Recurrence quantification analysis of postural sway in patients with persistent postural perceptual dizziness.
Megan J Kobel, Andrew R Wagner, Daniel M Merfeld
PMID 37576917WHAT IT FOUND
Patients with persistent postural perceptual dizziness showed more predictable, rigid sway patterns than controls during quiet standing.
Traditional measures of sway amount and variability found no differences between the groups.
Key findings
01Patients with PPPD exhibited higher determinism and maximum line length in sway signals compared to healthy controls, indicating a more predictable and less flexible postural control strategy.
02Traditional linear measures of postural sway, such as path length and standard deviation, did not show significant differences between patients with PPPD and healthy controls.
03The difference in sway regularity between groups was most evident during easier balance tasks on firm surfaces, rather than during more challenging conditions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was very small (12 patients and 12 controls), which limits the generalizability of the findings. Three patients were actively undergoing vestibular rehabilitation at the time of testing, which may have influenced their balance performance. The study excluded patients with permanent peripheral vestibular loss, so results do not apply to PPPD patients with comorbid conditions like Meniere's disease. The groups had unequal sex distribution, with the PPPD group being predominantly female.
Declared interests
The research was supported by a Department of Defense Congressionally Directed Medical Research Programs award. The authors declared no other conflicts of interest.
The easy way to misread this
Do not assume that normal results on standard balance tests (like sway path length) mean a PPPD patient has normal postural control. This study shows that deficits in sway flexibility and predictability can exist even when traditional measures appear normal.