An initial evaluation of work fatigue and circadian changes as assessed by multiplate posturography

The sensitivity of postural responses to the effects of work fatigue and circadian changes was explored in a pilot study using a specific method of multiplate posturography based on the differential assessment of vertical pressure on four separate platforms for each heel and set of toes of each foot, respectively 8 normal subjects, M.D.s, were given six posturographic examinations immediately before and after three 8-hr. work shifts in the emergency room of a major hospital in Tel-Aviv. 3 posturographic measures (stability, spectral power of postural sway at low frequency of 0.1-0.25 Hz, and unilateral weakening of heel-toe synchronisation) were significantly affected by work fatigue whilst also showing interaction with circadian rhythm. 2 additional measures (power of sway at high frequency of 1.00-3.00 Hz and dysharmonic distribution of weight over the four platforms) were not related to workload but showed significant circadian changes. These effects appeared only on positions involving restricted visual and somatosensory feedback causing vestibular stress. Results justify the application of multiplate posturography as an ancillary tool in measuring objectively the effects of fatigue and circadian changes as well as the interaction between endogenous chronobiological processes and their external conditioning factors (Zeitgebers). Pragmatic implications of the findings in the context of industrial medicine and interdisciplinary efforts to prevent road and air accidents are discussed.