YSGII-3

Higher gait and stance functions in patients with balance problems

Principle Investigator:

Roman Schniepp, MD

 

Objectives:

We are interested in the sensorimotor control principles of healthy subjects and patients with dizziness or vertigo that allow for the maintenance of postural stability during standing and walking. The final goal is to develop a quantitative and standardized diagnostic tool for the assessment of fall risk based neurophysiologic markers.

 

Project description(s):

 I.)  Stability principles of human posture

 

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What are the sensorimotor and biomechanical control mechanisms that allow for postural stability in humans during standing and during walking? We will examine the qualitative and quantitative changes of these mechanisms when peripheral and central sensory functions are disturbed. Finally, we will look at compensation strategies that are applied by patients in order to individually optimize postural stability during standing or walking.

 

II.)  Coping strategies during critical, “complex” balances situations

 

 

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Human mobility not only involves quiet standing and steady-state walking, but also continuous adaptive changes in order to cope with external, environmental situations. Typical “complex” situations are accelerations, decelerations, turns, walking stairs, and motor-cognitive dual tasks. During such situations, dynamic stability is frequently challenged and insufficient coping strategies result in imbalance and in the occurrence of falls. In this subproject we will investigate different coping strategies for critical balance tasks in healthy subjects and patients with sensorimotor disorders. These strategies will be evaluated with respect to their applicability for patients in order to avoid falls. Finally, we aim to implement these findings into the therapeutic regimens for patients.

 

III.)  Fall risk estimation for patients with vertigo and dizziness

Here, we combine findings of the subprojects I and II on order to develop a fall risk estimation procedure that can be used for the rating of an individual´s fall risk. External and internal risk factors for falls, as well as neurophysiological markers will be used in a multimodal, computational approach. Subsequent to a big validation study of the fall risk estimation procedure, we aim to implement the paradigm into the clinical routine.

 

Methods:

  • Virtual reality (MCM-N)
  • Computational modeling (MCM-M)
  • Cross sectional surveys (MCM-E)
  • (functional) magnetic resonance imaging (MCM-I)
  • Implementation into patients´ treatment and diagnosis (MCM-R)

 

Relevant publications:

Pradhan C, Wuehr M, Akrami F, Neuhaeusser M, Huth S, Brandt T, Jahn K, Schniepp R.
Automated classification of neurological disorders of gait using spatio-temporal gait parameters. J Electromyogr Kinesiol 2015, 25(2):413-22

Schniepp R, Wuehr M, Huth S, Pradhan C, Brandt T, Jahn K. Gait characteristics of patients with phobic postural vertigo: effects of fear of falling, attention, and visual input. J Neurol. 2014, 261(4):738-46

Schniepp R, Wuehr M, Schlick C, Huth S, Pradhan C, Dieterich M, Brandt T, Jahn K. Increased gait variability is associated with the history of falls in patients with cerebellar ataxia. J Neurol. 2014 Jan;261(1):213-23

Schniepp R, Wuehr M, Pradhan C, Novozhilov S, Krafczyk S, Brandt T, Jahn K. Nonlinear variability of body sway in patients with phobic postural vertigo. Front Neurol 2013, 4:115

Schniepp R, Wuehr M, Neuhaeusser M, Benecke AK, Adrion C, Brandt T, Strupp M, Jahn K. 4-aminopyridine and cerebellar gait: a retrospective case series. J Neurol. 2012, 259(11):2491-3.

Schniepp R, Wuehr M, Neuhaeusser M, Kamenova M, Dimitriadis K, Klopstock T, Strupp M, Brandt T, Jahn K. Locomotion speed determines gait variability in cerebellar ataxia and vestibular failure. Mov Disord. 2012, 27(1):125-31

Team:

schniepp wühr phradan
Roman Schniepp    

 Max Wühr     

Cauchy Pradhan
hesselbarth schlick

Kristin Hesselbarth

Cornelia Schlick