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Auditory biofeedback substitutes for loss of sensory information in maintaining stance

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Abstract

The importance of sensory feedback for postural control in stance is evident from the balance improvements occurring when sensory information from the vestibular, somatosensory, and visual systems is available. However, the extent to which also audio-biofeedback (ABF) information can improve balance has not been determined. It is also unknown why additional artificial sensory feedback is more effective for some subjects than others and in some environmental contexts than others. The aim of this study was to determine the relative effectiveness of an ABF system to reduce postural sway in stance in healthy control subjects and in subjects with bilateral vestibular loss, under conditions of reduced vestibular, visual, and somatosensory inputs. This ABF system used a threshold region and non-linear scaling parameters customized for each individual, to provide subjects with pitch and volume coding of their body sway. ABF had the largest effect on reducing the body sway of the subjects with bilateral vestibular loss when the environment provided limited visual and somatosensory information; it had the smallest effect on reducing the sway of subjects with bilateral vestibular loss, when the environment provided full somatosensory information. The extent that all subjects substituted ABF information for their loss of sensory information was related to the extent that each subject was visually dependent or somatosensory-dependent for their postural control. Comparison of postural sway under a variety of sensory conditions suggests that patients with profound bilateral loss of vestibular function show larger than normal information redundancy among the remaining senses and ABF of trunk sway. The results support the hypothesis that the nervous system uses augmented sensory information differently depending both on the environment and on individual proclivities to rely on vestibular, somatosensory or visual information to control sway.

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Acknowledgments

We would like to thank Dr. Conrad Wall and Dr. Angelo Cappello for stimulating inspiration, Dr. Sandra Oster for English editing and education, Andrew Owings and Dr. Charles Russell for technical support, Triana Nagel-Nelson for recruitment of subjects, and all of our subjects for donating their time. We also thank Dr. Velio Macellari and Dr. Daniele Giansanti for having made available the portable measurement system. This study was supported by NIH grants DC01849, DC04082, and DC06201.

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Authors and Affiliations

  1. Neurological Sciences Institute, Oregon Health & Science University, 505 NW 185th Ave, Beaverton, OR, 97006, USA

    Marco Dozza & Fay B. Horak

  2. Department of Electronics, Computer Science, and Systems, University of Bologna, Bologna, Italy

    Marco Dozza & Lorenzo Chiari

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  1. Marco Dozza
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  2. Fay B. Horak
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  3. Lorenzo Chiari
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Correspondence to Fay B. Horak.

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Dozza, M., Horak, F.B. & Chiari, L. Auditory biofeedback substitutes for loss of sensory information in maintaining stance. Exp Brain Res 178, 37–48 (2007). https://doi.org/10.1007/s00221-006-0709-y

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