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Hyperventilation effect on postural sway

V Sakellari1, A M Bronstein

  • 1MRC Human Movement and Balance Unit, National Hospital of Neurology and Neurosurgery, London, UK.

Archives of Physical Medicine and Rehabilitation
|July 1, 1997
PubMed
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Voluntary hyperventilation (HV) increases body sway, particularly with eyes closed, and this effect is not solely due to changes in CO2 levels or vestibular function. This objective unsteadiness may contribute to dizziness in patients experiencing HV syndrome.

Area of Science:

  • Human movement and balance
  • Neuroscience
  • Respiratory physiology

Background:

  • Voluntary hyperventilation (HV) is known to induce physiological changes, including alterations in blood gases.
  • The impact of HV on postural control and balance is not fully understood, particularly in individuals with and without vestibular function.

Purpose of the Study:

  • To investigate the acute effects of voluntary hyperventilation (HV) on postural sway in healthy individuals and patients with absent vestibular function.
  • To explore the relationship between CO2 levels, duration of HV, and the degree of postural instability.

Main Methods:

  • A crossover controlled experimental study was conducted in a human movement and balance clinical research unit.
  • Participants included healthy subjects and patients with bilateral absence of vestibular function.

Related Experiment Videos

  • Postural sway was measured using a force platform under various conditions (eyes open/closed, different surfaces, head/body movements) immediately following maximal voluntary HV (30-90 seconds). Transcutaneous partial carbon dioxide pressure (tc-PCO2) was also monitored.

    • Main Results:

    • Voluntary hyperventilation significantly increased body sway across all tested conditions, with greater effects observed when subjects stood on the platform with eyes closed.
    • While CO2 levels decreased with longer HV durations, body sway did not proportionally increase further, indicating a non-linear relationship.
    • HV-induced increases in sway were also noted after active movements and were more pronounced in sway area and deviations than in sway velocity, with a preference for low-frequency oscillations. These effects persisted in subjects lacking vestibular function.

    Conclusions:

    • Voluntary hyperventilation demonstrably increases postural sway, suggesting an objective component to the unsteadiness experienced by individuals with HV syndrome.
    • The relationship between reduced CO2 levels and the magnitude of sway increase is not linear.
    • The presence of HV-induced unsteadiness in individuals without vestibular input indicates that the vestibular system is not the primary mediator of these effects.