Walking balance recovery in people with unilateral vestibular hypofunction

Background People with vestibular hypofunction (PwVH) often demonstrate abnormal gait and increased fall risk. An analysis of the strategies used for maintaining walking balance is lacking in PwVH. Objective The purpose of this study was to examine how PwVH use recovery strategies and maintain stability following perturbations. Methods PwVH and healthy controls were perturbed during walking with mediolateral ground shifts while kinematic responses were recorded. Results As a group, PwVH ( n = 9, unilateral loss) responded similarly to healthy participants ( n = 15) with changes in foot placement, ankle inversion, ankle push-off, and trunk sway. However, responses in PwVH depended on the vestibular lesion side and functional compensation as assessed by the Functional Gait Assessment (FGA). PwVH had larger changes in stability when perturbations caused body movement toward the side of the lesion and more effective trunk responses when perturbations caused body movement away from the lesion. Additionally, PwVH who performed poorly on the FGA showed worse stability and overactive ankle and trunk responses following medial perturbations. Conclusions These findings demonstrate kinematic differences in balance recovery in PwVH and suggest that PwVH are more susceptible to instability when falling toward the lesion.