Affiliations: [a] Dept. of Otolaryngology, University Hospital, Basel, Switzerland | [b] Dept. of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, USA
Note: [*] Address for correspondence: Prof. J.H.J. Allum, University HNO-Klinik, Petersgraben 4, CH-4031 Basel, Switzerland. Fax: +41 61 265 2750; E-mail: [email protected]
Abstract: Dynamic posturography comprises a series of balance control tests which help physicians overcome numerous diagnostic and treatment challenges arising when examining patients complaining of a debilitating balance disorder. These challenges include the specific differential diagnosis, documentation of symptoms and assessment of functional disability. It must be determined whether the cause of the disability is an organic sensory deficit, a central nervous system (CNS) lesion or a non-organic (that is, possibly psychogenic or just overtly simulated) disorder. This review is targeted towards providing the reader (a) an overview of the effects sensori-motor deficits have on balance control, specifically vestibulo-spinal and proprioceptive reflex deficits; and, (b) how these effects may be assessed objectively in a clinical setting to differentiate between various organic and non-organic balance-disorders. The techniques used to study these effects are based on the analysis of both rapid balance-correcting and slow balance-stabilizing responses to fast and slow movements in the pitch plane of the support surface on which the test subject stands.
Keywords: human postural control, human balance control, peripheral vestibular deficit, lower-leg proprioceptive loss, balance disorders, EMG activity, motion analysis
