Locomotor sensory organization test: a novel paradigm for the assessment of sensory contributions in gait.

Feedback based balance control requires the integration of visual, proprioceptive and vestibular input to detect the body's movement within the environment. When the accuracy of sensory signals is compromised, the system reorganizes the relative contributions through a process of sensory recalibration, for upright postural stability to be maintained. Whereas this process has been studied extensively in standing using the Sensory Organization Test (SOT), less is known about these processes in more dynamic tasks such as locomotion. In the present study, ten healthy young adults performed the six conditions of the traditional SOT to quantify standing postural control when exposed to sensory conflict. The same subjects performed these six conditions using a novel experimental paradigm, the Locomotor SOT (LSOT), to study dynamic postural control during walking under similar types of sensory conflict. To quantify postural control during walking, the net Center of Pressure sway variability was used. This corresponds to the Performance Index of the center of pressure trajectory, which is used to quantify postural control during standing. Our results indicate that dynamic balance control during locomotion in healthy individuals is affected by the systematic manipulation of multisensory inputs. The sway variability patterns observed during locomotion reflect similar balance performance with standing posture, indicating that similar feedback processes may be involved. However, the contribution of visual input is significantly increased during locomotion, compared to standing in similar sensory conflict conditions. The increased visual gain in the LSOT conditions reflects the importance of visual input for the control of locomotion. Since balance perturbations tend to occur in dynamic tasks and in response to environmental constraints not present during the SOT, the LSOT may provide additional information for clinical evaluation on healthy and deficient sensory processing.