Sensory Reweighting as a Method of Balance Training for Labyrinthine Loss

Haran, F J. MS; Keshner, Emily A. PT, EdD

Journal of Neurologic Physical Therapy: December 2008 - Volume 32 - Issue 4 - pp 186-191
doi: 10.1097/NPT.0b013e31818dee39
Case Report

Background and Purpose: Instability is a significant risk factor for falls in individuals with a bilateral labyrinthine deficit. The purpose of this case report is to describe an intervention that we found to improve balance in a patient with bilateral labyrinthine deficit using a training paradigm based on the sensory reweighting hypothesis.

Case Description: The participant was a female and 10 years post-onset of bilateral labyrinthine deficit. The participant was instructed to focus on the motion of her hips and knees while standing on a dynamic platform that was either stationary or matched to the excursion of her center of mass (COM) but in the opposite direction and with gradually increasing amplitude. She was tested for her ability to maintain her balance under conditions of sensory conflict both before the training and on two periods after training.

Outcomes: Decreases in anteroposterior and mediolateral motion of the COM were observed between the pretest and both posttests with a stationary and a moving platform when in the dark and under conditions of sensory conflict. Using the method of approximate entropy, we found that the complexity of the center of pressure (COP) response increased in both the anteroposterior and medolateral directions from the pretest to both posttests when on the platform matched to the COM motion.

Summary: Results indicated that training on a dynamic platform diminished the destabilizing effect of conflicting sensory signals. Additionally, a relationship was observed between decreased COM motion and increased complexity in COP, which represents a more self-organized system. This finding suggests that improved stability may be associated with an increased complexity in the COP trajectory.

Departments of Physical Therapy (F.J.H., E.A.K.) and Kinesiology (F.J.H.), College of Health Professions; and Department of Electrical and Computer Engineering (E.A.K.), College of Engineering, Temple University, Philadelphia, Pennsylvania.

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Address correspondence to: Emily A. Keshner, E-mail:

© 2008 Neurology Section, APTA