Head extension and age-dependent posturographic instability in normal subjects

Area of Science:

• Neurology
• Gerontology
• Vestibular Science

Background:

• Posturography assesses balance and is crucial for diagnosing neurological and vestibular disorders.
• Head extension is sometimes used to challenge balance systems, but its effect on normal elderly subjects is not well-defined.

Purpose of the Study:

• To investigate the impact of head extension on posturography results in normal subjects, particularly the elderly.
• To determine if head extension can help differentiate normal aging from abnormal neurological or vestibular patterns in older adults.

Main Methods:

• 144 healthy subjects (ages 22-85, majority >60) underwent sensory posturography using the NeuroCom Equitest protocol.
• Tests were performed twice: once with the head erect and once with the head extended 55 degrees.

Main Results:

• No falls occurred in subjects under 59 with heads erect.
• With heads erect, 35 of 101 older subjects (35%) fell.
• Head extension increased total falls from 79 to 171, with 52% of all subjects falling compared to 24% with heads erect. The increase was most pronounced in the elderly.

Conclusions:

• Head extension significantly increases falls in normal elderly subjects during posturography.
• This maneuver is not a reliable tool for identifying neurological or vestibular abnormalities in the elderly population.
• Head extension may be useful for uncovering compensated balance deficits in younger and middle-aged individuals.