Visual-vestibular control of posture and gait: physiological mechanisms and disorders

The scientific analysis of clinical disorders of posture and gait is an emerging field. Precise definition of the forces and postural movements involved has been pivotal to understanding many aspects of the visual and vestibular contributions to balance. However, a great deal of argument still surrounds the question of how much gait and posture laboratories actually contribute to improve the clinical management of individual patients. One of the reasons why gait analysis techniques have not penetrated rehabilitation clinics may be that the research questions asked have been aimed at understanding mechanisms rather than at quantifying disability. The condition known as primary orthostatic tremor, which is not too well known to many neuro-otologists and posturographists, is briefly reviewed here. We propose that posturography could be the easiest way to diagnose this treatable condition.