Comparison of Computerized Sway Referencing and Standing on a Compliant Surface

Background: By removing vision and altering somatosensory inputs, we can examine the contributions of the vestibular system on balance control. Computerized Dynamic Posturography (CDP) systems accomplish this by using a dynamic plate that moves in proportion to the sway of the subject. A potential alternative to CDP is the use of a compliant foam surface. The goal of this study was to compare postural sway during each condition. Methods: Thirty-two healthy subjects (16 male and 16 female) were tested on a Equitest computerized posturography system and on a 5 inch thick block of foam (NeuroCom International; Clackamas, OR). Subjects performed three trials with their head erect and five trials with dynamic head tilts ( 20 at 0.33Hz) in the anterior-posterior (AP) plane. Subjects were instructed to stand quietly with their arms folded and eyes closed for each trial lasting 20 seconds. The sway in both AP and medial-lateral (ML) planes was calculated for each trial, as well as the total sway path length. Results: In general, AP sway tended to be greater on the Equitest than on foam and greater during the head movement trials than the head erect. The ML sway was consistently higher on foam and did not vary between head erect and moving conditions. Sway path length was consistently greater for head erect trials on foam and tended to be greater for head movement trials on the Equitest. The addition of head movements increases AP sway and the total path length. Conclusions: Based on the increase of sway in the ML direction, it is important to quantify sway in all directions when on a compliant foam surface.