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Balance control of children and adolescents suffering from vertigo symptoms: in what way posturography is helpful in clinical evaluation of vestibular system pathology?

Szczerbik Ewa, Iwanicka-Pronicka Katarzyna, Syczewska Małgorzata, Kalinowska Małgorzata, Graff Krzysztof

Acta of Bioengineering and Biomechanics

2019

Vol. 21, no. 1

73--78

The aim of the study was to determine balance parameters in a group of young patients with vertigo symptoms and to verify posturography helpfulness in clinical evaluation of vestibular system pathology. Methods: 77 children and adolescents of age 3–18 suffering from vertigo episodes participated in the study (46 girls, 31 boys). They underwent audiology objective tests and balance test on stable surface. Calculated balance parameters were analyzed in reference to: eyes opened and closed, age influence, sway comparison in anterior-posterior and medial-lateral, differences between subgroups with and without vestibular deficits. Discriminant analysis was performed to assess classification ability to impaired group in two cases: only balance parameters and both audiology and balance parameters. Results: Patients with vertigo symptoms generally keep their balance properly on stable surface. Balance parameters do not depend on presence of vestibular system pathology. Values increased in eyes closed conditions. Left/Right and Anterior/Posterior differences were not statistically significant. The negative correlation between age and some balance parameters is present, stronger in the case of eyes opened and weaker or absent in vestibular impaired group. Also, correlations between axes were found, higher in impaired group in comparison with not impaired one. Conclusions: Discrimination based on balance parameters is poor not comparable to one built on combined: audiology and balance parameters, so typical balance parameters’ analysis is not so useful in clinical practice when the reason of vertigo episodes should be assessed, but verify compensation process and measure with objective numbers the progress of recovering, the actual functional patient’s status.

An alternative 3D numerical method to study the biomechanical behaviour of the human inner ear semicircular canal

Santos C. F., Belinha J., Gentil F., Parente M., Jorge R. N.

Acta of Bioengineering and Biomechanics

2017

Vol. 19, no. 1

3--15

Purpose: The vestibular system is the part of the inner ear responsible for balance. Vertigo and dizziness are generally caused by vestibular disorders and are very common symptoms in people over 60 years old. One of the most efficient treatments at the moment is vestibular rehabilitation, permitting to improve the symptoms. However, this rehabilitation therapy is a highly empirical process, which needs to be enhanced and better understood. Methods: This work studies the vestibular system using an alternative computational approach. Thus, part of the vestibular system is simulated with a three dimensional numerical model. Then, for the first time using a combination of two discretization techniques (the finite element method and the smoothed particle hydrodynamics method), it is possible to simulate the transient behavior of the fluid inside one of the canals of the vestibular system. Results: The obtained numerical results are presented and compared with the available literature. The fluid/solid interaction in the model occurs as expected with the methods applied. The results obtained with the semicircular canal model, with the same boundary conditions, are similar to the solutions obtained by other authors. Conclusions: The numerical technique presented here represents a step forward in the biomechanical study of the vestibular system, which in the future will allow the existing rehabilitation techniques to be improved.

Stabilność strukturalna osób z zawrotami głowy i zaburzeniami równowagi pochodzenia układowego

Curzytek M., Mraz M., Mraz M., Gawron W., Skolimowski T.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

2008

Vol. 14, nr 4

287--291

Celem pracy jest ocena stabilności strukturalnej osób z układowymi zawrotami głowy i zaburzeniami równowagi na podstawie obrazu wychwiań postawy ciała w płaszczyźnie czołowej i strzałkowej. Badaniom poddano 20 osób (17 kobiet, 3 mężczyzn), w wieku od 25 do 60 lat (50,61±16,12) z układowymi zawrotami głowy (vertigo). Do oceny stabilności ciała w pozycji stojącej wykorzystano platformę posturograficzną firmy Pro-Med. Badane osoby objęto postępowaniem usprawniającym, na które składały się ćwiczenia koordynacji wzrokowo-ruchowej na platformie posturograficznej oraz ćwiczenia równoważne na stabilnym i niestabilnym podłożu. Pod wpływem zastosowanych ćwiczeń uzyskano istotne statystycznie skrócenie długości stabilogramu w płaszczyźnie czołowej (L-P) przy oczach otwartych i przy świadomej kontroli wzrokowej. Uzyskany po fizjoterapii wzrost wskaźnika WCOP procentowy udział przemieszczeń położenia środka nacisku stóp COP (centre pressure) w płaszczyźnie strzałkowej i czołowej był wynikiem wzrostu długości stabilogramu w płaszczyźnie strzałkowej (P-T). Zmiana obrazu stabilności strukturalnej osób zukładowymi zawrotami głowy i zaburzeniami równowagi po fizjoterapii dowodzi normalizacji wychwiań podczas utrzymywania równowagi ciała w pozycji stojącej.

The aim of the study was to evaluate the structural stability in people with systemic vertigo and balance disturbances on the basis of body sway in frontal and sagittal plane. The examinations involved 20 subjects (17 females, 3 males) aged from 25 to 60 years (50.61±16.12) with systemic vertigo. The body stability in a standing position was evaluated on a posturographic platform manufactured by Pro-Med. The subjects underwent rehabilitation program including visual--movement coordination training on a posturographic platform and balance exercises on stable and unstable base. The applied exercise program resulted in a statistically significant shortening of the stabiologram in the frontal plane with eyes opened and intentional visual control. An increase in WCOP the percentage of COP (centre pressure) shifting in the segittal and frontal plane index obtained after physiotherapy program resulted from increased stabilogram length in the sagittal plane. The observed improvements instructural stability in subjects with systemic vertigo and imbalance after a physiotherapy program were stated.