title: Deficient recovery response and adaptive feedback potential in dynamic gait stability in unilateral peripheral vestibular disorder patients.
abstract: Unilateral peripheral vestibular disorder (UPVD) causes deficient locomotor responses to novel environments due to a lack of accurate vestibular sensory information, increasing fall risk. This study aimed to examine recovery response (stability recovery actions) and adaptive feedback potential in dynamic stability of UPVD-patients and healthy control subjects during perturbed walking. 17 UPVD-patients (>6 months since onset) and 17 matched healthy control participants walked on a treadmill and were subjected to eight unexpected perturbations during the swing phase of the right leg. For each perturbation, the margin of stability (MS; state of body's centre of mass in relation to the base of support), was determined at touchdown of the perturbed leg and during the following six recovery steps. The first perturbation caused a reduced MS at touchdown for the perturbed leg compared to baseline, indicating an unstable position, with controls requiring five recovery steps to return to MS baseline and UPVD-patients not returning to baseline level within the analyzed six recovery steps. By the eighth perturbation, control subjects needed two steps, and UPVD-patients required three recovery steps, both thereby improving their recovery response with practice. However, MS at touchdown of the perturbed leg increased only for the controls after repeated perturbations, indicating adaptive feedback-driven locomotor improvements for the controls, but not for the UPVD-patients. We concluded that UPVD-patients have a diminished ability to control dynamic gait stability during unexpected perturbations, increasing their fall risk, and that vestibular dysfunction may inhibit the neuromotor system adapting the reactive motor response to perturbations.
authors.affiliation: Human Movement Science, NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
authors.forename: Christopher
authors.initials: C
authors.lastname: McCrum
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Eysel-Gosepath
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, Germany.
authors.forename: Gaspar
authors.initials: G
authors.lastname: Epro
authors.affiliation: Human Movement Science, NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Meijer
authors.affiliation: Human Movement Science, NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
authors.forename: Hans H C M
authors.initials: HH
authors.lastname: Savelberg
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: Gert-Peter
authors.initials: GP
authors.lastname: Brüggemann
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, Germany Department of Mathematics and Technology, University of Applied Sciences Koblenz, RheinAhrCampus Remagen, Remagen, Germany.
authors.forename: Kiros
authors.initials: K
authors.lastname: Karamanidis
keywords: Fall risk; gait adaptation; margin of stability; vestibular dysfunction