Impact of multi-task on symptomatic patient affected by chronical vestibular disorders.

PURPOSE: After a vestibular deficit some patients may be affected by chronical postural instability. The aim of this study was to identify the emotional and cognitive factors of these symptomatic patients. In particular, the double cognitive task and the anxiety disorder were identified by our patients. Through a retrospective study, 14 patients (65.4 ± 18 years) participated in the experiment. METHOD: The experimentation consists in the study of the standing position of our patients through the aggregate of the trajectories of the center of pressure (COP) using a force plate device. With the aim of isolating the emotional and cognitive influence, this experimentation was defined in two conditions. In the first one, the patients were asked to maintain their balance without additional tasks. In the second one, the patients were submitted to an additional cognitive arithmetic task. The stabilogram surface, length (the forward and backward displacement distance during deviations in COP), lateral and the antero-posterior deviations were assessed. RESULTS: Our results showed an increase of postural instability of patients affected by chronical vestibular disorders when submitted to the double task. The patients submitted to the cognitive task present a larger surface of activity in comparison with the free-task one (Wilcoxon test p-value equals p = 0.0453). In addition, their displacements inside this area are more important (p = 0.0338). The COP of all our patients deviated forward in the presence of the double task. CONCLUSION: The increase in instability during the double cognitive task could be explained by an additional stress caused by the desire to make a success of the cognitive task.

[Rehabilitation of balance disorders for elderly]. / Rééducation des troubles de l'equilibre de la personne agée.

The problems encountered by elderly in balancing themselves, possibly causing instability, perception troubles, and even falls, are the consequence of physiopathological causes. Their comprehension by the way of a thorough clinical survey gives a lead to the rehabilitation based on precise objectives. The subsequent programme of exercises presents the significant features of modularity, clarity of objectives and a progress led by the evolution of the symptoms. This personalized undertaking may include a correction of the musculosqueletics troubles, a sensorial resetting, a development of postural stabilization capabilities independent of the internal or external circumstances, a self-balancing capability independent of the current cognitive condition, a restoration of self-confidence, a physical resetting and an adaptation of the living place. The transposition of the exercises in ecological situation, the virtual reality of which is getting closer and closer, remains a priority in order to achieve the best results.