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Published on: August 30, 2019
Does the postural variable affect the determination of balance compensation level in vestibular schwannoma patients?
Julien Frère1, Charles P Hoffmann1, Gérome C Gauchard1
1Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, F-54000 Nancy, France; University of Lorraine, Laboratory ``Development, Adaption and Disability'' (EA 3450), Faculty of Sports Sciences and Faculty of Medicine, 9 avenue de la Forêt de Haye, CS 50184, F-54505 Vandœuvre-lès-Nancy, France.
Abstract:
Previous sensory organization test (SOT) outcomes provided evidences that the vestibular schwannoma (VS) removal led to acute and slow changes in the ability to use vestibular cues for balance control. However, the assumptions behind the equilibrium score (ES) are somewhat controversial within the literature. Therefore, we compared the time-course of balance control in eighteen VS patients across different postural variables. Analyses of variance and unsupervised clustering (k-means) were used to compare the whole dataset of four postural variables: ES, a modified ES which factored in the time before a fall (cES), the mean amplitude (MA) and the mean velocity (MV) of center of pressure displacements. Early after surgery, postural performances significantly decreased (p < 0.01), especially when vestibular cues are predominant, with lower ES (12.5 ± 22.8%) and cES (26.6 ± 16.7%) and higher MA (27.7 ± 7.1 mm) and MV (95.2 ± 53.2 mm.s-1) than before or three months after surgery. For each postural variable, the k-means clustering divided the whole dataset into two clusters: cluster #1 corresponded to a SOT with low sway amplitude and cluster #2 with high sway amplitude and falls. Overall, whatever the selected postural variable, the main recovery profile of VS patients was highlighted, thus surpassing the ambiguities inherent of the ES calculation.
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