Imperceptible noisy galvanic vestibular stimulation (nGVS) improves standing balance due to the presence of stochastic resonance (SR). There is, however, a lack of consensus regarding the optimal levels and type of noise used to elicit SR like dynamics. We aimed to confirm the presence of SR behavior in the vestibular system of young healthy adults by examining postural responses to increasing amplitudes of white and pink noise stimulation scaled to individual cutaneous perceptual threshold.
View Article and Find Full Text PDFDtsch Med Wochenschr
November 2024
Dizziness is one of the most common reasons for medical consultations. The interdisciplinary range of differential diagnoses often leads to difficulties in proper classification. Artificial Intelligence and machine learning can assist through data-driven algorithms and facilitate the collection of important clinical signs as digital biomarkers.
View Article and Find Full Text PDFMobile health technologies enable continuous, quantitative assessment of mobility and gait in real-world environments, facilitating early diagnoses of gait disorders, disease progression monitoring, and prediction of adverse events like falls. Traditionally, mobile gait assessment predominantly relied on body-fixed sensors positioned at the feet or lower trunk. Here, we investigate the potential of an algorithm utilizing an ear-worn motion sensor for spatiotemporal segmentation of gait patterns.
View Article and Find Full Text PDFAn earlier observational study described selected patients with acute neck pain syndrome, who experienced short bursts of cervical vertigo elicited by rapid head movements. The current study on a larger cohort of 20 patients with chronic or frequently recurring neck pain syndrome and age-matched controls focused on two major questions: (1) Can head movements in subjects with exacerbations of neck pain and restrictions of neck mobility also elicit bursts of vertigo? (2) What is the impact on postural balance measured by analysis of body sway and locomotion? A detailed questionnaire was applied, posture and gait were evaluated by use of instrumented posturography-and gait analysis with and without slow or rapid horizontal head rotations in the yaw plane with and without sight/visual input. All patients reported some or frequent episodes of dizziness in the range of seconds only elicited by rapid, not by slow head movements.
View Article and Find Full Text PDFBackground: Physical inactivity and subsequent muscle atrophy are highly prevalent in neurocritical care and are recognized as key mechanisms underlying intensive care unit acquired weakness (ICUAW). The lack of quantifiable biomarkers for inactivity complicates the assessment of its relative importance compared to other conditions under the syndromic diagnosis of ICUAW. We hypothesize that active movement, as opposed to passive movement without active patient participation, can serve as a valid proxy for activity and may help predict muscle atrophy.
View Article and Find Full Text PDFPostural instability is a common complication in advanced Parkinson's disease (PD) associated with recurrent falls and fall-related injuries. The test of retropulsion, consisting of a rapid balance perturbation by a pull in the backward direction, is regarded as the gold standard for evaluating postural instability in PD and is a key component of the neurological examination and clinical rating in PD (e.g.
View Article and Find Full Text PDFBackground: Gait impairment is a key feature in later stages of Parkinson's disease (PD), which often responds poorly to pharmacological therapies. Neuromodulatory treatment by low-intensity noisy galvanic vestibular stimulation (nGVS) has indicated positive effects on postural instability in PD, which may possibly be conveyed to improvement of dynamic gait dysfunction.
Objective: To investigate the effects of individually tuned nGVS on normal and cognitively challenged walking in PD patients with mild-to-moderate gait dysfunction.
Human activity recognition (HAR) technology enables continuous behavior monitoring, which is particularly valuable in healthcare. This study investigates the viability of using an ear-worn motion sensor for classifying daily activities, including lying, sitting/standing, walking, ascending stairs, descending stairs, and running. Fifty healthy participants (between 20 and 47 years old) engaged in these activities while under monitoring.
View Article and Find Full Text PDFBackground: The current diagnostic workup for chronic dizziness in elderly patients often neglects neuropsychological assessment, thus missing a relevant proportion of patients, who perceive dizziness as a subjective chief complaint of a concomitant cognitive impairment. This study aimed to establish risk prediction models for cognitive impairment in chronic dizzy patients based on data sources routinely collected in a dizziness center.
Methods: One hundred patients (age: 74.
Low-intensity noisy galvanic vestibular stimulation (nGVS) can improve static and dynamic postural deficits in patients with bilateral vestibular loss (BVL). In this study, we aimed to explore the neurophysiological and neuroanatomical substrates underlying nGVS treatment effects in a rat model of BVL. Regional brain activation patterns and behavioral responses to a repeated 30 min nGVS treatment in comparison to sham stimulation were investigated by serial whole-brain F-FDG-PET measurements and quantitative locomotor assessments before and at nine consecutive time points up to 60 days after the chemical bilateral labyrinthectomy (BL).
View Article and Find Full Text PDFBackground: Previous studies indicate that imbalance in patients with bilateral vestibulopathy (BVP) may be reduced by treatment with low-intensity noisy galvanic vestibular stimulation (nGVS).
Objective: To elucidate the potential mechanisms underlying this therapeutic effect. In particular, we determined whether nGVS-induced balance improvements in patients are compatible with stochastic resonance (SR)-a mechanism by which weak noise stimulation can paradoxically enhance sensory signal processing.
Objective: We aimed to relate clinical measures of disability in chronic cerebellar degeneration to structural whole-brain changes using voxel-based and surface-based morphometry (vbm and sbm). We were particularly interested in remote effects of cerebellar degeneration in the cerebral cortex.
Methods: We recruited 30 patients with cerebellar degeneration of different aetiologies (downbeat nystagmus syndrome, DBN n = 14, spinocerebellar ataxia, SCA n = 9, sporadic adult late-onset ataxia, SAOA n = 7).
Background: Vestibular rehabilitation therapy (VRT) is effective for most patients with dizziness and imbalance. Home exercise programs are widely used. It is unknown, however, how specific the instructions for exercises have to be.
View Article and Find Full Text PDFQuantitative assessment of motor function is increasingly applied in fall risk stratification, diagnosis, and disease monitoring of neuro-geriatric disorders of balance and gait. Its broad application, however, demands for low-cost and easy to use solutions that facilitate high-quality assessment outside laboratory settings. In this study, we validated in 30 healthy adults (12 female, age: 32.
View Article and Find Full Text PDFArch Orthop Trauma Surg
July 2023
Introduction: Orthoses are designed to achieve immobilization or off-loading of certain regions of the foot. Yet, their off-loading capacity for the specific regions has not yet been studied. Therefore, the aim of this study was to analyze the plantar pressure distribution of five commonly applied orthoses for foot and ankle in a healthy population.
View Article and Find Full Text PDFBackground: Patients with bilateral vestibulopathy (BVP) suffer from impaired vestibular motion perception that is linked to deficits in spatial memory and navigation.
Objective: To examine the potential therapeutic effect of imperceptible noisy galvanic vestibular stimulation (nGVS) on impaired vestibular perceptual performance in BVP.
Methods: In 11 patients with BVP (mean age: 54.
The aim of the study was to distinguish the hypokinetic gait disorder in idiopathic normal pressure hydrocephalus (NPH) patients from the gait decline in the elderly population by quantifying pathological gait parameter thresholds utilizing a multiple condition gait assessment. 55 NPH patients and 55 age-matched healthy subjects underwent a standardized gait assessment with eight gait conditions. Spatiotemporal gait parameters were assessed through a pressure-sensitive carpet.
View Article and Find Full Text PDFBackground: Quantitative gait assessment is increasingly applied in fall risk stratification, diagnosis, and disease monitoring of neuro-geriatric gait disorders. Its broad application, however, demands for low-cost and mobile solutions that facilitate high-quality assessment outside laboratory settings. The aim of this study was to present and evaluate the concurrent validity of a mobile and low-cost gait assessment tool (mVEGAS) that combines body-fixed inertial sensors and a smartphone-based video capture for spatiotemporal identification of gait sequences.
View Article and Find Full Text PDFBackground: Postural instability is a major disabling factor in patients with advanced Parkinson's disease (PD) and often resistant to treatment. Previous studies indicated that imbalance in PD may be reduced by low-intensity noisy galvanic vestibular stimulation (nGVS).
Objective: To investigate the potential mode of action of this therapeutic effect.
Objective: To study the behavioral relevance of postural and ocular-motor deficits on daily activity and risk of falling in patients with bilateral vestibular hypofunction (BVH).
Methods: Thirty patients with BVH and 30 age- and gender-matched healthy controls participated in a continuous 2-week assessment of daily activities and mobility using a body-worn inertial sensor and a 6-month prospective fall risk assessment. At inclusion, patients and controls further underwent a multi-modal clinical, score- and instrument-based assessment of general health and balance status.