People with persistent postural-perceptual dizziness demonstrate altered postural strategies in complex visual and cognitive environments

Anat V. Lubetzky, Moshe M.H. Aharoni, Liraz Arie, Tal Krasovsky

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: People with PPPD report imbalance, increase in symptoms and impaired function within complex visual environments, but understanding of the mechanism for these behaviors is still lacking. OBJECTIVE: To investigate postural control in PPPD we compared changes in center of pressure (COP) and head kinematics of people with PPPD (N = 22) and healthy controls (N = 20) in response to different combinations of visual and cognitive perturbations during a challenging balance task. METHODS: Participants stood in a tandem position. Static or moving stars (0.2 Hz, 5 mm or 32 mm amplitude, anterior-posterior direction) were displayed through a head-mounted display (HTC Vive). On half the trials, participants performed a serial-3 subtraction task. We measured medio-lateral and anterior-posterior path and acceleration of COP and head. RESULTS: Controls significantly increased all COP and head parameters with the cognitive task whereas PPPD increased only COP ML path and acceleration. Only controls significantly increased head anterior-posterior medio-lateral acceleration with moving visual load. Cognitive task performance was similar between groups. CONCLUSIONS: We observed altered postural strategies in people with PPPD, in the form of reduced movement with challenge, particularly around the head segment. The potential of this simple and portable head-mounted display setup for differential diagnosis of vestibular disorders should be further explored.

Original languageEnglish (US)
Pages (from-to)505-517
Number of pages13
JournalJournal of Vestibular Research: Equilibrium and Orientation
Volume31
Issue number6
DOIs
StatePublished - 2021

Keywords

  • balance
  • dual task
  • head mounted display
  • PPPD
  • sensory integration
  • virtual reality

ASJC Scopus subject areas

  • Neuroscience(all)
  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

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