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Sant'Ambrogio di Torino, Italy

Agostini V.,Polytechnic University of Turin | Chiaramello E.,Polytechnic University of Turin | Bredariol C.,Clinica C. Sperino | Cavallini C.,Clinica C. Sperino | Knaflitz M.,Polytechnic University of Turin
Gait and Posture | Year: 2011

Postural instability is a common and devastating consequence of traumatic brain injury (TBI). The majority of TBI patients also suffer from neuro-ophthalmic deficits that can be an important contributing element to their sensation of vertigo and dizziness. Static posturography aims at the objective evaluation of patient balance impairment, but is usually affected by large inter- and intra-subject variability. Here we propose a protocol based on 10 randomized trials stimulating in different ways the visual and vestibular systems. Due to its completeness, our protocol highlights the specific residual difficulties of each patient in the various conditions. In this way, it was possible to evidence significant balance abnormalities in TBI patients with respect to controls. Moreover, by means of a multivariate analysis we were able to discriminate different levels of residual neuro-ophthalmic impairment. © 2011 Elsevier B.V.

Agostini V.,Polytechnic University of Turin | Sbrollini A.,Polytechnic University of Turin | Cavallini C.,Clinica C. Sperino | Busso A.,Clinica C. Sperino | And 2 more authors.
Gait and Posture | Year: 2016

The role of central and peripheral vision in the maintenance of upright stance is debated in literature. Stargardt disease causes visual deficits affecting the central field, but leaving unaltered a patient's peripheral vision. Hence, the study of this rare pathology gives the opportunity to selectively investigate the role of central vision in posture. Postural sway in quiet stance was analyzed in 10 Stargardt patients and 10 control subjects, in three different conditions: (1) eyes closed, (2) eyes open, gazing at a fixed target, and (3) eyes open, tracking a moving target. Stargardt patients outperformed controls in the condition with eyes closed, showing a reduced root mean square (RMS) of the medio-lateral COP displacement, while their performance was not significantly different from controls in the antero-posterior direction. There were no significant differences between patients and controls in open eyes conditions. These results suggest that Stargardt patients adapted to a different visual-somatosensory integration, relying less on vision, especially in the medio-lateral direction. Hence, the central vision seems to affect mostly the medio-lateral direction of postural sway. This finding supports the plausibility of the "functional sensitivity hypothesis", that assigns complementary roles to central and peripheral vision in the control of posture. © 2015 Elsevier B.V.

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