Sensory reweighting is altered in adolescent patients with scoliosis: Evidence from a neuromechanical model

摘要

Idiopathic scoliosis is the most frequent spinal deformity in adolescence. While its aetiology remains unclear, impairments in balance control suggest a dysfunction of the sensorimotor control mechanisms. The objective of this paper is to evaluate the ability of patients with idiopathic scoliosis to reweigh sensory information. Using a neuromechanical model, the relative sensory weighting of vestibular and proprioceptive information was assessed. Sixteen healthy adolescents and respectively 20 and 16 adolescents with mild or severe scoliosis were recruited. Binaural bipolar galvanic vestibular stimulation was delivered to elicit postural movement along the coronal plane. The kinematics of the upper body, using normalized horizontal displacement of the 7th cervical vertebra, was recorded 1 s before, 2 s during, and I s following vestibular stimulation. The neuromechanical model included active feedback mechanisms that generated corrective torque from the vestibular and proprioceptive error signals. The model successfully predicted the normalized horizontal displacement of the 7th cervical vertebra. All groups showed similar balance control before vestibular stimulation; however, the amplitude (i.e., peak horizontal displacement) of the body sway during and immediately following vestibular stimulation was approximately 3 times larger in patients compared to control adolescents. The outcome of the model revealed that patients assigned a larger weight to vestibular information compared to controls; vestibular weight was 6.03% for controls, whereas it was 13.09% and 13.26% for the mild and severe scoliosis groups, respectively. These results suggest that despite the amplitude of spine deformation, the sensory reweighting mechanism is altered similarly in adolescent patients with scoliosis. (C) 2015 Elsevier B.V. All rights reserved.