Stocktaking on the development of posturography for clinical use

Article type: Research Article

Authors: Kingma, Herman^{a; b} | Gauchard, Gérome C.^{c; d} | de Waele, Catherine^{e; f} | van Nechel, Christian^{g; h} | Bisdorff, Alexandre^{c; d; i} | Yelnik, Alain^j | Magnusson, Mans^k | Perrin, Philippe P.^{c; d; l; *}

Affiliations: [a] Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands | [b] Department of Biomedical Technology, Technical University Eindhoven, Eindhoven, The Netherlands | [c] Nancy-University, Henri Poincaré University, Balance Control and Motor Performance, UFR STAPS, Villers-lès-Nancy, France | [d] INSERM U 954, Group “Neurodegenerative Diseases, Neuroplasticity, Cognition”, Faculty of Medicine, Vandoeuvre-lès-Nancy, France | [e] Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Pitié Salpêtrière Hospital, AP-HP, Paris, France | [f] CNRS UMR 7060, Laboratoire de Neurobiologie des Réseaux Sensorimoteurs, Paris, France | [g] Department of Neurological Rehabilitation, Brugmann University Hospital, Brussels, Belgium | [h] Department of Neuro-Ophtalmology, Erasme Hospital, ULB, Brussels, Belgium | [i] Department of Neurology, Emile Mayrisch Hospital, Esch-sur-Alzette, Luxembourg | [j] Department of Physical Medicine and Rehabilitation, Lariboisière – Fernand Widal Hospitals, AP-HP, Paris, France | [k] Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Clinical Sciences, University Hospital of Lund, Lund, Sweden | [l] Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France

Correspondence: [*] Corresponding author: Prof. Philippe P. Perrin, ESCEBD, Equilibration et Performance Motrice, Nancy-Université, Université Henri Poincaré, UFR STAPS, 30 rue du Jardin Botanique, 54 600 Villers-lès-Nancy, France. Tel.: +33 383 682 929; Fax: +33 383 154 647; E-mail: Philippe.Perrin@staps.uhp-nancy.fr

Abstract: This report identifies fundamental problems to be addressed in order to build relevant clinical tests of human balance while standing. The stated purpose of these tests is identification of lesion site and/or definition of functional balance deficits in a specific patient. During a recent consensus meeting (ESCEBD), 60 researchers and experienced clinical users of posturography (14 European countries, 9 different disciplines) inventoried and critically analyzed the various methodologies of posturography currently used for clinical evaluation. To complement posturography, alternative methods of assessment of balance control were considered. The indications for the clinical use of posturography were defined as well as recommendations regarding measurement parameters, type of perturbations and signal analysis techniques to improve assessment of balance control. Consensus was reached that a force platform cannot be considered as a technique which is sufficient on its own to perform a clinically relevant test for the assessment of neuro-otological and musculo-skeletal conditions, evaluation of compensation or treatment (rehabilitation) or prediction of falls. It should be supported by complementary methods, such as segment motion analysis, body-fixed 2D or 3D accelerometer-gyroscope or electromyography. At present, no generally applicable posturography test is available with reasonable sensitivity and specificity for the diagnosis of balance disorders. Perturbation techniques are most likely needed to enhance the diagnostic yield of posturography.

Keywords: Balance control, clinical evaluation, posturography

DOI: 10.3233/VES-2011-0397

Journal: Journal of Vestibular Research, vol. 21, no. 3, pp. 117-125, 2011