Walking performance of vestibular-defective patients before and after unilateral vestibular neurotomy

Borel, Liliane; Harlay, F.; Lopez, Christophe; Magnan, Jacques; Chays, A.; Lacour, Michel

doi:10.1016/s0166-4328(03)00257-2

Cited by 99 publications

(78 citation statements)

References 36 publications

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“…Results showed a mean deviation of 2.26±7.23º for cervical extension and 18.84±9.56º for flexion, confirming a significant difference between the two states 29 . Borel et al 30 used the same method of marking points with infrared diodes to measure walking performance in patients with Ménière' s disease pre and post-operatively. The authors found gait deviation toward the operated side in blindfolded tests one week after unilateral vestibular neurotomy with patients showing deviations of 3.7±2.5º when walking at normal speed 30 .…”

Section: Resultsmentioning

confidence: 99%

“…Borel et al 30 used the same method of marking points with infrared diodes to measure walking performance in patients with Ménière' s disease pre and post-operatively. The authors found gait deviation toward the operated side in blindfolded tests one week after unilateral vestibular neurotomy with patients showing deviations of 3.7±2.5º when walking at normal speed 30 . Jahn et al 16 assessed the differential effects on gait deviation in ten healthy young adults of galvanic stimulation walking at frequencies of 1 and 3 Hz.…”

Section: Resultsmentioning

confidence: 99%

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Assessment of gait deviation on the Babinski-Weill test in healthy Brazilians

Miranda

Stefani

et al. 2013

Arq. Neuro-Psiquiatr.

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Objective: The aim of this study was to validate a simple and reproducible method for assessing gait deviation on the Babinski-Weill test in a representative sample of healthy Brazilians. Methods: Gait deviations were measured in 75 individuals (median=30 years, 41 women) for forward, backwards, and Babinski-Weill steps. The test entailed blindfolded individuals walking 10 paces at a frequency of 1 Hz with deviations subsequently measured by a protractor. Results: Mean gait deviation forward was 0.53º with standard deviation (SD)=4.22 and backwards was 2.14º with SD=4.29. No significant difference in deviation was detected between genders (t test p=0.40 forward and p=0.77 backwards) or for age (ANOVA, p=0.33 forward and p=0.63 backwards). On the Babinski-Weill test, mean gait deviation was 5.26º; SD=16.32 in women and -3.11º; SD=12.41 in men, with no significant difference between genders (t test, p=0.056). Discussion: Defining normative gait patterns helps distinguish pathological states.Key words: vestibular system, gait, Babinski-Weill test. RESUMOObjetivo: O objetivo deste trabalho foi validar para uso no Brasil um método simples e reprodutível para avaliação do desvio no teste da marcha de Babinski-Weill. Métodos: As medidas de desvio da marcha foram realizadas em 75 indivíduos (mediana=30 anos, 41 mulheres) na marcha para frente, para trás e no teste da marcha Babinski-Weill. Durante os testes, indivíduos com olhos vendados andavam 10 passos na freqüência de 1 Hz, sendo os desvios mensurados com transferidor. Resultados: O desvio para frente teve média de 0,53º com desvio padrão (DP)=4,22 e para trás 2,14º com DP=4,29. Não houve diferença nos desvios entre os gêneros (teste t p=0,40 frente e p=0,77 trás) e entre as idades (ANOVA, p=0,33 frente e p=0,63 trás). No teste da marcha de Babinski-Weill as mulheres desviaram em média 5,26º; DP=16,32 e os homens -3,11º; DP=12,41, sem diferença entre os gêneros (teste t, p=0,056). Discussão: O estabelecimento de padrões de normalidade possibilita a identificação de estados patológicos.Palavras-Chave: sistema vestibular, marcha, teste de Babinski-Weill. Assessment of gait deviation on the Babinski-Weill test in healthy BraziliansAvaliação do desvio no teste da marcha de Babinski-Weill em uma amostra representativa de indivíduos brasileiros saudáveis The role of the vestibular system is to stabilize the image on the retina, control posture and balance, as well as to provide information on spatial orientation. The system is comprised peripherally by the otolith organs and semicircular canals which measure linear and angular acceleration, respectively. These send signals to the central nervous system, mainly to the vestibular nuclear complex and cerebellum. This information is used in conjunction with inputs from the visual and somatosensory systems to control gait 1-5 .Normal gait requires maintaining an erect posture, bearing weight, forward locomotion at different speeds and determining position in three-dimensional space. The vestibular system is involved i...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Assessment of gait deviation on the Babinski-Weill test in healthy Brazilians

Miranda

Stefani

et al. 2013

Arq. Neuro-Psiquiatr.

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“…For example, the subjects walked and moved the head and up and down at the same time. Borel et al [2004] also reported reduced gait speed when VN patients were asked just to walk with eyes open or with eyes closed. As in our study the reduced gait speed occurred before and after VN for Menière's disease.…”

Section: Discussionmentioning

confidence: 99%

Measurements of Trunk Sway for Stance and Gait Tasks 2 Years after Vestibular Neurectomy

et al. 2018

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The aim of this study was to investigate changes in balance control for stance and gait tasks in patients 2 years before and after vestibular neurectomy (VN) performed to alleviate intractable Meniere’s disease. Amplitudes of trunk sway in roll and pitch directions were measured for stance and gait tasks in 19 patients using gyroscopes mounted at the lower-back. Measurements before VN and 2 years later were compared to those of healthy age-matched controls (HC). We also examined if changes in trunk sway amplitudes were correlated with patients’ subjective assessment of disability using the AAO-HNS scale. For patients with low AAO-HNS scores 0–2 (n = 14), trunk roll and pitch sway velocities, standing eyes closed on foam, increased 2 years post VN compared to HC values (p < 0.01). Trunk sway amplitudes remained at levels of HC for simple gait tasks, but task durations were longer and therefore gait slower. For complex gait tasks (stairs), balance control remained impaired at 2 years. In patients with AAO-HNS high scores level 6 (n = 5), balance control remained abnormal, compared to HC, 2 years postoperatively for all stance, several simple and all complex gait tasks. Trunk sway in the pitch and roll directions for stance tasks was correlated with clinical (AAO-HNS) scores (p ≤ 0.05). These results indicate that VN leads to chronic balance problems for stance and complex gait tasks. The problems are greater for patients with high compared to low AAO-HNS scores, thereby explaining the different symptoms reported by these patients. The lack of balance recovery in VN patients to levels of HCs after 2 years contrasts with the 3 months average recovery period for acute vestibular neuritis patients and is indicative of the effects of neurectomy on central compensation processes.

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“…This has been well demonstrated in animal models and in vestibular patients. Visual substitution was shown to compensate for the vestibular deficit at low frequencies of stimulation [86][87][88][89] . Proprioceptive afferents also play a very important role.…”

Section: Sensory Substitution and Behavioral Strategiesmentioning

confidence: 99%

Recovery after Vestibular Lesions: From Animal Models to Patients

Vidal¹,

Vibert²,

Moore³

et al. 2004

Neuroembryol Aging

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Gaze and postural stabilization is the result of a complex multisensory integration, which can be defined as the process of matching multiple internal representations of an external event (head and/or trunk rotation), obtained from different sensory modalities, into a unique intrinsic frame of reference in which appropriate motor commands can be coded. Despite the importance of the labyrinths, their lesions are not rare. They result in static and dynamic deficits. What is remarkable is that some of these deficits recover in mammalian species, including humans: the vestibular compensation process refers to the complete or partial normalization of the static and dynamic postural and ocular motor deficits. In the following, only two aspects of vestibular compensation will be discussed: (1) the relationship between the recovery of the vestibulo-ocular reflexes and the postlesional plasticity of the intrinsic membrane properties of the medial vestibular nucleus, and (2) the relationship between the postural recovery and the vestibular control of the skeletal geometry at large. Subsequently, the results of investigations in animal models will be related to some clinical findings. While such an exercise is highly speculative, it points to new directions for clinical research and vestibular rehabilitation.

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Walking performance of vestibular-defective patients before and after unilateral vestibular neurotomy

Cited by 99 publications

References 36 publications

Assessment of gait deviation on the Babinski-Weill test in healthy Brazilians

Assessment of gait deviation on the Babinski-Weill test in healthy Brazilians

Measurements of Trunk Sway for Stance and Gait Tasks 2 Years after Vestibular Neurectomy

Recovery after Vestibular Lesions: From Animal Models to Patients

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