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Trunk and Head Control During Walking in Patients with Unilateral Vestibular Hypofunction

Effect of Lower Limb Somatosensory Input

Zhang, Fang PhD1; Liu, Peng MSc2; Ou, Yongkang MD2; Huang, Qiuhong MD, PhD2; Song, Rong PhD4; Dou, Zulin MD, PhD1,3; Zheng, Yiqing MD2,3

American Journal of Physical Medicine & Rehabilitation: May 20, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001223
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Objectives To investigate (1) postural control, especially trunk and head control, in patients with unilateral vestibular hypofunction (UVH) and healthy controls (HCs) during walking on firm and foam surface; (2) the difference between the impact of left and right-side UVH, and correlation between trunk/head control and vestibular function in the patients.

Design 13 patients and 13 HCs were recruited. Vestibular function was examined based on the canal paresis value. Participants walked on a treadmill on firm and foam surface. Peak-to-peak trunk (Troll and Tpitch) and head roll and pitch angle (Hroll and Hpitch) were calculated as primary outcome measures.

Results In the UVH group but not HCs, Troll was significantly higher on foam than firm surface (p=0.03). Tpitch was significantly higher on foam than firm surface in both groups (p=0.02). Patients had significantly lower Hroll (p=0.03), Hpitch (p=0.02) and lower head-trunk correlation in both medio-lateral (p=0.05) and antero-posterior direction (p=0.03) than those in the HC group.

Conclusion Patients with UVH appeared to rely more on lower limb somatosensory input for trunk control especially in the medio-lateral direction compared to HCs. Lower head sway and head-trunk correlation may suggest a more independent and successful head control strategy in patients.

1 Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.

2 Department of Otolaryngology-HNS, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.

3 Department of Hearing and Speech Science, Xinhua College, Sun Yat-sen University, Guangzhou, People's Republic of China.

4 Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices, School of Engineering, Sun Yat-sen University, Guangzhou, People's Republic of China.

The two authors contributed equally to this study, Fang Zhang, Peng Liu

All correspondence should be addressed to Dr Zulin Dou and Dr Yiqing Zheng.

Corresponding authors: Zulin Dou, Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, 600 Yianhe Road, Guangzhou, People's Republic of China, Tel: +8602085252357, E-mail: douzul@163.com; Yiqing Zheng, Department of Otolaryngology-HNS, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, People's Republic of China. Tel: +8602034070287, E-mail: zhengyiq@mail.sysu.edu.cn

Disclosure: The author(s) declared no potential conflicts of interest related to this work.

Funding: This study was financially supported by Technology Program of Guangdong Province (No.2014A020212097), National Natural Science Foundation of China (No. 81771018), Guangdong Science and Technology Planning Project (Grant Nos. 2014B090901056 and 2015B020214003), Guangzhou Research Collaborative Innovation Projects (Grant No. 201604020108) and National Science & Technology Pillar Program during the 12th Five-year Plan Period of China (No. 2012BAI12B02).

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