Brandt T, Wenzel D, Dichgans J
Arch Psychiatr Nervenkr (1970). 1976 Dec 31;223(1):1-13. doi: 10.1007/BF00367449.
The development of the visual contribution to postural stabilization has been tested using a large visual display rotating around the stationary subject's line of sight. This, in the adult, causes a marked optokinetic postural reaction with a shift of the body center of gravity toward the direction of pattern motion. Scalings of the reactions in children between 6 months and 16 years revealed three phases of development: (1) 6--12-month-old-babies show none or very little optokinetic disturbance of their newly acquired ability to sit. With the development of upright stance and gait, optokinetic influences become increasingly important. (2) Children between the age of 2--5 show a marked dependence of postural stability on vision. In them, the disturbing optokinetic stimulus leads to a marked ipsilateral postural deviation or irresistible fall. (3) From 5 to 15 years of age, visual effects on postural balance slowly decrease to their final strength in adulthood--moderate head and body tilt--in response to the rotating stimulus. It is concluded that the optokinetic loop participates rather late in the multisensory process of postural stabilization. The calibration of the three main loops, visual, vestibular, and proprioceptive, seems to be sequential and mutually interactive. Optimal functioning requires the continuous evaluation of the reafferent sensory consequences of self-generated body movements. Optokinetic destabilization of stance requires the maturity of opto-vestibulo-spinal pathways. Its clinical applicability as a maturity test, however, sofar seems limited.
通过使用围绕静止受试者视线旋转的大型视觉显示器,对视觉在姿势稳定中的作用发展进行了测试。在成年人中,这会引发明显的视动姿势反应,身体重心会朝着图案运动的方向移动。对6个月至16岁儿童的反应进行测量,揭示了三个发展阶段:(1)6至12个月大的婴儿在其新获得的坐立能力方面,视动干扰很少或几乎没有。随着直立姿势和步态的发展,视动影响变得越来越重要。(2)2至5岁的儿童,姿势稳定性明显依赖于视觉。对他们而言,干扰性的视动刺激会导致明显的同侧姿势偏差或不可抗拒的跌倒。(3)5至15岁,视觉对姿势平衡的影响会慢慢降低,直至成年时达到最终强度——对旋转刺激的反应是头部和身体适度倾斜。研究得出的结论是,视动环路在姿势稳定的多感官过程中参与得较晚。视觉、前庭和本体感觉这三个主要环路的校准似乎是循序渐进且相互作用的。最佳功能需要持续评估自身产生的身体运动的再传入感觉结果。姿势的视动不稳定需要视-前庭-脊髓通路的成熟。然而,到目前为止,其作为成熟度测试的临床适用性似乎有限。