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Journal of Neuroscience, Vol 2, 536-544, Copyright © 1982 by Society for Neuroscience
Adaptation to altered support and visual conditions during stance: patients with vestibular deficits
LM Nashner, FO Black and C Wall 3d
Patients whose deficits were limited to clinically well qualified
vestibular disorders have been exposed to a number of altered support
surface and visual environments while standing unsupported. A six-
degrees-of-freedom platform employing movable support surfaces for each
foot and a movable visual surround deprived patients of normal inputs
derived from a fixed level support surface and from an immobile surround.
Various tests employing EMG, force, and body movement recording identified
quantitative changes in the patients' strategy for the relative weighting
of proprioceptive, vestibular, and visual inputs. The most dramatic
performance deficit of patients was their inability to suppress the
influence of visual and proprioceptive inputs appropriately whenever
motions of external surface disturbed the orientation information provided
by these inputs. Thus, the more mildly afflicted patients experienced
instability not so much because of the loss of vestibular inputs directly
to posture but because of their inappropriate responses to proprioceptive
inputs and vision. Discussion is centered on the role of vestibular input
as an internal reference system for orientation about which adaptive
changes in proprioceptive and visual inputs are made.
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