Associations Between Bipedal Stance Stability and Locomotor Stability Following a Trip in Unilateral Vestibulopathy

Abstract

Posturography is used to assess balance in clinical settings, but its relationship to gait stability is unclear. We assessed if dynamic gait stability is associated with standing balance in 12 patients with unilateral vestibulopathy. Participants were unexpectedly tripped during treadmill walking and the change in the margin of stability (MoS) and base of support (BoS) relative to nonperturbed walking was calculated for the perturbed and first recovery steps. The center of pressure (COP) path during 30-s stance with eyes open and closed, and the distance between the most anterior point of the COP and the anterior BoS boundary during forward leaning (A), were assessed using a force plate. Pearson correlations were conducted between the static and dynamic variables. The perturbation caused a large decrease in the BoS, leading to a decrease in MoS. One of 12 correlations was significant (MoS at the perturbed step and A; r = -.595, P = .041; nonsignificant correlations: .068 ≤ P ≤ .995). The results suggest that different control mechanisms may be involved in stance and gait stability, as a consistent relationship was not found. Therefore, posturography may be of limited use in predicting stability in dynamic situations.

Gait in patients with symptomatic osteoporotic vertebral compression fractures over 6 months of recovery

“…However, as the majority of falls in older adults occurs during walking, stability control specifically while walking should be considered. It is important to note that stability control during static tasks shows little relationship with more dynamic and reactive tasks [12][13][14].…”

<p>Effect of a semirigid thoracolumbar orthosis on gait and sagittal alignment in patients with an osteoporotic vertebral compression fracture</p>

“…No studies are available evaluating the effect of a dynamic orthosis on gait and global sagittal alignment (GSA) of the spine 12,14,15. Data in previous studies regarding balance has mainly been retrieved during static tasks, such as standing, but it is important to note that stability control during static tasks shows little relationship with more dynamic tasks performed during activities of daily living 7,8,17…”

A trip to remember

“…not older adults), or that reactive adaptation was not analysed in the studies. Cable trip systems, in conjunction with either treadmill or overground walking have been used effectively on multiple occasions to analyse gait stability and adaptation in multiple participant groups 3.1 (Süptitz et al, 2012, Senden et al, 2014, McCrum et al, 2016a, McCrum et al, 2017a. Another method for initiating tripping responses is the use of objects popping up from the ground, inhibiting the swing phase of gait (Pijnappels et al, 2005b, Pijnappels et al, 2005c.…”

“…a jump and land test). Regarding falls, standing balance tests in various forms have often been used to assess fall risk, but static and dynamic posturography outcomes could not distinguish previous older fallers from older non-fallers in one study (Baloh et al, 1994) and have repeatedly shown a lack of association with balance recovery performance during dynamic and reactive balance tasks (Owings et al, 2000, Mackey and Robinovitch, 2005, Bhatt et al, 2011, McCrum et al, 2017a.…”

“…Balance maintenance requires a complex interaction of several mechanisms and hence, improved balance control in one task in particular is not likely to be of benefit during other tasks (Kummel et al, 2016). Accordingly, only negligible associations between static posturography and dynamic stability performance (forward lean-andrelease and slip/trip recovery tasks) have been reported (Owings et al, 2000, Mackey and Robinovitch, 2005, Bhatt et al, 2011, McCrum et al, 2017a. Therefore, testing and training tasks more specific to balance recovery mechanisms may provide more insight and benefit for falls reduction and prevention.…”