Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Sci Rep. 2023 Sep 27;13(1):16213. doi: 10.1038/s41598-023-42441-2.
Head kinematics are altered in individuals with vestibular schwannoma (VS) during short duration gait tasks [i.e., Functional Gait Assessment (FGA)], both before and after surgery, yet whether these differences extend to longer duration gait exercises is currently unknown. Here we examined the effects of vestibular loss and subsequent compensation on head kinematics in individuals with VS during gait exercises of relatively extended versus short duration (< 10 versus 30 s), compared to age-matched controls. Six-dimensional head movements were recorded during extended and short duration gait exercises before and then 6 weeks after sectioning of the involved vestibular nerve (vestibular neurectomy). Standard functional, physiological, and subjective clinical assessments were also performed at each time point. Kinematics were differentially altered in individuals with vestibular loss at both time points during extended versus short duration exercises. Range of motion was significantly reduced in extended tasks. In contrast, movement variability predominately differed for the short duration exercises. Overall, our results indicate that quantifying head kinematics during longer duration gait tasks can provide novel information about how VS individuals compensate for vestibular loss, and suggest that measurements of range of motion versus variability can provide information regarding the different strategies deployed to maintain functional locomotion.
头部运动学在前庭神经鞘瘤（VS）患者的短时间步态任务（即功能性步态评估（FGA））中发生改变，包括手术前后，但这些差异是否会延伸到更长时间的步态练习目前尚不清楚。在这里，我们研究了前庭丧失及其后续代偿对 VS 患者在相对延长和短时间（<10 秒与 30 秒）步态练习中的头部运动学的影响，并与年龄匹配的对照组进行了比较。在切断受累前庭神经（前庭神经切断术）前后，记录了 6 名患者在延长和短时间步态练习期间的 6 维头部运动。在每个时间点还进行了标准的功能、生理和主观临床评估。在延长和短时间练习期间，前庭丧失的个体在两个时间点的运动学均有差异。在延长的任务中，运动范围明显减小。相比之下，运动变异性主要在短时间练习中不同。总体而言，我们的结果表明，在更长时间的步态任务中量化头部运动学可以提供有关 VS 患者如何代偿前庭丧失的新信息，并表明运动范围与变异性的测量可以提供有关维持功能运动所采用的不同策略的信息。
