TY - JOUR
T1 - Development of a Computerized Device for Evaluating Vestibular Function in Locomotion
T2 - A New Evaluation Tool of Vestibular Hypofunction
AU - Chen, Po Yin
AU - Chou, Li Wei
AU - Jheng, Ying Chun
AU - Huang, Shih En
AU - Li, Lieber Po Hung
AU - Yu, Chung Huang
AU - Kao, Chung Lan
N1 - Funding Information:
Funding. This study was funded by the Ministry of Science and Technology (105-2314-B-010-006, 106-2314-B010-038, 107-2314-B-010-010, 108-2314-B-010-042-MY3, 108-2811-B-010-541), Taipei Veterans General Hospital (VN109-11), and Taipei Veterans General Hospital-National Yang-Ming University Excellent Physician Scientists Cultivation Program, No. 108-V-B-008. This work was financially supported by the “Center For Intelligent Drug Systems and Smart Bio-devices (IDS2B)” from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan. This paper is particularly supported by the Ministry of Education through the SPROUT Project-Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B) of National Chiao Tung University, and the Cancer Progression Center of National Yang-Ming University, Taiwan.
Publisher Copyright:
© Copyright © 2020 Chen, Chou, Jheng, Huang, Li, Yu and Kao.
PY - 2020/6/12
Y1 - 2020/6/12
N2 - To evaluate vestibular function in the clinic, current assessments are applied under static conditions, such as with the subject in a sitting or supine position. Considering the complexities of daily activities, the combination of dynamic activities, dynamic visual acuity (DVA) and postural control could produce an evaluation that better reflects vestibular function in daily activities. Objective: To develop a novel sensor-based system to investigate DVA, walking trajectory, head and trunk movements and the chest-pelvis rotation ratio during forward and backward overground walking in both healthy individuals and patients with vestibular hypofunction. Methods: Fifteen healthy subjects and 7 patients with bilateral vestibular hypofunction (BVH) were recruited for this study. Inertial measurement units were placed on each subject's head and torso. Each subject walked forward and backward for 5 m twice with 2 Hz head yaw. Our experiment comprised 2 stages. In stage 1, we measured forward (FW), backward (BW), and medial-lateral (MLW) walking trajectories; head and trunk movements; and the chest-pelvis rotation ratio. In stage 2, we measured standing and locomotion DVA (loDVA). Using Mann–Whitney U-test, we compared the abovementioned parameters between the 2 groups. Results: Patients exhibited an in-phase chest/pelvis reciprocal rotation ratio only in FW. The walking trajectory deviation, calculated by normalizing the summation of medial-lateral swaying with 1/2 body height (%), was significantly larger (FW mean ± standard deviation: 20.4 ± 7.1% (median (M)/interquartile range (IQR): 19.3/14.4–25.2)in healthy vs. 43.9 ± 27. 3% (M/IQR: 36.9/21.3–56.9) in patients, p = 0.020)/(BW mean ± standard deviation: 19.2 ± 11.5% (M/IQR: 13.6/10.4–25.3) in healthy vs. 29.3 ± 6.4% (M/IQR: 27.7/26.5–34.4) in patients, p = 0.026), and the walking DVA was also significantly higher (LogMAR score in the patient group [FW LogMAR: rightDVA: mean ± standard deviation:0.127 ± 0.081 (M/IQR: 0.127/0.036–0.159) in healthy vs. 0.243 ± 0.101 (M/IQR: 0.247/0.143–0.337) in patients (p = 0.013) and leftDVA: 0.136 ± 0.096 (M/IQR: 0.127/0.036–0.176) in healthy vs. 0.258 ± 0.092 (M/IQR: 0.247/0.176–0.301) in patients (p = 0.016); BW LogMAR: rightDVA: mean ± standard deviation: 0.162 ± 0.097 (M/IQR: 0.159/0.097–0.273) in healthy vs. 0.281 ± 0.130 (M/IQR: 0.273/0.176–0.418) in patients(p = 0.047) and leftDVA: 0.156 ± 0.101 (M/IQR: 0.159/0.097–0.198) in healthy vs. 0.298 ± 0.153 (M/IQR: 0.2730/0.159–0.484) in patients (p = 0.038)]. Conclusions: Our sensor-based vestibular evaluation system provided a more functionally relevant assessment for the identification of BVH patients.
AB - To evaluate vestibular function in the clinic, current assessments are applied under static conditions, such as with the subject in a sitting or supine position. Considering the complexities of daily activities, the combination of dynamic activities, dynamic visual acuity (DVA) and postural control could produce an evaluation that better reflects vestibular function in daily activities. Objective: To develop a novel sensor-based system to investigate DVA, walking trajectory, head and trunk movements and the chest-pelvis rotation ratio during forward and backward overground walking in both healthy individuals and patients with vestibular hypofunction. Methods: Fifteen healthy subjects and 7 patients with bilateral vestibular hypofunction (BVH) were recruited for this study. Inertial measurement units were placed on each subject's head and torso. Each subject walked forward and backward for 5 m twice with 2 Hz head yaw. Our experiment comprised 2 stages. In stage 1, we measured forward (FW), backward (BW), and medial-lateral (MLW) walking trajectories; head and trunk movements; and the chest-pelvis rotation ratio. In stage 2, we measured standing and locomotion DVA (loDVA). Using Mann–Whitney U-test, we compared the abovementioned parameters between the 2 groups. Results: Patients exhibited an in-phase chest/pelvis reciprocal rotation ratio only in FW. The walking trajectory deviation, calculated by normalizing the summation of medial-lateral swaying with 1/2 body height (%), was significantly larger (FW mean ± standard deviation: 20.4 ± 7.1% (median (M)/interquartile range (IQR): 19.3/14.4–25.2)in healthy vs. 43.9 ± 27. 3% (M/IQR: 36.9/21.3–56.9) in patients, p = 0.020)/(BW mean ± standard deviation: 19.2 ± 11.5% (M/IQR: 13.6/10.4–25.3) in healthy vs. 29.3 ± 6.4% (M/IQR: 27.7/26.5–34.4) in patients, p = 0.026), and the walking DVA was also significantly higher (LogMAR score in the patient group [FW LogMAR: rightDVA: mean ± standard deviation:0.127 ± 0.081 (M/IQR: 0.127/0.036–0.159) in healthy vs. 0.243 ± 0.101 (M/IQR: 0.247/0.143–0.337) in patients (p = 0.013) and leftDVA: 0.136 ± 0.096 (M/IQR: 0.127/0.036–0.176) in healthy vs. 0.258 ± 0.092 (M/IQR: 0.247/0.176–0.301) in patients (p = 0.016); BW LogMAR: rightDVA: mean ± standard deviation: 0.162 ± 0.097 (M/IQR: 0.159/0.097–0.273) in healthy vs. 0.281 ± 0.130 (M/IQR: 0.273/0.176–0.418) in patients(p = 0.047) and leftDVA: 0.156 ± 0.101 (M/IQR: 0.159/0.097–0.198) in healthy vs. 0.298 ± 0.153 (M/IQR: 0.2730/0.159–0.484) in patients (p = 0.038)]. Conclusions: Our sensor-based vestibular evaluation system provided a more functionally relevant assessment for the identification of BVH patients.
KW - computerized functional assessment
KW - dizziness
KW - gaze and locomotion
KW - vertigo
KW - vestibular hypofunction
KW - vestibular rehabilitation
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U2 - 10.3389/fneur.2020.00485
DO - 10.3389/fneur.2020.00485
M3 - Article
AN - SCOPUS:85087036060
SN - 1664-2295
VL - 11
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 485
ER -