Hypoxia-induced changes in standing balance

Linsey S. Wagner, Sarah R. Oakley, Pao Vang, Brie N. Noble, Michael J. Cevette, Jan P. Stepanek

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: A few studies in the literature have reported postural changes with hypoxia, but none have quantifi ed the magnitude of change. Further understanding of this condition could have implications for patients at risk for falls, individuals undergoing acute altitude exposure, and pilots and commercial passengers. The objective of this study was to evaluate the effect of different levels of hypoxia (oxygen nitrogen mixtures) on postural standing balance using the computerized dynamic posturography (CDP) system. This improves upon previous protocols by manipulating vision and standing balance with a sway-referenced visual fi eld and/or platform. Additionally, normative data were available for comparison with the cumulative test scores and scores for each condition. Methods: Altitude hypoxia was simulated by use of admixing nitrogen to the breathing gas to achieve equivalent altitudes of 1524 m, 2438 m, and 3048 m. Subjects were evaluated using the CDP system. Results: Subjects showed an overall trend toward decreased performance at higher simulated altitudes consistent with the initial hypothesis. Composite standing balance sway scores for the sensory organization subtest of CDP were decreased compared to baseline for simulated altitudes as low as 2438 m (mean sway scores: 81.92 at baseline; 81.85 at 1524 m; 79.15 at 2438 m; 79.15 at 3048 m). Reaction times to unexpected movements in the support surface for the motor control subtest (MCT) increased compared to baseline (mean composite scores: 133.3 at baseline; 135.9 ms at 1524 m; 138.0 ms at 2438 m; 140.9 ms at 3048 m). Conclusions: The CDP testing provided a reliable objective measurement of degradation of balance under hypoxic conditions.

Original languageEnglish (US)
Pages (from-to)518-522
Number of pages5
JournalAviation Space and Environmental Medicine
Issue number5
StatePublished - May 2011


  • Computerized dynamic posturography
  • Disequilibrium
  • Dizziness
  • Oxygen saturation
  • Simulated altitudes
  • Sway magnitude
  • Sway referencing

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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