The objective of this PhD study is to investigate dynamic balance control in a population consisting of healthy adults, patients with vestibular dysfunction and stroke patients, thereby exploring different strategies to adapt gait to reduced dynamic balance control. To do so, biomechanical measures of gait stability, will be considered as primary outcome measures. Secondary outcome measures are postural instability, falls and fear of falling, documented using the "Dizziness Handicap Inventory" (DHI) and the "Activities specific Balance Confidence scale" (ABC). Fall risk is determined using standardized clinical tests.
The goal of this study is to gain further insight into the relation between variability in foot placement, measures of biomechanical stability and postural instability, risk of falling and documented falls. Different populations will be considered, consisting of community dwelling adults, patients with vestibular deficit and stroke patients. Patients with vestibular deficit are an interesting population to study gait adaptability because, despite loss of vestibular function, in unilateral vestibular deficit no increased risk of falling is observed. In stroke patients, on the other hand, up to 50 percent annually reports a fall. Differences in gait adaptability strategies in these three populations will be investigated using a case-control design. To investigate predictive ability of gait stability measures a prospective cohort study will be performed.
Insight into gait adaptability strategies creates opportunities to develop guidelines for gait training and rehabilitation.