Characterization of Head-Trunk Coordination Deficits After Unilateral Vestibular Hypofunction Using Wearable Sensors

Paul, Serene S.; Dibble, Leland E.; Walther, Raymond G.; Shelton, Clough; Gurgel, Richard K.; Lester, M.

doi:10.1001/jamaoto.2017.1443

Cited by 29 publications

(38 citation statements)

References 32 publications

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“…In contrast, deficits in vestibular function cause various disturbances in spatial orientation, gait, head movement, and upper body coordination. It was recently reported that patients with unilateral vestibular hypofunction reveal fewer, smaller, and slower head movements after surgery [3,4]. Additionally, these authors suggested that early referral for vestibular rehabilitation may be beneficial to improve the recovery of gait, dynamic stability, head movement, and upper body coordination.…”

Section: Discussionmentioning

confidence: 99%

“…Such symptoms can cause changes in movement kinematics and compensatory alterations with respect to gait parameters [2]. For example, previous studies have reported significantly reduced head movement during both community ambulation (approximately ten minutes) [3] and during standardized gait testing of short duration [4]. Although such altered movement kinematics may also result in less efficient turning, the current clinical assessment of turning and its related outcome in patients with vestibular dysfunction are not validated.…”

Section: Introductionmentioning

confidence: 99%

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Vestibular physical therapy improves turning not straight walking during the inertial sensor-instrumented Timed Up and Go test

Kim

Gimmon

Millar

et al. 2020

Preprint

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Background: Deficits in vestibular function increase the risk for fall while turning. However, the clinical assessment of turning in patients with vestibular dysfunction is lacking, and evidence is limited that identifies how effective vestibular physical therapy (VPT) is for improving turning performance. Objective: To quantify and compare walking and turning performance during the instrumented timed up and go (TUG) test using inertial measurement units (IMUs) for clinical settings. We investigate novel instrumented TUG parameters for ability to distinguish patients with unilateral vestibular deafferentation (UVD) from control groups, and discriminate the differences in turning parameters of UVD patients following a VPT program. Methods: We recruited 38 patients following UVD surgery, 26 age-matched Veteran patient (VA) controls with reports of non-vestibular dizziness, and 12 age-matched healthy controls. Individuals were donned with body-worn IMUs and given verbal instructions to complete the TUG test as fast as safely possible. The IMU-instrumented and automated assessment of the TUG test provided component-based TUG parameters, including the novel walking:turning ratio. Among the UVD patients, 19 patients completed an additional instrumented TUG testing after VPT. Results: The walking:turning time ratio showed that turning performance in pre VPT UVD patients are significantly more impaired than VA patients and healthy controls (p < 0.001). Vestibular rehabilitation significantly improved turning performance and “normalized” their walking:turning time ratio compared to healthy controls (p < 0.001). However, the duration of the straight walking component in UVD patients before VPT was not significantly different as to that after VPT as well as healthy controls. Conclusions: Our data showed that the IMU-instrumented TUG test can distinguish patients with vestibular deafferentation and objectively quantify the change in their turning performance after surgery. The IMU-based instrumented TUG parameters have potential to quantify the efficacy of VPT and be adopted in the clinic.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vestibular physical therapy improves turning not straight walking during the inertial sensor-instrumented Timed Up and Go test

Kim

Gimmon

Millar

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Trunk coordination is an important aspect of trunk strength [27,28] and has been intensively studied in low back pain research [2,[5][6][7][10][11][12][13][14][15]. Different types of coordination have been investigated in previous studies, including headtrunk coordination [9], arm-trunk coordination [8], trunkpelvis coordination [11,13,15], and trunk-lower limb coordination [29].…”

Section: Trunk Coordinationmentioning

confidence: 99%

“…Whereas people tend to equate trunk strength with the strength of trunk muscles, there is increasing evidence that the coordination of muscles, joints and ligaments is even more important in providing sufficient trunk strength and is yet not strongly associated to trunk muscle strength [3,4]. Moreover, impaired coordination was found to be associated to many sickness including low back pain [5][6][7], stroke [8], and unilateral vestibular hypofunction [9]. To this end, trunk coordination ability can be used as an indicator of a person's physical health.…”

Section: Introductionmentioning

confidence: 99%

“…We sought for solutions at the intersection of pervasive sensing and machine learning, so that our methods could benefit anyone who has simple mobile devices such as smartphones, iPod and iPad. The accelerometers and gyroscopes embedded in these devices have enabled data-driven and ubiquitous approaches for motion tracking and analysis in free-living conditions [9,[16][17][18][19][20][21]. These portable sensors allow for capturing motion data in all three planes of motion (i.e.…”

Section: Introductionmentioning

confidence: 99%

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A Pervasive Sensing Approach to Automatic Assessment of Trunk Coordination Using Mobile Devices

Liang¹,

Yoshida²,

Iino³

et al. 2018

EAI Endorsed Transactions on Pervasive Health and Technology

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Assessing trunk coordination has many potential applications in health promotion. However, traditional bio-mechanical approaches are not suited for daily use as they require expensive devices and manual analysis. This study aimed to develop an approach for automatic classification of good and poor trunk coordination using widely available mobile devices. We investigated different combinations of sensor locations (i.e. chest and pelvis), sensing modalities (i.e. accelerometer and gyroscope) and classification techniques (i.e. SVM, KNN, and decision tree). Results showed that using both sensing modalities at chest and pelvis with SVM produced the best classification accuracy: 96% for chest rotation and 100% for pelvis rotation. In practice, however, using one device with both sensing modalities (i.e. accelerometer and gyroscope) will achieve a better trade-off between feasibility and accuracy. In this case, the device should be fixed on the chest. KNN should be selected as the classification technique for chest rotation (best accuracy 95%), and SVM should be selected as the classification technique for pelvis rotation (best accuracy 79%). Post hoc analysis found that poor coordination during chest rotation was associated to weak cross-correlation of angular velocity between chest and pelvis in the frontal plane, while poor coordination during pelvis rotation was associated to weak correlations of angular velocity between the three orthogonal components at chest. This study demonstrated how simple mobile devices can capture relevant motion data and extract key features that help construct computational models for automatic assessment of trunk coordination.

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Instrumented Gait Analysis to Identify Persistent Deficits in Gait Stability in Adults With Chronic Vestibular Loss

Grove

Whitney

Pyle

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCERegaining the ability to walk safely is a high priority for adults with vestibular loss. Thus, practitioners need comprehensive knowledge of vestibulopathic gait to design, provide, and/or interpret outcomes of interventions. To date, few studies have characterized the effects of vestibular loss on gait.OBJECTIVES To investigate the use of an instrumented 2-minute walk test in adults with vestibular loss, to further characterize vestibulopathic gait, and to assess whether those with chronic vestibular loss have enduring gait deficits. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study, conducted between April 3, 2018, and June 27, 2019, recruited adults 20 to 79 years of age from an academic, tertiary, hospital-based, ambulatory care setting who were healthy or had confirmed unilateral or bilateral vestibular hypofunction. Of the 43 adults who were screened from convenience and referred samples, 2 declined, and 7 were excluded because of health conditions. EXPOSURES The main exposure was the instrumented 2-minute walk test, which was conducted with participants using wearable inertial measurement units while they walked a 10-m path at their self-selected speed and turned 180°in their self-selected direction at either end. MAIN OUTCOMES AND MEASURESThe primary measures were spatiotemporal gait metrics (eg, stride length [SL] and peak whole-body turning velocity). Multivariate analysis of variance was used to assess between-group differences. Validity was assessed using the area under the curve from receiver operator characteristic analyses.RESULTS Data from 17 healthy adults (mean [SD] age, 39.27 [11.20] years; 13 [76%] female) and 13 adults with vestibular loss (mean [SD] age, 60.50 [10.81] years; 6 [46%] female) were analyzed. Very large between-group differences were found for SL (left) (estimated marginal mean [SE] for healthy vs vestibular groups, 1.47 [0.04] m vs 1.31 [0.04] m; Cohen d, 1.35; 95% CI, 0.18-2.52), SL (right) (estimated marginal mean [SE] for healthy vs vestibular groups, 1.46 [0.04] m vs 1.29 [0.04] m; Cohen d, 1.44; 95% CI, 0.25-2.62), and peak turn velocity (estimated marginal mean [SE] for healthy vs vestibular groups, 240.17 [12.78]°/s vs 189.74 [14.70]°/s; Cohen d, 1.23; 95% CI, 0.07-2.40). The area under the curve was 0.79 (95% CI, 0.62-0.95) for SL (left), 0.81 (95% CI, 0.64-0.97) for SL (right), and 0.86 (95% CI, 0.72-0.99) for peak turn velocity. CONCLUSIONS AND RELEVANCEIn this cross-sectional study, instrumented gait analysis had good discriminative validity and revealed persistent deficits in gait stability in those with chronic vestibular loss. The findings of this study suggest that these clinically and functionally meaningful deficits could be targets for vestibular rehabilitation.

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Characterization of Head-Trunk Coordination Deficits After Unilateral Vestibular Hypofunction Using Wearable Sensors

Cited by 29 publications

References 32 publications

Vestibular physical therapy improves turning not straight walking during the inertial sensor-instrumented Timed Up and Go test

Vestibular physical therapy improves turning not straight walking during the inertial sensor-instrumented Timed Up and Go test

A Pervasive Sensing Approach to Automatic Assessment of Trunk Coordination Using Mobile Devices

Instrumented Gait Analysis to Identify Persistent Deficits in Gait Stability in Adults With Chronic Vestibular Loss

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