Stance Postural Strategies in Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Area of Science:

• Neuroscience
• Biomechanics
• Clinical Neurology

Background:

• Polyneuropathy significantly impacts balance, leading to postural instability and increased fall risk.
• Impaired proprioception and motor control are key consequences of neuropathy affecting postural strategies.

Purpose of the Study:

• To investigate how sensory-motor deficits in neuropathy influence the selection and adaptation of postural strategies.
• To compare postural control mechanisms between healthy individuals and patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Main Methods:

• Platformless bisegmental posturography utilized head and hip electromagnetic trackers.
• Sway amplitude, velocity, and mean direction difference (MDD) were recorded in healthy subjects and CIDP patients.
• MDD served as a flexibility index to quantify postural strategy adaptation.

Main Results:

• CIDP patients exhibited greater head and hip postural sway compared to healthy controls.
• Increased MDD values in CIDP patients indicated a greater reliance on hip-based postural strategies.
• Healthy subjects adapted postural strategies in the eyes-closed condition, while CIDP patients did not.

Conclusions:

• Sensory-motor impairment in neuropathy alters the balance of postural control strategies.
• Motor impairment leads to an overreliance on hip strategies, particularly in visually open conditions.
• The ability to re-balance postural strategies is compromised in CIDP patients when proprioceptive input is critical (eyes closed).