The walking speed-dependency of gait variability in bilateral vestibulopathy and its association with clinical tests of vestibular function

Abstract

Understanding balance and gait deficits in vestibulopathy may help improve clinical care and our knowledge of the vestibular contributions to balance. Here, we examined walking speed effects on gait variability in healthy adults and in adults with bilateral vestibulopathy (BVP). Forty-four people with BVP, 12 healthy young adults and 12 healthy older adults walked at 0.4 m/s to 1.6 m/s in 0.2 m/s increments on a dual belt, instrumented treadmill. Using motion capture and kinematic data, the means and coefficients of variation for step length, time, width and double support time were calculated. The BVP group also completed a video head impulse test and examinations of ocular and cervical vestibular evoked myogenic potentials and dynamic visual acuity. Walking speed significantly affected all gait parameters. Step length variability at slower speeds and step width variability at faster speeds were the most distinguishing parameters between the healthy participants and people with BVP, and among people with BVP with different locomotor capacities. Step width variability, specifically, indicated an apparent persistent importance of vestibular function at increasing speeds. Gait variability was not associated with the clinical vestibular tests. Our results indicate that gait variability at multiple walking speeds has potential as an assessment tool for vestibular interventions.

An exploratory investigation on spatiotemporal parameters, margins of stability, and their interaction in bilateral vestibulopathy

“…We aimed to determine the effect of a loss of peripheral vestibular function by comparing the spatiotemporal gait parameters and their step-to-step variability between BVP-patients and healthy controls during overground walking at preferred walking speed. We hypothesize that, in accordance with previous studies 24 , 26 , 27 , 33 , 34 , BVP-patients will show an increased gait variability during walking. Additionally, we also examined the interaction between the spatiotemporal gait parameters and MoS in BVP as compared to the healthy controls.…”

“…This could indicate a shift from a sensory feedback-driven control of balance to a more feedforward control of balance, as has been suggested before 22 , 35 – 37 . In addition, it has been shown that during slow walking speeds, the variability of most parameters is highest in BVP-patients 24 , 26 , 27 , 34 , 38 . The reason for this could be an increased need for sensory feedback at slower walking speeds in general, as passive dynamics play a smaller role in stabilising the body during this condition.…”

Paving the Way Toward Distinguishing Fallers From Non-fallers in Bilateral Vestibulopathy: A Wide Pilot Observation

“…These alterations are hypothesized to reflect compensatory strategies to stabilize the impaired walking performance ( 57 ), test these differences are completely lacking in the current BVP population, which again could be the result of the higher walking speed of the present sample. It has been shown that, during faster walking and increased cadence, the vestibular influence on the lower limb muscles is selectively suppressed ( 58 , 59 ) and the direction and variability of walking are less affected by vestibular perturbations ( 60 – 62 ). Therefore, BVP patients may utilize a higher walking speed to suppress the inaccurate vestibular information.…”

Relative Contribution of Proprioceptive and Vestibular Sensory Systems to Locomotion: Opportunities for Discovery in the Age of Molecular Science

“…Similarly, in quadrupedal animals with vestibular lesions, the main phenotypes are also associated with disruptions to the balance system. Animals generally maintain a lower center of mass, reduced cadence, shorter swing and variability in foot placement [ 110 , 111 ].…”