Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Longitudinal Studies Section, National Institute on Aging, Baltimore, Maryland, USA.
Ear Hear. 2019 Mar/Apr;40(2):340-344. doi: 10.1097/AUD.0000000000000619.
Standing on foam with eyes closed (FOEC) has been characterized as a measure of vestibular function; however, the relative contribution of vestibular function and proprioceptive function to the FOEC test has not been well described. In this study, the authors investigate the relationship between peripheral sensory systems (vestibular and proprioception) and performance on the FOEC test in a cohort of healthy adults.
A total of 563 community-dwelling healthy adults (mean age, 72.7 [SD, 12.6] years; range, 27 to 93 years) participating in the Baltimore Longitudinal Study of Aging were tested. Proprioceptive threshold (PROP) was evaluated with passive motion detection at the right ankle. Vestibulo-ocular reflex (VOR) gain was measured using video head impulses. Otolith function was measured with cervical and ocular vestibular-evoked myogenic potentials. Participants stood on FOEC for 40 sec while wearing BalanSens (BioSensics, LLC, Watertown, MA) to quantify center of mass sway area. A mixed-model multiple logistic regression was used to examine the odds of passing the FOEC test based on PROP, VOR, cervical vestibular-evoked myogenic potential, and ocular vestibular-evoked myogenic potential function in a multisensory model while controlling for age and gender.
The odds of passing the FOEC test decreased by 15% (p < 0.001) for each year of increasing age and by 8% with every 0.1 reduction in VOR gain (p = 0.025). Neither PROP nor otolith function was significantly associated with passing the FOEC test.
Failure to maintain balance during FOEC may serve as a proxy for rotational vestibular contributions to postural control. Semicircular canals are more sensitive to low-frequency motion than otoliths that may explain these relationships because standing sway is dominated by lower frequencies. Lower VOR gain and increased age independently decreased the odds of passing the test.
闭眼站在泡沫上（FOEC）已被认为是一项评估前庭功能的指标；然而，前庭功能和本体感觉功能对 FOEC 测试的相对贡献尚未得到很好的描述。在这项研究中，作者研究了健康成年人队列中周围感觉系统（前庭和本体感觉）与 FOEC 测试表现之间的关系。
共有 563 名居住在社区的健康成年人（平均年龄 72.7 [SD，12.6] 岁；范围 27 至 93 岁）参与了巴尔的摩老龄化纵向研究。通过右脚踝的被动运动检测评估本体感觉阈值（PROP）。使用视频头脉冲测量前庭眼反射（VOR）增益。通过颈和眼前庭诱发肌源性电位测量耳石功能。参与者在佩戴 BalanSens（BioSensics，LLC，沃特敦，MA）的情况下在 FOEC 上站立 40 秒，以量化质心摆动面积。使用混合模型多逻辑回归检查在多感觉模型中根据 PROP、VOR、颈前庭诱发肌源性电位和眼前庭诱发肌源性电位功能以及控制年龄和性别，通过 FOEC 测试的几率。
FOEC 测试通过的几率随着年龄的每增加 1 岁而降低 15%（p < 0.001），随着 VOR 增益每降低 0.1 而降低 8%（p = 0.025）。PROP 或耳石功能均与 FOEC 测试通过无显著相关性。
在 FOEC 期间无法保持平衡可能是姿势控制中旋转前庭贡献的替代指标。半规管对低频运动比耳石更敏感，这可能解释了这些关系，因为站立摆动主要由较低的频率主导。较低的 VOR 增益和年龄的增加独立降低了通过测试的几率。
