=Paper=
{{Paper
|id=Vol-1910/paper0210
|storemode=property
|title=Equilibrioception: A Method to Evaluate the Sense of Balance
|pdfUrl=https://ceur-ws.org/Vol-1910/paper0210.pdf
|volume=Vol-1910
|authors=Matteo Cardaioli,Marina Scattolin,Patrizia Bisiacchi
|dblpUrl=https://dblp.org/rec/conf/chitaly/CardaioliSB17
}}
==Equilibrioception: A Method to Evaluate the Sense of Balance==
https://ceur-ws.org/Vol-1910/paper0210.pdf
Equilibrioception: A Method To
Evaluate The Sense Of Balance
Matteo Cardaioli when perturbations occur. This ability to monitor and
GFT maintain balance can be considered as a physiological
Padova, Italy
sense, so, as for the other senses, it is fair to assume
matteo.cardaioli@gmail.com
that healthy people can perceive and evaluate
Marina Scattolin differences between balance states. The aim of this
Department of General Psycology study is to investigate how changes in stabilometric
Padova, Italy parametres are perceived by young, healthy adults.
marina.scattolin@gmail.com
Participants were asked to stand still on a Wii Balance
Patrizia Bisiacchi Board (WBB) with feet in a constrained position; 13
Department of General Psycology trials of 30 s each were performed by each subject, the
Padova, Italy order of Eyes Open (EO) and Eyes Closed (EC) trials
patrizia.bisiacchi@unipd.it
being semi-randomized. At the end of each trial (except
the first one), participants were asked to judge if their
performance was better or worse than the one in the
immediately preceding trial. SwayPath ratio data were
used to calculate the Just Noticeable Difference (JND)
between two consecutive trials, which was of 0.2 when
participants improved their performance from one trial
Abstract to the next, and of 0.4 when performance on a trial was
In this study, we present an algorithm for the worse than in the previous one. This “need” of a bigger
assessment of one’s own perception of balance difference for the worsening to be perceived seems to
(equilibrioception). Upright standing position is suggest a tendency towards overestimation of one’s
maintained by continuous updating and integration of own balance. Interestingly, participants’ judgement was
vestibular, visual and proprioceptive information, so more reliable when evaluating consecutive EC rather
that a compensatory reaction can be implemented than EO trials, at least when performance was
worsening.
Copyright is held by the authors/owner(s).
CHItaly '17, September 18-20, 2017, Cagliari, Italy.
Keywords differences between them. The aim of this study is to
equilibrioception; sense of balance ;Wii Balance Board; investigate the rate of agreement between objective
stabilometry. measures of balance and participants' self-report on
their own performance.
Introduction Material and Methods
Falls are a major public health problem with 30% of Participants
older people falling at least once a year. 78 healthy individuals participated to the study, 29
Falling is associated with increased mortality, injuries, males and 49 females (mean age = 23.1, SD = ±2.5).
loss of independence and adverse psychosocial Participants were all normal weight and did not report
consequences [10]. any history of neurological diseases, orthopedic
In everyday life, standing balance is a rather simple pathologies, use of medication or temporary problems
task regulated automatically by subcortical nervous that may have influenced the results of standing
structures and spinal motor neuron pools [6]. balance tests. The study was approved by the
Multisensory feedback is involved in the regulation of Institution’s Research Ethics Committee; all participants
posture control by continuously updating the internal provided written informed consent.
model of the body’s position [7]. To maintain a good
postural control humans have to integrate multisensory Procedure
information from vestibular, visual and proprioceptive Each subject performed 13 trials of 30 seconds each in
inputs [1]. a constrained foot position. Half of the participants
When posture is disturbed, evaluation of afferent performed an EO first trial and the other half performed
multisensory information allows compensatory an EC first trial. 6 out of the 12 remaining trials were
reactions to be implemented [4]. performed with participants keeping their eyes open
The use of objective measures for the assessment of (EO) and 6 with their eyes closed (EC); the sequence of
standing balance has widely taken place over the last EO-EC trials was semi-randomized, so that 4 possible
years [9,2]: several studies demonstrated how conditions could be investigated: EO trial followed by
stabilometric parameters can well describe changes in another EO trial (EO-EO); EC trial followed by another
balance due to different causes, such as age, posture EC trial (EC-EC), EO trial followed by an EC trial (EO-
and neurological diseases [11,3,5]. Maintenance of the EC), EC trial followed by an EO trial (EC-EO).
standing position is the result of complex interactions of For all conditions, subjects were asked to place their
different body systems which work synergistically. feet according to the lines designed on the surface of
The ability to maintain balance can be effectively the platform: heels had to be kept together where lines
considered as a physiological sense, which can be touched while toes were to be placed on top of the
referred to as “sense of balance” or “equilibrioception”. lines, so to form a 30° angle. Once in the correct
As for the other senses, it is fair to assume that healthy position, participants were asked to maintain a relaxed
people can also physically and cognitively discern upright standing position with their arms along the
different balance states and in some way evaluate body. For EO trials, a fixation cross was placed at 3m
distance and adjusted according to participants’ height, smaller than 0, performance in the latter trial is better
so that each subject was looking straight ahead during than the one preceding it, while if RSP shows values
trials. For EC trials, participants were instructed to look bigger than 0, performance in the last trial was worse
at the fixation cross before closing their eyes, so that than performance in the immediately preceding one.
head position was the same across trials. In order to evaluate a just noticeable difference (JND)
At the end of each trial, except the first one, subjects for the sense of balance we first identified RSP intervals
were asked to judge if their performance on the present where participants did not perceive differences, that is
trial was better or worse than their performance on the to say participants gave 50% of correct answers to RSP
immediately preceding one. Subjects were given values falling within this interval (centered in 0).
approximately 1 minute to relax between one trial and The range amplitude has been calculated iteratively, so
the following. The examiner always waited for that the percentage of correct answers of at least one
participants to announce their intention to resume the of the two adjacent intervals to the one centered in 0
test, stop talking and eventually close their eyes before was statistically different from the chance level
proceeding with data acquisition. Trials were performed observed for the 0 interval. Following this procedure,
in a non-noisy environment. we determined a range amplitude of 0,2 for RSP.
Data were recorded with the Nintendo Wii Balance
Board (WBB) using Matlab [8] and acquired at a Results and Discussion
frequency of 50 Hz. Paired t-tests were performed for SP in order to assess
A total of 1010 trials was recorded without any possible fatigue or practice effects (from the first to the
malfunction or technical problem leading to the test thirteenth trial): no significant difference was found. In
being invalidated. Table 1 are reported mean and standard deviation (SD)
values for SP parameter in each tested condition (EO
Data Analysis and EC) grouped by sequence order.
In order to assess participants’ sense of balance,
responses given by subjects to their own SwayPath EO EC
parameter (SP) were compared. Since participants
Trials Mean SD Mean SD
were asked to evaluate their own performance in
1 36,53 8,15 54,70 18,40
subsequent trials, the ratio between parameters
recorded in subsequent trials was considered according 2 35,79 8,13 52,79 16,98
to the following formula: 3 36,40 9,39 52,08 16,87
RSP=log2(SPi/SPi-1),where i=2,3…,13 is the considered 4 36,73 9,15 51,28 15,40
trial.
5 36,73 9,03 50,74 16,05
Smaller values for SP indicate a better balance
performance, while higher values indicate a worsened 6 36,56 9,88 50,89 17,09
balance performance. Hence, when evaluating 7 37,60 9,30 49,65 20,94
subsequent trials, we can say that if the RSP value is
Table 1: SP mean and standard deviation values (in cm) in The use of WBB and the algorithm used in this study
each tested condition EO and EC. permit to merge objective stabilometric data with self
Furthermore a series of χ2 tests were performed in evaluation judgements, giving a measure of
order to determine the JND. This has been calculated equilibrioception. A unimodal function has been
iteratively, for all trials changing the range interval obtained by RSP self evaluation distribution,
until the percentage of correct answers of at least one demonstrating that RSP describes participants’ ability to
of the two adjacent intervals to the one centered in 0 perceive changings in their balance performance. This
was significant. Following this procedure, we ability is not completely symmetric: JND is smaller for
determined a JND of 0.2 for RSP (χ2 = 6.57 p<0.01) balance improvement and bigger for worsening. This
when participants improved their performance and a “need” of a bigger difference for the worsening to be
JND of 0.4 when participants’ performance worsened perceived seems to suggest a tendency towards
(χ2 = 5.69 p<0.05). In Figure 1 the overall distribution overestimation of one’s own balance. Interestingly,
of balance self evaluation is reported. participants’ judgement was more reliable when
Considering the responses given by participants in the evaluating consecutive EC rather than EO trials, at least
same subsequent condition (EO-EO,EC-EC and EO-EC when performance was worsening.
together) we found that : EO - EO χ2 = 7.56 p<0.01;
EC - EC χ2 =2.42 ns; EO - EC χ2 = 6.38 p<0.05.
Figure 1: Overall distribution of balance self evaluation for RSP
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