Real sounds influence postural stability in people with vestibular loss but not in healthy controls.

Objective: What we hear may influence postural control, particularly in people with vestibular hypofunction. Would hearing a moving subway destabilize people similarly to seeing the train move? We investigated how people with unilateral vestibular hypofunction and healthy controls incorporated broadband and real-recorded sounds with visual load for balance in an immersive contextual scene.

Design: Participants stood on foam placed on a force-platform, wore the HTC Vive headset, and observed an immersive subway environment. Each 60-second condition repeated twice: static or dynamic visual with no sound or static white noise or real recorded subway station sounds [real] played from headphones.

Setting: Human motion laboratory.

Participants: 41 healthy controls (mean age 52 years, range 22-78) and 28 participants with unilateral peripheral vestibular hypofunction (mean age 61.5, 27-82).

Main Outcome Measures: We collected center-of-pressure (COP, anterior-posterior, medio-lateral) from the force-platform and head (anterior-posterior, medio-lateral, pitch, yaw, roll) from the headset and quantified root mean square velocity (cm/s or rad/s).

Results: Adjusting for age, the vestibular group showed significantly more sway than controls on: COP medio-lateral (no sound or real with static or dynamic visual); COP anterior-posterior (only on dynamic visuals in the presence of either sound); head medio-lateral and anterior-posterior (all conditions), head pitch and yaw (only on dynamic visuals in the presence of either sound). A significant increase in sway with sounds was observed for the vestibular group only on dynamic visuals COP anterior-posterior and head yaw (real) and head anterior-posterior and pitch (either sound).

Conclusions: The addition of auditory stimuli, particularly contextually-accurate sounds, to a challenging, standing balance task in real-life simulation increased sway in people with vestibular hypofunction but not in healthy controls.

Trial Registration: Clinical trial registrationThis study was registered on clinicaltrials.gov at the following link: https://clinicaltrials.gov/study/NCT04479761.