PNF and Movement

Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
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A Study of the Differences in Subjective Visual Vertical Between the Elderly and Young Adults and Balance, Dizziness, and Gait Changes

노인과 젊은 성인의 주관적 시수직의 차이와 그에 따른 균형, 어지럼증 및 보행 변화 연구

  • Kwon, Jung-Won (Department of Physical Therapy, College of Health and Welfare, Dankook University) ;
  • Yeo, Sang-Seok (Department of Physical Therapy, College of Health and Welfare, Dankook University)
  • 권중원 (단국대학교 보건복지대학 물리치료학과) ;
  • 여상석 (단국대학교 보건복지대학 물리치료학과)
  • Received : 2020.08.11
  • Accepted : 2020.08.31
  • Published : 2020.12.31
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Abstract

Purpose: Balance and gait dysfunction caused by aging affect elderly individuals' independent life, which, in turn, can reduce their overall quality of life. The purpose of this study is to compare the differences in the vestibular function of healthy elderly and young adults based on the subjective visual vertical (SVV) test as well as to compare and analyze the gait ability between these two groups to study the differences and association between vestibular, dizziness, and balance ability. Methods: The subjects were 18 young and 16 elderly adults with no neurological or musculoskeletal damage. To evaluate vestibular function, a subjective visual vertical test was performed. To evaluate the gait function, the step time, step length, stride length, stance phase ratio, and swing phase ratio were measured. Balance was evaluated using the Berg Balance Scale (BBS), and dizziness was evaluated using a dizziness handicap inventory (DHI). Results: There were significant differences in the SVV, BBS, and DHI between the young and elderly adults (p < 0.05). The gait variables of the older adults were all significantly different (except for the swing phase ratio) than those of the young adults (p < 0.05). As the result of correlation analysis, the SVV values of the young adults showed a significant negative correlation with step length and stride length (p < 0.05), while the SVV values of the elderly adults only showed a significant positive correlation with the DHI (p < 0.05). Conclusion: The elderly appeared to show a decrease in vestibular function when compared to the young adults, and it is thought that walking and balance function declined, while dizziness increased. Moreover, it is believed that these results can be used as basic data for vestibular rehabilitation in the future.

Keywords

References

  1. Agrawal Y, Zuniga MG, Davalos-Bichara M, et al. Decline in semicircular canal and otolith function with age. Otology & neurotology. 2012;33(5):832-839. https://doi.org/10.1097/mao.0b013e3182545061
  2. Agrawal Y, Smith PF, Rosenberg PB. Vestibular impairment, cognitive decline and Alzheimer's disease: balancing the evidence. Aging & Mental Health. 2019;24(5):705-708. https://doi.org/10.1080/13607863.2019.1566813
  3. Agrawal Y, Merfeld DM, Horak FB. Aging, vestibular function, and balance: proceedings of a national institute on aging/national institute on deafness and other communication disorders workshop. The Journals of Gerontology Series A Biological Sciences and Medical Sciences. 2020;75(12):2471-2480. https://doi.org/10.1093/gerona/glaa097
  4. Alexander NB. Postural control in older adults. Journal of American Geriatrics Society. 1994;42(1):93-108. https://doi.org/10.1111/j.1532-5415.1994.tb06081.x
  5. Allen D, Ribeiro L, Arshad Q, et al. Age-related vestibular loss: current understanding and future research directions. Frontiers in neurology. 2017;7(1):231.
  6. Batuecas-Caletrio A, Santacruz-Ruiz S, Munoz-Herrera A, et al. Vestibular compensation after vestibular schwannoma surgery: normalization of the subjective visual vertical and disability. Acta Oto Laryngologica. 2013;133(5):475-480. https://doi.org/10.3109/00016489.2012.757798
  7. Beck DL, Petrak MR. Subjective visual vertical (SVV) and the dizzy patient. Hearing Review. 2017;24(11):30-32.
  8. Benvenuti F, Ferrucci L, Guralnik JM, et al. Foot pain and disability in older persons: an epidemiologic survey. Journal of the American Geriatrics Society. 1995;43(5):479-484. https://doi.org/10.1111/j.1532-5415.1995.tb06092.x
  9. Bogle Thorbahn LD, Newton RA. Use of the berg balance test to predict falls in elderly persons. Physical Therapy. 1996;76(6):576-583. https://doi.org/10.1093/ptj/76.6.576
  10. Borel L, Harlay F, Lopez C, et al. Walking performance of vestibular-defective patients before and after unilateral vestibular neurotomy. Behavioural Brain Research. 2004;150(1-2):191-200. https://doi.org/10.1016/S0166-4328(03)00257-2
  11. Chen G, Patten C, Kothari DH, et al. Gait differences between individuals with post-stroke hemiparesis and non-disabled controls at matched speeds. Gait & posture. 2005;22(1):51-56. https://doi.org/10.1016/j.gaitpost.2004.06.009
  12. Duckrow R, Abu-Hasaballah K, Whipple R, et al. Stance perturbation-evoked potentials in old people with poor gait and balance. Clinical Neurophysiology. 1999;110(12):2026-2032. https://doi.org/10.1016/S1388-2457(99)00195-9
  13. El Haber N, Erbas B, Hill KD, et al. Relationship between age and measures of balance, strength and gait: Linear and non-linear analyses. Clinical Science. 2008a;114(12):719-727. https://doi.org/10.1042/CS20070301
  14. Fitzpatrick R, McCloskey D. Proprioceptive, visual and vestibular thresholds for the perception of sway during standing in humans. The Journal of Physiology. 1994;478(1):173-186. https://doi.org/10.1113/jphysiol.1994.sp020240
  15. Francis CA, Franz JR, O'Connor SM, et al. Gait variability in healthy old adults is more affected by a visual perturbation than by a cognitive or narrow step placement demand. Gait & posture. 2015;42(3):380-385. https://doi.org/10.1016/j.gaitpost.2015.07.006
  16. Gandor F, Basta D, Gruber D, et al. Subjective visual vertical in pd patients with lateral trunk flexion. Parkinson's Disease. 2016;2016:1-4. https://doi.org/10.1155/2016/7489105
  17. Gill J, Allum JH, Carpenter MG, et al. Trunk sway measures of postural stability during clinical balance tests: effects of age. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001;56(7):M438-447. https://doi.org/10.1093/gerona/56.7.M438
  18. Gittings NS, Fozard JL. Age related changes in visual acuity. Experimental gerontology. 1986;21(4-5):423-433. https://doi.org/10.1016/0531-5565(86)90047-1
  19. Gaerlan MG, Alpert PT, Cross C, et al. Postural balance in young adults: the role of visual, vestibular and somatosensory systems. Journal of the American Academy of Nurse Practitioners. 2012;24(6):375-381. https://doi.org/10.1111/j.1745-7599.2012.00699.x
  20. Hall CD, Heusel-Gillig L, Tusa RJ, et al. Efficacy of gaze stability exercises in older adults with dizziness. Journal of Neurologic Physical Therapy. 2010;34(2):64-69. https://doi.org/10.1097/NPT.0b013e3181dde6d8
  21. Han G, Lee E, Lee J, et al. The study of standardization for a Korean adaptation of self-report measures of dizziness. Journal of the Korean Balance Society. 2004;3(2):307-325.
  22. Herdman SJ, Hall CD, Schubert MC, et al. Recovery of dynamic visual acuity in bilateral vestibular hypofunction. Archives of Otolaryngology-Head & Neck Surgery. 2007;133(4):383-389. https://doi.org/10.1001/archotol.133.4.383
  23. Iwasaki S, Yamasoba T. Dizziness and imbalance in the elderly: age-related decline in the vestibular system. Aging and disease. 2015;6(1):38. https://doi.org/10.14336/AD.2014.0128
  24. Jahn K, Kressig RW, Bridenbaugh SA, et al. Dizziness and unstable gait in old age: etiology, diagnosis and treatment. Deutsches Arzteblatt International. 2015;112(23):387-393.
  25. Kantner RM, Rubin AM, Armstrong CW, et al. Stabilometry in balance assessment of dizzy and normal subjects. American Journal of Otolaryngology. 1991;12(4):196-204. https://doi.org/10.1016/0196-0709(91)90120-5
  26. Keller K, Engelhardt M. Strength and muscle mass loss with aging process. Age and strength loss. Muscles Ligaments and Tendons Journal. 2013;3(4):346-350. https://doi.org/10.32098/mltj.04.2013.17
  27. Kerber KA, Baloh RW. The evaluation of a patient with dizziness. Neurology: clinical practice. 2011;1(1):24-33. https://doi.org/10.1212/CPJ.0b013e31823d07b6
  28. Kim JS. Dizziness in the elderly. Journal of the Korean Neurological Association. 2015;33(1):1-7. https://doi.org/10.17340/jkna.2015.1.1
  29. Kim JY, Hur DG, Jeon SY, et al. Assessment of subjective symptoms using dizziness handicap inventory in patients with vestibular neuritis. Research in Vestibular Science. 2009;8(1):27-31.
  30. King LA, Priest KC, Salarian A, et al. Comparing the mini-bestest with the berg balance scale to evaluate balance disorders in Parkinson's disease. Parkinson's Disease. 2012;2012:1-7.
  31. Lacour M, Bernard-Demanze L. Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: 10 recommendations for optimal functional recovery. Frontiers in neurology. 2015;5(1):285.
  32. Lee MM, Song CH, Lee KJ, et al. Concurrent validity and test-retest reliability of the optogait photoelectric cell system for the assessment of spatio-temporal parameters of the gait of young adults. Journal of physical therapy science. 2014;26(1):81-85. https://doi.org/10.1589/jpts.26.81
  33. Lundin-Olsson L, Nyberg L, Gustafson Y. "Stops walking when talking" as a predictor of falls in elderly people. Lancet. 1997;349(9052):617. https://doi.org/10.1016/S0140-6736(97)24009-2
  34. Maes L, Dhooge I, D'haenens W, et al. The effect of age on the sinusoidal harmonic acceleration test, pseudorandom rotation test, velocity step test, caloric test, and vestibular-evoked myogenic potential test. Ear Hear. 2010;31(1):84-94. https://doi.org/10.1097/AUD.0b013e3181b9640e
  35. Marchetti GF, Whitney SL, Blatt PJ, et al. Temporal and spatial characteristics of gait during performance of the dynamic gait index in people with and people without balance or vestibular disorders. Physical therapy. 2008;88(5):640-651. https://doi.org/10.2522/ptj.20070130
  36. Menz, HB, Lord SR. Gait instability in older people with hallux valgus. Foot & ankle international. 2005;26(6):483-489 https://doi.org/10.1177/107110070502600610
  37. Michelson PL, McCaslin DL, Jacobson GP, et al. Assessment of subjective visual vertical (svv) using the "bucket test" and the virtual svv system. American journal of audiology. 2018;27(3):249-259. https://doi.org/10.1044/2018_AJA-17-0019
  38. Nola G, Mostardini C, Salvi C, et al. Validity of italian adaptation of the dizziness handicap inventory (dhi) and evaluation of the quality of life in patients with acute dizziness. Acta Otorhinolaryngologica Italica. 2010;30(4):190.
  39. Öhlin J, Ahlgren A, Folkesson R, et al. The association between cognition and gait in a representative sample of very old people-the influence of dementia and walking aid use. BMC geriatrics. 2020;20(1): 34. https://doi.org/10.1186/s12877-020-1433-3
  40. Ostrosky KM, VanSwearingen JM, Burdett RG, et al. A comparison of gait characteristics in young and old subjects. Physical therapy. 1994;74(7):637-644. https://doi.org/10.1093/ptj/74.7.637
  41. Pereira CB, Kanashiro AK, Maia FM, et al. Correlation of impaired subjective visual vertical and postural instability in Parkinson's disease. Journal of the neurological sciences. 2014;346(1-2):60-65. https://doi.org/10.1016/j.jns.2014.07.057
  42. Pirker W, Katzenschlager R. Gait disorders in adults and the elderly: a clinical guide. Wien Klin Wochenschr. 2017;129(3-4):81-95. https://doi.org/10.1007/s00508-016-1096-4
  43. Rambold H. Clinical value of rotational-chair testing in vestibular disease. Clinical Otorhinolaryngology. 2017;1(1):013.
  44. Ricci NA, Aratani MC, Caovilla HH, et al. Effects of vestibular rehabilitation on balance control in older people with chronic dizziness: A randomized clinical trial. American journal of physical medicine & rehabilitation. 2016;95(4):256-269. https://doi.org/10.1097/PHM.0000000000000370
  45. Rosengren SM, Colebatch JG, Young AS, et al. Vestibular evoked myogenic potentials in practice: Methods, pitfalls and clinical applications, Clinical Neurophysiology Practice. 2019; 4(1):47-68. https://doi.org/10.1016/j.cnp.2019.01.005
  46. Schubert MC, Migliaccio AA. New advances regarding adaptation of the vestibulo-ocular reflex. J Neurophysiol. 2019;122(2):644-658. https://doi.org/10.1152/jn.00729.2018
  47. Shaffer SW, Harrison AL. Aging of the somatosensory system: a translational perspective. Physical therapy. 2007;87(2):193-207. https://doi.org/10.2522/ptj.20060083
  48. Smith PS, Hembree JA, Thompson ME. Berg balance scale and functional reach: determining the best clinical tool for individuals post acute stroke. Clinical rehabilitation. 2004;18(7):811-818. https://doi.org/10.1191/0269215504cr817oa
  49. Sturnieks DL, St George R, Lord SR. Balance disorders in the elderly. Neurophysiologie Clinique/Clinical Neurophysiology. 2008;38(6):467-478. https://doi.org/10.1016/j.neucli.2008.09.001
  50. Whitney S, Wrisley D, Furman J. Concurrent validity of the berg balance scale and the dynamic gait index in people with vestibular dysfunction. Physiotherapy Research International. 2003;8(4):178-186. https://doi.org/10.1002/pri.288
  51. Wiesmeier IK, Dalin D, Maurer C. Elderly use proprioception rather than visual and vestibular cues for postural motor control. Frontiers in Aging Neuroscience. 2015;7:97.
  52. Yang YA. The responding strategies of musculorskeletal disease in aging society. Journal of the Ergonomics Society of Korea. 2010;29(4):505-511. https://doi.org/10.5143/JESK.2010.29.4.505
  53. Zacharias A, Pizzari T, Semciw A, et al. Comparison of gluteus medius and minimus activity during gait in people with hip osteoarthritis and matched controls. Scandinavian journal of medicine & science in sports. 2019;29(5):696-705. https://doi.org/10.1111/sms.13379