STATIC AND DYNAMIC POSTURE CONTROL IN POSTLINGUAL COCHLEAR IMPLANTED PATIENTS: Effects of dual-tasking, visual and auditory inputs suppression

• Main Authors: BERNARD DEMANZE eLaurence, LEONARD eJacques, DUMITRESCU eMichel, MELLER eRenaud, MAGNAN eJacques, LACOUR eMichel
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2014-01-01
• Series: Frontiers in Integrative Neuroscience
• Subjects: posture control; dual-tasking; cochlear implanted patients; visual input; auditory input
• Online Access: http://journal.frontiersin.org/Journal/10.3389/fnint.2013.00111/full

Posture control is based on central integration of multisensory inputs, and on internal representation of body orientation in space. This multisensory feedback regulates posture control and continuously updates the internal model of body’s position which in turn forwards motor commands adapted to the environmental context and constraints. The peripheral localization of the vestibular system, close to the cochlea, makes vestibular damage possible following cochlear implant (CI) surgery. Impaired vestibular function in CI patients, if any, may have a strong impact on posture stability. The simple postural task of quiet standing is generally paired with cognitive activity in most day life conditions, leading therefore to competition for attentional resources in dual-tasking, and increased risk of fall particularly in patients with impaired vestibular function. <br/>This study was aimed at evaluating the effects of post-lingual cochlear implantation on posture control in adult deaf patients. Possible impairment of vestibular function was assessed by comparing the postural performance of patients to that of age-matched healthy subjects during a simple postural task performed in static and dynamic conditions, and during dual-tasking with a visual or auditory memory task. Postural tests were done in eyes open (EO) and eyes closed (EC) conditions, with the cochlear implant activated (ON) or not (OFF). Results showed that the CI patients significantly reduced limits of stability and increased postural instability in static conditions. In dynamic conditions, they spent considerably more energy to maintain equilibrium, and their head was stabilized neither in space nor on trunk while the controls showed a whole body rigidification strategy. Hearing (prosthesis on) as well as dual-tasking did not really improve the dynamic postural performance of the CI patients. We conclude that CI patients become strongly visual dependent mainly in challenging postural conditions.<br/>