Characterizing head motion in three planes during combined visual and base of support disturbances in healthy and visually sensitive subjects.

Multiplanar environmental motion could generate head instability, particularly if the visual surround moves in planes orthogonal to a physical disturbance. We combined sagittal plane surface translations with visual field disturbances in 12 healthy (29-31 years) and 3 visually sensitive (27-57 years) adults. Center of pressure (COP), peak head angles, and RMS values of head motion were calculated and a three-dimensional model of joint motion was developed to examine gross head motion in three planes. We found that subjects standing quietly in front of a visual scene translating in the sagittal plane produced significantly greater (p<0.003) head motion in yaw than when on a translating platform. However, when the platform was translated in the dark or with a visual scene rotating in roll, head motion orthogonal to the plane of platform motion significantly increased (p<0.02). Visually sensitive subjects having no history of vestibular disorder produced large, delayed compensatory head motion. Orthogonal head motions were significantly greater in visually sensitive than in healthy subjects in the dark (p<0.05) and with a stationary scene (p<0.01). We concluded that motion of the visual field could modify compensatory response kinematics of a freely moving head in planes orthogonal to the direction of a physical perturbation. These results suggest that the mechanisms controlling head orientation in space are distinct from those that control trunk orientation in space. These behaviors would have been missed if only COP data were considered. Data suggest that rehabilitation training can be enhanced by combining visual and mechanical perturbation paradigms.