immediately after application, and after four days of use. The outcome measures used were the Sensory Organisation Test (SOT), assessed by computerised dynamic Posturography (CDP), the modified star excursion balance test (mSEBT), the Spanish version of the KOOS and the Lysholm Knee Score. A 2-way repeated measures analysis of variance (ANOVA) was performed, with time as a within-subject factor and group as a between-subjects factor. Bonferroni correction was applied when the ANOVA was significant. Results ANOVA showed that there was no significant interaction between group and time for all outcome measures. However, a significant effect on the time factor was observed for: composite SOT score in both groups immediately after tape application; composite SOT after four days of use in the KT group; mSEBT in the KT group immediately after tape application. The KOOS improved in both groups after four days of tape use, while the Lysholm Knee Score improved only in the NST group. Conclusions No differences were observed between the KT or NST groups in balance measurements.

Nationwide Utilization of Computerized Dynamic Posturography in an Era of Deimplementation.

Computerized dynamic posturography (CDP) provides multisensory assessment of balance. Consensus is lacking regarding CDP utility and coverage determinations vary. To inform best practices and policy, this cross-sectional study quantifies provider use of CDP among Medicare beneficiaries over time (2012-2017), by geographic region (hospital referral region [HRR]), and specialty. We observed 195,267 beneficiaries underwent 212,847 CDP tests totaling $15,780,001 in payments. Number of CDPs billed per 100,000 beneficiaries varied 534-fold across HRRs. Over 6 years, CDP use grew by 84% despite stagnant reimbursement. More utilization was attributable to primary care clinicians than specialties focused on care for dizziness and balance disorders. The observed growth and variation illustrate the potential for policy and provider preferences to drive unexpected practice patterns and underscore the need to engage a broad network of providers to develop optimal guidelines for use. CDP may offer a use case for deimplementation of low-value diagnostic services.

Peripheral Vestibular System Involvement in Multiple Sclerosis and Associations with the Disease Severity

Introduction: Multiple sclerosis (MS) is an autoimmune disease that can affect balance, gait, and improve fall risk. The aim of this study was to investigate peripheral vestibular system involvement in MS and associations with the disease severity. Methods: Thirty-five adult patients with MS and 14 age- and gender-matched healthy controls were evaluated using video head impulse test (v-HIT), cervical vestibular evoked myogenic potential (c-VEMP), ocular vestibular evoked myogenic potentials (o-VEMPs), and sensory organization test (SOT) of computerized dynamic posturography (CDP). The results of both groups were compared, and association with EDSS scores was evaluated. Results: There was no significant difference between the groups regarding v-HIT and c-VEMP results (p > 0.05). There was no association of the v-HIT, c-VEMP, and o-VEMP results with EDSS scores (p > 0.05). There was no significant difference between the o-VEMP results of the groups (p > 0.05) except for N1-P1 amplitudes (p = 0.01). The amplitudes of N1-P1 were significantly lower in the patients compared to controls (p = 0.01). There was no significant difference between the SOT results of the groups (p > 0.05). However, significant differences were found within and between groups when the patients were categorized according to their EDSS scores with a cutoff point of 3 (p < 0.05). There were negative correlations between the EDSS scores and composite (r = −396, p = 0.02) and somatosensory (SOM) scores (r = −487, p = 0.04) of CDP in the MS group. Conclusion: Although central and peripheral balance-related systems are affected in MS, the impact of disease on the peripheral vestibular end organ is subtle. In particular, the v-HIT, which was mentioned previously as a detector of brainstem dysfunction could not be a reliable tool in the detection of brainstem pathologies in MS patients. The o-VEMP amplitudes may be affected in the early stages of the disease, possibly due to the crossed ventral tegmental tract, oculomotor nuclei, or interstitial nucleus of Cajal involvements. An EDSS score >3 seems a cutoff level indicating abnormalities in balance integration.

Balance functions and primitive reflexes in dyslexic children

Background Dyslexia is considered a neurodevelopmental disorder accordingly; investigating primitive reflexes – which considered as indicator for neuromotor maturation – possibly be of clinical value for evaluating dyslexic children. Objectives To assess balance functions and primitive reflexes in dyslexic children. Material and methods The study was conducted on 60 children divided into two groups. Control group consists of 20 normal children and study group consists of 40 children with dyslexia (diagnosed by Arabic Reading Screening test (ARST) and Modified Arabic Dyslexia Screening Test (MADST). Both study and control groups aged from 6 6/12 to 9 years old. They were subjected to clinical diagnostic tests for primitive reflexes and balance function tests (office tests, computerized dynamic posturography (CDP), sensory organization test (SOT)). Results Dyslexic children have poorer balance functions compared to control group. Sixty seven percent of the study group has retained primitive reflexes. Conclusions Dyslexic children have poorer balance functions in challenging situations and have retained primitive reflexes indicating delayed neural maturation. Dyslexia is a medical complex that needs assessment and management of balance functions and primitive reflexes for better quality of life.

Evolution of postural control assessment: From dynamic posturography to virtual reality.

During the early years of spaceflight it was documented that astronauts were impaired and incapacitated upon return to earth. Computerized Dynamic Posturography (CDP) was devised to investigate and quantify this deficit, and eventually progressed into a clinical assessment tool. The current sprouting of virtual reality (VR) technologies has allowed for the development of an alternative approach that could be more informative. Many low-cost VR systems (including desktop gaming programs designed for rehabilitation) are now available. Continued improvements in this technology indicate a high probability that VR will become an integral component of posturography by replacing present mechanical CDP techniques. We researched the relevant literature to evaluate the strengths and weaknesses of CDP using the Equitest (Neurocom International; Clackamas USA), and the added benefits of incorporating VR to help clinicians assess the complex task of balance maintenance. VR is capable of manipulating task and environmental demands in order to assess functional postural behavior. VR is also a useful tool for clinical testing of postural disorders resulting from sensory mismatch. Although posturography is still a useful clinical tool, VR provides an inherent conflict between the visual and vestibular senses and can elevate the effectiveness of CDP for both assessment and intervention. We conclude that, when initially developed, CDP was innovative and ahead of its time. However, with the advent of VR, we have a chance to modernize CDP and enhance its value as a clinical instrument.

Age- and gender-specific normative data on computerized dynamic posturography in a cohort of Danish adults.

Balance performance can be measured with a computerized dynamic posturography (CDP). Frequently used CDP protocols include the sensory organization test (SOT), motor control test (MCT) and adaptation test (ADT). The primary aim of this study was to produce normative data using the Bertec® Balance Advantage CDP on a cohort of healthy adults aged 20-79years for the SOT, MCT and ADT. The secondary aim was to determine age- and gender-related differences. The study population of 120 participants were divided into age groups of 20-29, 30-39years, etc., with an equal number of men and women in each group. Using the Bertec® CDP, the SOT, MCT and ADT protocols were performed. SOT found that the 70-79 age group and men scored lower equilibrium scores (ES) on SOT4, and SOT6. Women had higher ES on SOT1. For the MCT, backward translation. latencies were higher for the 60s and 70s age groups. The 60s age group had higher forward translation latencies. Women had lower latencies on all MCTs. For the ADT toes up test, the 70-79 age group scored higher sway energy. On the toes down test, higher sway energy was registered for the 50-79 age groups. Women had lower sway energy for both ADT's. We have produced normative data for healthy adults aged 20-79years for the SOT, MCT and ADT protocols using the Bertec® Balance Advantage CDP. Balance performance differences might be due to decline in visual acuity, presbyvestibulopathy and differences in body composition.

Relationship Between Obstructive Sleep Apnea and Balance on Computerized Dynamic Posturography.

Obstructive sleep apnea (OSA) leads to chronic sleep deprivation. The relationship between OSA and balance is poorly understood. This study aimed to determine if OSA adversely affects standing balance. Adults with a clinically indicated polysomnogram (PSG) diagnostic of OSA, who were not on therapy, were recruited from an academic tertiary care referral clinic. Subjects completed the Epworth Sleepiness Scale (ESS), the Stanford Sleepiness Scale (SSS), and the STOP-BANG questionnaire (SBQ). Their balance was tested with the Sensory Organization Test (SOT) of computerized dynamic posturography (CDP). Sixteen subjects participated in the study, including three with mild OSA, six with moderate OSA, and seven with severe OSA. CDP scores were not related to the subjective screening for OSA (ESS, SSS, and SBQ) or to objective measures of OSA (apnea-hypopnea index, respiratory disturbance index, and oxygen saturation nadir). Subjective and objective measures of sleepiness and sleep disorder are not related to standing balance. The sleep deficit from OSA did not affect standing balance. Therefore, OSA patients are unlikely to be at significant risk for falls due to OSA.