title: Postural Stability of Patients with Schizophrenia during Challenging Sensory Conditions: Implication of Sensory Integration for Postural Control.
abstract: Postural dysfunctions are prevalent in patients with schizophrenia and affect their daily life and ability to work. In addition, sensory functions and sensory integration that are crucial for postural control are also compromised. This study intended to examine how patients with schizophrenia coordinate multiple sensory systems to maintain postural stability in dynamic sensory conditions. Twenty-nine patients with schizophrenia and 32 control subjects were recruited. Postural stability of the participants was examined in six sensory conditions of different level of congruency of multiple sensory information, which was based on combinations of correct, removed, or conflicting sensory inputs from visual, somatosensory, and vestibular systems. The excursion of the center of pressure was measured by posturography. Equilibrium scores were derived to indicate the range of anterior-posterior (AP) postural sway, and sensory ratios were calculated to explore ability to use sensory information to maintain balance. The overall AP postural sway was significantly larger for patients with schizophrenia compared to the controls [patients (69.62±8.99); controls (76.53±7.47); t1,59 = -3.28, p<0.001]. The results of mixed-model ANOVAs showed a significant interaction between the group and sensory conditions [F5,295 = 5.55, p<0.001]. Further analysis indicated that AP postural sway was significantly larger for patients compared to the controls in conditions containing unreliable somatosensory information either with visual deprivation or with conflicting visual information. Sensory ratios were not significantly different between groups, although small and non-significant difference in inefficiency to utilize vestibular information was also noted. No significant correlations were found between postural stability and clinical characteristics. To sum up, patients with schizophrenia showed increased postural sway and a higher rate of falls during challenging sensory conditions, which was independent of clinical characteristics. Patients further demonstrated similar pattern and level of utilizing sensory information to maintain balance compared to the controls.
authors.affiliation: Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan.|Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Ya-Ling
authors.identifier: http://orcid.org/0000-0002-8496-3861
authors.initials: YL
authors.lastname: Teng
authors.affiliation: Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan.|Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Chiung-Ling
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Shu-Zon
authors.initials: SZ
authors.lastname: Lou
authors.affiliation: Department of Psychiatry, Cen-Der Hospital, Taichung, Taiwan.
authors.forename: Wei-Tsan
authors.initials: WT
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Jui-Yen
authors.initials: JY
authors.lastname: Wu
authors.affiliation: Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Hui-Ing
authors.initials: HI
authors.lastname: Ma
authors.affiliation: Department of Psychiatry, Chiayi Chang Gung Memorial Hospital & Chang Gung University, Chiayi, Taiwan.|School of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Vincent Chin-Hung
authors.initials: VC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D010465:Perception; D004856:Postural Balance; D011187:Posture; D012559:Schizophrenia / Q000150:complications / Q000503:physiopathology*; D012678:Sensation Disorders; D014785:Vision, Ocular