Relationship of visual dependence to age, balance, attention, and vertigo

Lee, Shu-Chun

doi:10.1589/jpts.29.1318

Cited by 15 publications

(14 citation statements)

References 29 publications

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“…This suggests a greater impact of the visual surround manipulations on older adult perception of vertical and indicates differences in weighing sensory information. Such findings are in accordance with those found in the elderly and confirm the age-dependent increase in visual dependence reported in the literature [ 24 , 32 , 35 , 65 – 67 ].…”

Section: Discussionsupporting

confidence: 93%

“…According to Bayesian theory, multisensory integration occurs in a weighted fashion based on the reliability of the component sensory signals [ 29 – 31 ], and the outcome of this integration process is a single percept. Normally, in a situation of sensory conflict, the central nervous system first identifies the discrepancy and reduces the weighting of inaccurate or noisy input while increasing the weight of input from the sensory systems deemed to provide more reliable (less noisy) information [ 32 , 33 ]. In bilateral vestibulopathy, patients reweight the remaining extravestibular sensory information relying more on visual and other nonvestibular inputs compared with healthy controls in the perception of spatial orientation [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

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Young and Older Adults Differ in Integration of Sensory Cues for Vertical Perception

Razzak

Bagust

Docherty

2020

Journal of Aging Research

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Introduction. The subjective visual vertical (SVV) measures the perception of a person’s spatial orientation relative to gravity. Weighted central integration of vestibular, visual, and proprioceptive inputs is essential for SVV perception. Without any visual references and minimal proprioceptive contribution, the static SVV reflects balance of the otolith organs. Normal aging is associated with bilateral and progressive decline in otolith organ function, but age-dependent effects on SVV are inconclusive. Studies on sensory reweighting for visual vertical and multisensory integration strategies reveal age-dependent differences, but most studies have included elderly participants in comparison to younger adults. The aim of this study was to compare young adults with older adults, an age group younger than the elderly. Methods. Thirty-three young and 28 older adults (50–65 years old) adjusted a tilted line accurately to their perceived vertical. The rod’s final position from true vertical was recorded as tilt error in degrees. For otolithic balance, visual vertical was recorded in the dark without any visual references. The rod and frame task (RFT) with tilted disorienting visual frames was used for creating visuovestibular conflict. We adopted Nyborg’s analysis method to derive the rod and frame effect (RFE) and trial-to-trial variability measures. Rod alignment times were also analyzed. Results. There was no age difference in signed tilts of SVV without visual reference. There was an age effect on RFE and on overall trial-to-trial variability of rod tilt, with older adults displaying larger frame effects and greater variability in rod tilts. Alignment times were longer in the tilted-frame conditions for both groups and in the older adults compared to their younger counterparts. The association between tilt accuracy and tilt precision was significant for older adults only during visuovestibular conflict, revealing an increase in RFE with an increase in tilt variability. Correlation of σSVV, which represents vestibular input precision, with RFE yielded exactly the same contribution of σSVV to the variance in RFE for both age groups. Conclusions. Older adults have balanced otolithic input in an upright position. Increased reliance on visual cues may begin at ages younger than what is considered elderly. Increased alignment times for older adults may create a broader time window for integration of relevant and irrelevant sensory information, thus enhancing their multisensory integration. In parallel with the elderly, older adults may differ from young adults in their integration of sensory cues for visual vertical perception.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Young and Older Adults Differ in Integration of Sensory Cues for Vertical Perception

Razzak

Bagust

Docherty

2020

Journal of Aging Research

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“…However, the conditions in which the participant stands on a floor with eyes open or eyes closed can be used to ensure individuals’ safety. Fear of falling 36 and visual dependence 37 in elderly people can generally increase the risk of an individual losing his or her balance. This characteristic was also observed in the present study, where the elderly fallers had higher FES scores than the nonfallers did.…”

Section: Discussionmentioning

confidence: 99%

The effect of the type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) on the accuracy in identifying older adults with fall history

Boonsinsukh

Khumnonchai

Saengsirisuwan

et al. 2020

Hong Kong Physiother. J.

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Background:The type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) influences the accuracy with which elderly fallers are identified. Two types of foam are commonly used in practice: Airex and Neurocom foam. Objective:The aim of this study was to assess the accuracy with which elderly fallers can be identified when the Airex foam and Neurocom foam are used in the mCTSIB. Methods:One hundred eighty-four elderly participants with a mean age of 69 years were classified into faller and nonfaller groups based on their 12-month fall history. Balance stability was measured under four conditions of the mCTSIB for 120 s each: standing on a floor or a foam pad with their eyes open or eyes closed. The time needed to maintain stability was measured by a stopwatch, and postural sway characteristics were measured using an acceleration-based system. Comparisons between groups were performed by two-way mixed ANOVA. The accuracy of differentiating elderly fallers from nonfallers with different foam types was evaluated using receiver operating characteristic curve (ROC) analysis. The time to maintain stability under four conditions of the mCTSIB (composite score) and under two conditions on the foam (foam score) were used for the ROC analysis. Results:The results showed that the nonfallers required more time to maintain stability and had a smaller sway area than the fallers ([Formula: see text]). The foam led to a larger difference between groups, suggesting the use of foam in examining the risk of falls. The Airex and the Neurocom foam pads led to a large area under the curve (0.93 to 0.95) in identifying elderly fallers and nonfallers when the composite and foam scores were used. A cutoff score of 447/480 s for the composite score and 223/240 s for the foam score yielded a posttest accuracy of 88% to 89%, with a sensitivity of 0.80–0.92 and specificity of 0.88–0.95. Conclusion:In conclusion, Airex and Neurocom foam can be used interchangeably with guidance in the mCTSIB, as they led to the accurate identification of elderly fallers among older persons who could walk and live independently in the community.

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“…The relation between subjective visual vertical (SVV) that is assumed to represent visual field dependency (17)(18)(19) and postural stability in the healthy population is well established (15,(30)(31)(32). Yet, the locomotive responses, which are behaviorally expressed by changes in gait speed is not fully understood.…”

Section: Inter Participant Variabilitymentioning

confidence: 99%

Gait Speed Modulations Are Proportional to Grades of Virtual Visual Slopes—A Virtual Reality Study

et al. 2021

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Gait is a complex mechanism relying on integration of several sensory inputs such as vestibular, proprioceptive, and visual cues to maintain stability while walking. Often humans adapt their gait to changes in surface inclinations, and this is typically achieved by modulating walking speed according to the inclination in order to counteract the gravitational forces, either uphill (exertion effect) or downhill (braking effect). The contribution of vision to these speed modulations is not fully understood. Here we assessed gait speed effects by parametrically manipulating the discrepancy between virtual visual inclination and the actual surface inclination (aka visual incongruence). Fifteen healthy participants walked in a large-scale virtual reality (VR) system on a self-paced treadmill synchronized with projected visual scenes. During walking they were randomly exposed to varying degrees of physical-visual incongruence inclinations (e.g., treadmill leveled & visual scene uphill) in a wide range of inclinations (−15° to +15°). We observed an approximately linear relation between the relative change in gait speed and the anticipated gravitational forces associated with the virtual inclinations. Mean relative gait speed increase of ~7%, ~11%, and ~17% were measured for virtual inclinations of +5°, +10°, and +15°, respectively (anticipated decelerating forces were proportional to sin[5°], sin[10°], sin[15°]). The same pattern was seen for downhill virtual inclinations with relative gait speed modulations of ~-10%, ~-16%, and ~-24% for inclinations of −5°, −10°, and −15°, respectively (in anticipation of accelerating forces). Furthermore, we observed that the magnitude of speed modulation following virtual inclination at ±10° was associated with subjective visual verticality misperception. In conclusion, visual cues modulate gait speed when surface inclinations change proportional to the anticipated effect of the gravitational force associated the inclinations. Our results emphasize the contribution of vision to locomotion in a dynamic environment and may enhance personalized rehabilitation strategies for gait speed modulations in neurological patients with gait impairments.

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Relationship of visual dependence to age, balance, attention, and vertigo

Cited by 15 publications

References 29 publications

Young and Older Adults Differ in Integration of Sensory Cues for Vertical Perception

Young and Older Adults Differ in Integration of Sensory Cues for Vertical Perception

The effect of the type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) on the accuracy in identifying older adults with fall history

Gait Speed Modulations Are Proportional to Grades of Virtual Visual Slopes—A Virtual Reality Study

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