Compensatory postural responses to backward loss of balance in patients with cerebellar disease |
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| Institution: | 1. Department of Brain Sciences, Imperial College London, W6 8RF London, UK;2. Faculty of Science and Engineering, School of Medicine & Clinical Practice, University of Wolverhampton, Wolverhampton, WV1 1LY, UK;3. Department of Health Sciences, Lund University, S-221 85 Lund, Sweden;4. Memory Clinic, Skåne University Hospital, S-212 24 Malmö, Sweden;5. Clinical Memory Research Unit, Faculty of Medicine, Lund University, S-221 85 Lund, Sweden;6. Department of Neurosurgery, Lund University, S-221 85 Lund, Sweden;7. Department of Clinical Sciences, Lund University, S-221 85 Lund, Sweden;8. Department of Automatic Control, Lund University, S-221 00 Lund, Sweden;1. Movement Analysis Laboratory, Central Remedial Clinic, Clontarf, Dublin 3, Ireland;2. Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland;1. Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil;2. Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil;3. Exercise Neuroscience Research Group, School of Arts, Sciences, and Humanities, University of São Paulo, São Paulo, Brazil;4. Laboratory of Integrative Motor Behaviour, Centre for Neuroscience Studies, Queen’s University, Ontario, Canada;1. Department of Anatomy, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria;2. Department of Physiotherapy, Enugu State University Teaching Hospital Park Lane, Enugu, Enugu State, Nigeria;1. Department of Neurology, University of Minnesota, 516 Delaware Street SE, Minneapolis, MN, 55455, United States;2. Department of Biomedical Engineering, University of Minnesota, 7-105 Hasselmo Hall, 312 Church Street SE, Minneapolis, MN, 55455, United States;3. Department of Neurosurgery, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, United States |
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| Abstract: | BackgroundImpaired control of balance and coordinated reactions are a primary deficit of cerebellar dysfunction. As compared to other neurological patients with balance impairments, there has been little research assessing the characteristics of compensatory responses associated with falls in patients with cerebellar disease (CD).Research questionThe aim of this study was to examine the effects of cerebellar disease on compensatory balance control in response to postural perturbation. Do CD patients increase the number of steps when responding to instability because of inappropriate initial step reactions or poor control of trunk motion or both?MethodsIn this explorative study, 10 patients suffering from degenerative cerebellar ataxia and 10 age-matched healthy controls were examined. The balance recovery reactions were assessed using a lean-and-release postural perturbation method. Spatiotemporal characteristics of stepping movement and COM variables associated with torso motion were analyzed using 3D motion capture system.ResultsCD patients took multiple steps whereas matched controls generally took single steps to recover balance following perturbation. The characteristics of the initial step at the time of the fall revealed that foot reaction time, foot response time, and step distance of the initial step were similar between CD patients and matched controls. However, CD patients exhibited a shorter foot-to?COM distance, higher COM velocity, and less trunk flexion with which to attenuate their body momentum after the landing of the first step than did matched controls.SignificanceAlthough initial step responses were probably adequate, poor control of torso motion appears to be a particular problem that causes multiple-step reactions in CD patients. This observation would help to guide the development of tailored fall intervention strategies in CD patients aimed at promoting their recovery capacity in response to a pronounced balance challenge. |
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| Keywords: | Cerebellar ataxia Falls Postural perturbation Compensatory balance strategy Multiple step |
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