Apparatus and method for sensory integration and muscular coordination analysis

• US 4,738,269 A
• Filed: 06/11/1986
• Issued: 04/19/1988
• Est. Priority Date: 08/16/1982
• Status: Expired due to Term

• Current Assignee: Lewis M. Nashner
• Original Assignee: Lewis M. Nashner
• Inventors: Nashner, Lewis M.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Hanley, John C.
• Application Number:
  US06/873,125
• Time in Patent Office: 678 Days
• Field of Search: 128/774, 128/779, 128/782, 272/144, 272/146, 434/55, 434/51, 434/247, 434/258
• US Class Current: 600/595
• CPC Class Codes: A61B 5/1036 Measuring load distribution, e.g. podologic studies
• CPC Class Codes: A61B 5/4023 Evaluating sense of balance
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: Y10S 482/901 having computer circuitry

Abstract

A subject'"'"'s ability to maintain a position in equilibrium by organizing sensory orientation inputs is tested utilizing a support surface and a visual surround. These items are moved by servo control in relation to a subject'"'"'s sway to provide perceptually misleading sensory orientation inputs to the subject, as part of various testing protocols.

Claims

1. A method for testing whether a subject'"'"'s ability to maintain position in equilibrium in a selected plane of motion is grossly abnormal with respect to both of two criteria, where the first criterion (termed "direct sensory control criterion") is the ability to maintain equilibrium position while support surface inputs and visual inputs related to motion in the selected plane are simultaneously disrupted, and the second criterion (termed "adaptive sensory control criterion") is the ability to maintain equilibrium position while surface inputs related to motion in the selected plane are disrupted and the subject is simultaneously exposed to incorrect visual inputs, and such method comprising:

(1) Performing Test Procedure Y as follows;

(A) placing the subject in a position of equilibrium on a support surface which is independently rotatable about an axis (hereinafter the "support surface rotation axis") related to the subject'"'"'s position in equilibrium and having the subject stand with eyes closed or blindfolded;

(B) measuring change (hereinafter termed "change in the subject'"'"'s orientation angle") in the angular orientation of the subject in the selected plane of motion;

(C) causing the support surface to undergo a change in angular orientation about the support surface rotation axis so as to equal the measured change in the subject'"'"'s orientation angle, thereby nullifying changes in angle between the orientation of the subject and the inclination of the support surface;

(D) determining whether or not the subject independently maintains the position in equilibrium;

(2) Performing Test Procedure Z as follows;

(A) placing the subject in a position in equilibrium on a support surface which is independently rotatable about an axis (hereinafter the "support surface rotation axis");

(B) substantially surrounding the subject'"'"'s field of view of a movable second surface (hereinafter the "visual surround");

(C) measuring the change in the subject'"'"'s orientation angle;

(D) causing the support surface to undergo a change in angular orientation about the support surface rotation axis so as to equal the measured change in subject'"'"'s orientation angle, thereby nullifying changes in angle between the orientation of the subject and the inclination of the support surface;

(E) causing the visual surround to undergo a change in angular orientation about the support surface rotation axis so as to equal the measured change in subject'"'"'s orientation angle, thereby nullifying changes in angle between the orientation of the subject and the orientation of the visual surround; and

(F) determining whether or not the subject independently maintains the position in equilibrium.

2. A method according to claim 1, for testing whether a subject'"'"'s ability to maintain an upright standing position in equilibrium by appropriately organizing sensory orientation inputs in the anteroposterior plane of motion is grossly abnormal with respect to both direct sensory criteria and adaptive criteria, wherein Step A of Test Procedure Y and Step A of Test Procedure Z each include the further step of standing the subject on a support surface with the support surface rotation axis colinear with the axis defined by subject'"'"'s ankle joints, and wherein Step B of Test Procedure Y and Step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s center of body mass in the anteroposterior plane around the axis defined by the subject'"'"'s ankle joints, and wherein the method further comprises:

(3) identifying as grossly abnormal with respect to direct sensory control and with respect to adaptive sensory control each subject who fails to maintain equilibrium in step D of Test Procedure Y and also fails to maintain equilibrium in step F of Test Procedure Z.

3. A method according to claim 1, for testing whether a subject'"'"'s ability to maintain an upright seated position in equilibrium by appropriately organizing sensory orientation inputs in the anteroposterior plane of motion is grossly abnormal with respect both direct sensory criteria and adaptive criteria, wherein step A of Test Procedure Y and step A of Test Procedure Z each include the step of seating the subject on a support surface with the support surface rotation axis colinear with the axis defined by the subject'"'"'s hip joints, and wherein step B of Test Procedure Y and step C of Test Procedure Z each includes the further step of measuring the change in the angular orientation of the subject'"'"'s trunk in the anteroposterior plane around the axis defined by the subject'"'"'s hip joints, and wherein the method further comprises:

(3) Identifying as grossly abnormal with respect to direct sensory control and with respect to adaptive sensory control each subject who fails to maintain equilibrium in step D of test procedure Y and also fails to maintain equilibrium in step F of test procedure Z.

4. A method according to claim 1, for testing whether a subject'"'"'s ability to maintain an upright standing position in equilibrium by appropriately organizing sensory orientation inputs in the lateral plane of motion is grossly abnormal with respect both direct sensory criteria and adaptive criteria, wherein step A of Test Procedure Y and step A of Test Procedure Z each include the further step of standing the subject on a support surface, with the support surface rotation axis perpendicular to the line segment defined by the subject'"'"'s ankle joints at the center point of said segment, wherein step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s center of body mass in the lateral plane around the support surface rotation axis, and wherein the method further comprises:

(3) identifying as grossly abnormal with respect to direct sensory control and with respect to adaptive sensory control each subject who fails to maintain equilibrium in step D of Test Procedure Y and also fails to maintain equilibrium in step F of Test Procedure Z.

5. A method according to claim 1, for testing whether a subject'"'"'s ability to maintain an upright seated position in equilibrium by appropriately organizing sensory orientation inputs in the lateral plane of motion is grossly abnormal with respect to both direct sensory criteria and adaptive criteria, wherein step A of Test Procedure Y and step A of Test Procedure Z each include the further step of seating the subject on a support surface with the support surface rotation axis perpendicular to the line segment defined by the subject'"'"'s hip joints at the center point of such sement, and wherein step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s trunk in the lateral plane around the support surface rotation axis, and wherein the method further comprises:

(3) Identifying as grossly abnormal with respect to direct sensory control and with respect to adaptive sensory control each subject who fails to maintain equilibrium in step D of test procedure Y and also fails to maintain equilibrium in step F of test procedure Z.

6. A method for testing whether a subject'"'"'s ability to maintain a position in equilibrium by appropriately organizing sensory orientation inputs in a selected plane of motion according to two criteria is normal with respect to the first criterion but grossly abnormal with respect to the second criterion, where the first criterion (termed "direct sensory control criterion") is the ability to maintain equilibrium position while support surface input and visual inputs are simultaneously disrupted, and the second criterion (termed "adaptive sensory control criterion") is the ability to maintain equilibrium position while surface inputs are disrupted and the subject is simultaneously exposed to incorrect visual inputs, such method comprising:

(1) Performing Test procedure X as follows;

(A) placing the subject in a position in equilibrium on a support surface which is independently rotatable about an axis (hereinafter the "support surface rotation axis") related to the subject'"'"'s position in equilibrium;

(B) measuring the change (hereinafter termed "change in subject'"'"'s orientation angle") in the angular orientation of the subject in the selected plane of motion;

(C) causing the support surface to undergo a change in angular orientation about the support surface rotation axis so as to equal the measured change in the subject'"'"'s orientation angle, thereby nullifying changes in angle between the orientation of the subject and the inclination of the support surface;

(D) determining whether or not the subject independently maintains the position in equilibrium.

(2) Performing Test Procedure Y as follows;

(A) placing the subject in a position in equilibrium on a support surface which is independently rotatable about an axis (hereinafter the "support surface rotation axis") related to the subject'"'"'s position in equilibrium, and having the subject stand with eyes closed or blindfolded;

(B) measuring the change in the subject'"'"'s orientation angle;

(C) causing the support surface to undergo a change in angular orientation about the support surface rotation axis so as to equal the measured change in the subject'"'"'s orientation angle, thereby nullifying changes in angle between the orientation of the subject and the inclination of the support surface;

(D) determining whether or not the subject independently maintains the position in equilibrium.

(E) determining, if the subject maintains the position in equilibrium over a specified time interval, an index of stability for this Test Procedure Y, such index termed the "index of blind stability," related to the average amplitude of change in the measured subject'"'"'s orientation angle during the specified interval of time;

(3) Performing Test Procedure Z as follows;

(A) placing the subject in a position in equilibrium on a support surface which is independently rotatable about an axis (hereinafter the "support surface rotation axis") related to subject'"'"'s position in equilibrium;

(B) substantially surrounding the subject'"'"'s field of view with a second surface (hereinafter the "visual surround") independently movable with respect to the support surface;

(C) measuring the change in the subject'"'"'s orientation angle;

(D) causing the support surface to undergo a change in angular orientation about the support surface rotation axis so as to equal the measured change in the subject'"'"'s orientation angle, thereby nullifying changes in angle between the orientation of the subject and the inclination of the support surface;

(E) causing the visual surround to undergo a change in angular orientation about the support surface rotation axis so as to equal the measured change in the subject'"'"'s orientation angle, thereby nullifying changes in the angle between the orientation of the subject and the AP orientation of the visual surround;

(F) determining whether or not the subject independently maintains the position in equilibrium;

(G) determining, if the subject maintains the position in equilibrium over a specified time interval, an index of stability for this Test Procedure Z, such index termed the "index of visually disinformed stability," related to the average amplitude of change in the measured subject'"'"'s orientation angle during the specified interval of time.

7. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright standing position in equilibrium by appropriately organizing sensory orientation inputs in the anteroposterior plane of motion is normal with respect to direct sensory control criteria but grossly abnormal with respect to adaptive sensory control criteria, wherein step A of each of Test Procedures X, Y, and Z includes the further step of standing the subject on a support surface with the support surface rotation axis colinear with the axis defined by subject'"'"'s ankle joints, and wherein step B of Test Procedure X, step B of Test Procedure Y and step C of Test Procedure Z each includes the further step of measuring the change in the angular orientation of the subject'"'"'s center of body mass in the anteroposterior plane around the axis defined by the subject'"'"'s ankle joints, and wherein the method comprises:

(4) identifying as normal with respect to direct sensory control but grossly abnormal with respect to adaptive sensory control each subject who has maintained a position in equilibrium in Test X and Test Y but not in Test Z; and

(5) identifying as normal with respect to direct sensory control but grossly abnormal with respect to adaptive sensory control each subject who has maintained a position in equilibrium in Test X, Test Y, and Test Z but whose index of visually disinformed stability is at least approximately 1.5 times as great as his index of blind stability.

8. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright standing position in equilibrium by appropriately organizing sensory orientation inputs in the anteroposterior plane of motion is mildly abnormal with respect to either direct sensory control criteria or adaptive sensory control criteria, wherein Step A of each of Test Procedures X, Y, and Z includes the further step of standing the subject on a support surface with the support surface rotation axis colinear with the axis defined by subject'"'"'s ankle joints, and wherein step B of Test Procedure X, step B of Test Procedure Y and step C of Test Procedure Z each includes the further step of measuring the change in the angular orientation of the subject'"'"'s center of body mass in the anteroposterior plane around the axis defined by the subject'"'"'s ankle joints, and wherein the method further comprises:

(4) identifying as mildly abnormal with respect to direct sensory control or with respect to adaptive sensory control each subject who maintains a position in equilibrium in step D of Test Procedure X, step D of Test Procedure Y and also step F of Test Procedure Z whose index of blind stability and whose index of visually disinformed stability are each above the range of values for an age-matched normal population of subjects according to a statistical criterion of significance.

9. A method according to claim 6, for testing whether a subject'"'"'s ablity to maintain an upright standing position in equilibrium by appropriately organizing sensory orientation inputs in the anteroposterior plane of motion is grossly normal, wherein step A of each of Test Procedures X, Y, and Z includes the further step of standing the subject on a support surface with the support surface rotation axis colinear with the axis defined by the subject'"'"'s ankle joints, and wherein step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s center of body mass in the anteroposterior plane around the axis defined by the subject'"'"'s ankle joints, and wherein the method further comprises:

(4) determining if the subject has maintained equilibrium in step D of Test Procedures X and Y and in step F of Test Procedure Z and also has an index of visually disinformed stability at least approximately 1.5 times as great as his index of blind stability;

(5) determining if the subject has maintained equilibrium in step D of each of Test Procedures X and Y and in step F of Test Procedure Z and also has an index of visually disinformed stability and an index of blind stability whose values are each above the range of values for an age-matched normal population of subjects according to a statistical criterion of significance;

(6) identifying as grossly normal each subject who satisfies the conditions of steps (4) and (5).

10. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright seated position in equilibrium by appropriately organizing sensory orientation inputs in the anteroposterior plane of motion is normal with respect to direct sensory control criteria but grossly abnormal with respect to adaptive sensory control criteria, wherein step A of each of Test Procedures X, Y, and Z includes the further step of seating the subject on a support surface with the support surface axis colinear with the axis defined by the subject'"'"'s hip joints, and wherein each of step B of Test Procedure X, step B of Test Procedure Y and step C of Test Procedure Z includes the further step of measuring the change in the angular orientation of the subject'"'"'s trunk in the anteroposterior plane around the axis defined by the subject'"'"'s hip joints and wherein the method further comprises:

(4) identifying as normal with respect to direct sensory control but grossly abnormal with respect to adaptive sensory control each subject who has maintained a position in equilibrium in Test X and Test Y but not in Test Z;

(5) identifying as normal with respect to direct sensory control but grossly abnormal with respect to adaptive sensory control each subject who has maintained a position in equilibrium in Test X, Test Y and Test Z but whose index of visually disinformed stability is at least approximately 1.5 times as great as his index of blind stability.

11. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright seated position in equilibrium by appropriately organizing sensory orientation inputs in the anteroposterior plane of motion is mildly abnormal with respect to either direct sensory control criteria or adaptive sensory control criteria, wherein step A of each of Test Procedures X, Y, and Z includes the further step of seating the subject on a support surface with the support surface axis colinear with the axis defined by the subject'"'"'s hip joints, and wherein each of step B of Test Procedure X, step B of Test Procedure Y and step C of Test Procedure Z includes the further step of measuring the change in the angular orientation of the subject'"'"'s trunk in the anteroposterior plane around the axis defined by the subject'"'"'s hip joints, and wherein the method further comprises:

(4) identifying as mildly abnormal with respect to direct sensory control or with respect to adaptive sensory control each subject who maintains a position in equilibrium in step D of Test Procedure X, step D of Test Procedure Y and also step F of Test Procedure Z whose index of blind stability and whose index of visually disinformed stability are each above the range of values for an age-matched normal population of subjects according to a statistical criterion of significance.

12. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright seated position in equilibrium by appropriately organizing sensory orientation inputs in the anteroposterior plane of motion is grossly normal, wherein step A of each of Test Procedures X, Y and Z includes the further step of seating the subject on a support surface with the support surface rotation axis colinear with the axis defined by the subject'"'"'s hip joints, and wherein step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s trunk in the anteroposterior plane around the axis defined by the subject'"'"'s hip joints, and wherein the method further comprises:

(4) determining if the subject has maintained equilibrium in step D of each of Test Procedures X and Y and in step F of Test Procedure Z and also has a index of usually disinformed stability at least 1.5 times as great as his index of blind stability;

(5) determining if the subject has maintained equilibrium in step D of each of Test Procedures X and Y and in step F of Test Procedure Z and also has an index of visually disinformed stability and an index of blind stability whose values are above the range of values of an age-matched normal population of subjects according to a statistical criterion of significance.

(6) identifying as grossly normal each subject who satisfies the conditions of steps (4) and (5).

13. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright standing position in equilibrium by appropriately organizing sensory orientation inputs in the lateral plane of motion is normal with respect to direct sensory control criteria but grossly abnormal with respect to adaptive sensory control criteria, wherein step A of Test Procedures X, Y, and Z each includes the further step of standing the subject on a support surface with the support surface axis perpendicular to the line segment defined by the subject'"'"'s ankle joints, at the center point of said segment, and wherein step B of Test Procedure X, step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s center of body mass in the lateral plane around the support surface rotation axis, and wherein the method further comprises:

(4) identifying as normal with respect to direct sensory control but grossly abnormal with respect to adaptive sensory control each subject who has maintained a position in equilibrium in Test X and Test Y but not in Test Z;

(5) identifying as normal with respect to direct sensory control but grossly abnormal with respect to adaptive sensory control each subject who has maintained a position in equilibrium in Test X, Test Y and Test Z but whose index of visually disinformed stability is at least approximately 1.5 times as great as his index of blind stability.

14. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright standing position in equilibrium by appropriately organizing sensory orientation inputs in the lateral plane of motion is midly abnormal with respect to either direct sensory control criteria or adaptive sensory control criteria, wherein step A of each of Test Procedures X, Y, and Z includes the further step of standing the subject on a support surface with the support surface axis perpendicular to the line segment defined by the subject'"'"'s ankle joints, at the center point of said segment, and wherein step B of Test Procedure X, step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s center of body mass in the lateral plane around the support surface rotation axis, and wherein the method further comprises:

(4) identifying as mildly abnormal with respect to direct sensory control or with respect to adaptive sensory control each subject who maintains a position in equilibrium in step D of Test Procedure X, step D of Test Procedure Y and also Step F of Test Procedure Z whose index of blind stability and whose index of visually disinformed stability are each above the range of values for an age-matched normal population of subjects according to a statistical criterion of significance.

15. A method according to claim 6, for testing whether a subject'"'"'s ability maintain an upright standing position in equilibrium by appropriately organizing sensory orientation inputs in the lateral plane of motion is grossly normal, wherein step A of each of Test Procedures X, Y and Z includes the further step of standing the subject on a support surface with the support surface rotation axis perpendicular to the line segment defined by the subject'"'"'s ankle joints at the center point of said segment, and wherein step B of Test Procedures X and Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s center of body mass in the lateral plane around the support surface rotation axis, and wherein the method further comprises:

(4) determining if the subject has maintained equilibrium in step D of each of Test Procedures X and Y and in step F of Test Procedure Z and also has a index of visually disinformed stability of at least approximately 1.5 times as great as his index of blind stability;

(5) determining if the subject has maintained equilibrium in step D of each of Test Procedures X and Y and in step F of Test Procedure Z and also has an index of visually disinformed stability and an index of blind stability whose values are above the range of values for an age-matched normal population of subjects according to a statistical criterion of significance;

(6) identifying as grossly normal each subject who satisfies the conditions of steps (4) and (5).

16. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright seated position in equilibrium by appropriately organizing sensory orientation inputs in the lateral plane of motion is normal with respect to direct sensory control criteria but grossly abnormal with respect to adaptive sensory control criteria, wherein step A of each of Test Procedures X, Y, and Z includes the further step of seating the subject on a support surface with the support surface rotation axis perpendicular to the line segment defined by the subject'"'"'s hip joints at the center point of such segment, and wherein step B of Test Procedure X, step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s trunk in the lateral plane around the support surface rotation axis, and wherein the method further comprises:

(4) Identifying as normal with respect to direct sensory control but grossly abnormal with respect to adaptive sensory control each subject who has maintained a position in equilibrium in Test X and Test Y but not in Test Z;

(5) Identifying as normal with respect to direct sensory control but grossly abnormal with respect to adaptive sensory control each subject who has maintained a position in equilibrium in Test X, Test Y, and Test Z but whose index of visually disinformed stability is at least approximately 1.5 times as great as his index of blind stability.

17. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright seated position in equilibrium by appropriately organizing sensory orientation inputs in the lateral plane of motion is mildly abnormal with respect to either direct sensory control criteria or adpative sensory control criteria, wherein step A of each of Test Procedures X, Y, and Z includes the further step of seating the subject on a support surface with the support surface rotation axis perpendicular to the line segment defined by the subject'"'"'s hip joints at the center point of such segment, and wherein step B of Test Procedure X, step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s trunk in the lateral plane around the support surface rotation axis, and wherein the method further comprises:

(4) identifying as mildly abnormal with respect to direct sensory control or with respect to adaptive sensory control each subject who maintains a position in equilibrium in step D of Test Procedure X, step D of Test Procedure Y and also step F of Test Procedure Z and whose index of blind stability and whose index of visually disinformed stability are each above the range of values for an age-matched normal population of subjects according to a statistical criterion of significance.

18. A method according to claim 6, for testing whether a subject'"'"'s ability to maintain an upright seated position in equilibrium by appropriately organizing sensory orientation inputs in the lateral plane of motion is grossly normal, wherein step A of each of Test Procedures X, Y, and Z includes the further step of seating the subject on a support surface with the support surface rotation axis perpendicular to the line segment defined by the subject'"'"'s hip joints at the center point of such segment, and wherein step B of Test Procedure Y and step C of Test Procedure Z each include the further step of measuring the change in the angular orientation of the subject'"'"'s trunk in the lateral plane around the support surface rotation axis, and wherein the method further comprises:

(4) Determining if the subject has maintained equilibrium in step D of each of Test Procedures X and Y and in step F of Test Procedure Z and also has an index of visually disinformed stability at least approximately 1.5 times as great as high index of blind stablity;

(5) Determining if the subject has maintained equilibrium in step D of each of Test Procedures X and Y and in step F of Test Procedure Z and also has index of visually disinformed stability and an index of blind stability whose values are both above the range of values for an age-matched normal population of subjects according to a statistical criterion of significance;

(6) Identifying as grossly normal each subject who satisfies the conditions of steps (4) and (5).