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Biomedical subjects

A Emasithi

Publications and source records attributed to A Emasithi.

4 recordsLinked to original sources

Suppression of the vertical vestibulo-ocular reflex in older persons at risk of falling.

A case-control design was used to assess eye-head-trunk coordination for community-dwelling elders performing a stand-walk task. Eighteen elders with a high risk of falling were matched to 18 subjects with low risk on the basis of age, living status (living alone or with someone) and category of residence (independent living or assisted living facility). Standard electro-oculography was used in conjunction with an electromagnetic tracking device to measure eye and head-trunk motion, respectively. For the low-risk group, the mean slope of gaze-head and gaze-trunk relationships was significantly greater than zero (0.91 and 0.64, respectively), whereas high-risk elders did not demonstrate slope magnitudes significantly different from zero (0.52 and 0.16, respectively) due to large inter-subject variations. While the majority of subjects showed some counter-rotation of the eyes with head pitch, a greater percentage of subjects in the high-risk group did not suppress this response and consequently gaze and gaze velocity overcompensated for head pitch. These findings suggest that the vertical vestibulo-ocular reflex is not adequately suppressed during the stand-walk task in elders who are at a high risk of falling. Possible mechanisms contributing to these findings are discussed.

Accidental Falls↗

Evaluating eye-body coordination during unrestrained functional activity in older persons.

BACKGROUND: Traditional paradigms for the study of ocular-motor control restrain subject motion and have not adequately quantified the sensorimotor strategies used by older persons to control gaze while performing activities of daily living. The purpose of our study was to describe eye-head-trunk coordination during a functional activity in freely moving community-dwelling older persons. METHODS: Thirty-five community-dwelling older persons (age range 71-92 years) participated in this study. Surface electro-oculography was used with an electromagnetic tracking device to measure vertical eye movement and linear and angular head position while each subject performed a stand-from-chair task. RESULTS: Standing from a chair involved low-frequency head motion (median z = 0.25 Hz; median pitch = 0.32 Hz). The distribution of phase for eyes versus vertical body motion were skewed toward head-trunk leading, suggesting that eye motion follows vertical body motion. Vertical gaze, however, was in phase with and moved in the same direction as head pitch. CONCLUSIONS: Gaze (eye position in space) was an active, integrated component of the standing motion. The results imply that both the oculomotor system and the head motor system in older persons are coordinated to direct gaze and, when necessary, work to suppress the vestibuloocular reflex. The interaction of eye-head-trunk motion provides a basis for understanding how a breakdown in the gaze control mechanisms in older persons might contribute to the risk of falling and fall-related injuries.

Aged↗

Validity of visual stabilization conditions used with computerized dynamic platform posturography.

Temporal and spatial relationships between head motion and tilt of a visual surround were evaluated in conditions 3 and 6 of the sensory organization test (SOT) to determine the validity of visual stabilization during computerized dynamic platform posturography (CDP). Seven healthy subjects participated (mean age 42.4 years, SD = 19 years, range 25-72 years). Sagittal head translation and head pitch were evaluated separately with respect to displacement of the visual surround. Overall, the mean correlation between sagittal head motion and surround tilt was r = 0.68 for C3 and r = 0.93 for C6. The average phase (aggregate findings supported with trial-by-trial analysis), however, showed that sagittal head displacement leads motion of the visual surround ( + 452 ms for C3 and + 250 ms for C6). The mean correlation between head pitch and surround tilt was r = -0.30 for C3 and r = -0.72 for C6. Head pitch also leads visual surround motion (+567 ms for C3 and +539 ms for C6), but with greater variability than sagittal head translation. The results showed that visual stabilization was not consistently achieved during SOT conditions 3 and 6. The fundamental assumption that posture behaves as an inverted pendulum, with control of equilibrium originating in the lower extremities, does not appear to be applicable to the voluntary corrections of sway required during the SOT.

Adult↗

Aging and the mechanisms underlying head and postural control during voluntary motion.

The quality of sensory information that is necessary for balance and postural stability will depend to a great extent on head stability as the body moves. How older persons coordinate head and body motion for balance during volitional activities is not known. The purposes of this article are to present a basis for understanding the influence of aging on head control during voluntary motion and to discuss some data that demonstrate how elderly people might control head movement to improve gaze and the quality of vestibular inputs. A "top-down" or "head-first" control scheme is proposed as the mechanism that elderly people without disabilities use to maintain head position during self-initiated motion. This type of control ensures that the angular position of the head in space remains relatively constant--through the use of a head-stabilization-in-space (HSS) strategy--regardless of the magnitude or direction of displacements in the body's center of force. The HSS strategy is thought to reduce potential ambiguities in the interpretation of sensory inputs for balance and is derived primarily from a geocentric (orientation to the vertical) frame of reference. Egocentric (orientation of the head with respect to the body) or exocentric (orientation to objects in the environment) frames of reference, however, refine the control of head stabilization. Preliminary research suggests that elderly people use the HSS strategy to control head pitch during difficult balance tasks. These findings, if supported by more definitive studies, may be useful in the treatment of patients with balance disorders. The treatment of patients with balance dysfunction is discussed within the conceptual framework of a "head-first" organization scheme.

Adult↗