Gait disorientation as a proxy for impaired spatial navigation: Associations between the Gait Disorientation Test and vestibular-mediated functions.

INTRODUCTION

Dizziness and imbalance from vestibular dysfunction may lead to gait disorientation and impaired construction of mental maps needed for spatial navigation. The Gait Disorientation Test (GDT), consisting of two components, walking eyes open (WEO) and walking eyes closed (WEC), can identify gait disorientation. We aimed to examine associations between the GDT and measures that reflect aspects of spatial navigation.

METHODS

40 adults (20 with vestibular hypofunction, 20 controls) recruited from the community completed the GDT, Sensory Organization Test (SOT), Activities-specific Balance Confidence Scale, Dizziness Handicap Inventory, dynamic visual acuity testing, and the 5-Times-Sit-to-Stand Test. The composite score (COMP) and sensory analysis scores for somatosensory (SOM), vision (VIS), vestibular (VEST), and vision preference (PREF) were calculated for the SOT.

RESULTS

The GDT was associated with the COMP (p < 0.001), VIS (p < 0.001), VEST (p = 0.001), and PREF (p = 0.021) but not the SOM (p = 0.223) scores. WEO was associated with VIS (-0.35 [-0.59, -0.04], p = 0.028), VEST (-0.32 [-0.57, -0.01], p = 0.046), and the COMP score (-0.44 [-0.66, -0.14], p = 0.005). WEC was associated with VIS (-0.73 [-0.85, -0.55], p < 0.001), VEST (-0.52 [-0.71, -0.24], p = 0.001), PREF (-0.37 [-0.61, -0.07], p = 0.018), and the COMP score (-0.75 [-0.86, -0.57], p < 0.001).

DISCUSSION: Greater gait disorientation on the GDT is moderately to strongly associated with balance in challenging sensory conditions. Stronger associations with WEC likely reflect the importance of the vestibular system for spatial navigation. Performance on the GDT might be viewed as a proxy for spatial navigation ability.