Advanced Techniques for Assessment of Postural and Locomotor Ataxia, Spatial Orientation, and Gaze Stability
In addition to adapting to microgravity, major neurovestibular problems of space flight include postflight difficulties with standing, walking, turning corners, and other activities that require stable upright posture and gaze stability. These difficulties inhibit astronauts' ability to stand or escape from their vehicle during emergencies. The long-ter7n goal of the NSBRI is the development of countermeasures to ameliorate the effects of long duration space flight. These countermeasures must be tested with valid and reliable tools. This project aims to develop quantitative, parametric approaches for assessing gaze stability and spatial orientation during normal gait and when gait is perturbed. Two of this year's most important findings concern head fixation distance and ideal trajectory analysis. During a normal cycle of walking the head moves up and down linearly. A simultaneous angular pitching motion of the head keeps it aligned toward an imaginary point in space at a distance of about one meter in front of a subject and along the line of march. This distance is called the head fixation distance. Head fixation distance provides the fundamental framework necessary for understanding the functional significance of the vestibular reflexes that couple head motion to eye motion. This framework facilitates the intelligent design of counter-measures for the effects of exposure to microgravity upon the vestibular ocular reflexes. Ideal trajectory analysis is a simple candidate countermeasure based upon quantifying body sway during repeated up and down stair stepping. It provides one number that estimates the body sway deviation from an ideal sinusoidal body sway trajectory normalized on the subject's height. This concept has been developed with NSBRI funding in less than one year. These findings are explained in more detail below. Compared to assessments of the vestibuo-ocular reflex, analysis of vestibular effects on locomotor function is relatively less well developed and quantified. We are improving this situation by applying methodologies such as nonlinear orbital stability to quantify responses and by using multivariate statistical approaches to link together the responses across separate tests. In this way we can exploit the information available and increase the ability to discriminate between normal and pathological responses. Measures of stability and orientation are compared to measures such as dynamic visual acuity and with balance function tests. The responses of normal human subjects and of patients having well documented pathophysiologies are being characterized. When these studies are completed, we should have a clearer idea about normal and abnormal patterns of eye, head, and body movements during locomotion and their stability in a wide range of environments. We plan eventually to use this information to validate the efficacy of candidate neurovestibular and neuromuscular rehabilitative techniques. Some representative studies made during this year are summarized.