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New York City, January 26, 2025 — A groundbreaking study published in PLOS ONE reveals that sound can have a significant impact on the balance of individuals suffering from vestibular hypofunction, a disorder of the vestibular system that impairs balance. The findings highlight a potential new avenue for balance interventions for those with this condition.
The vestibular system, located in the inner ear, plays a crucial role in detecting head movements and position. This information is used by the brain to maintain stability, integrating inputs from the eyes, joints, and muscles. While visual stimuli, such as strobe lights or moving patterns, have long been known to disrupt balance, new research suggests that sound may have a similarly destabilizing effect for those with vestibular disorders.
Anat Lubetzky, the lead author of the study and an associate professor of physical therapy at the NYU Steinhardt School of Culture, Education, and Human Development, explained the significance of the findings: “People with vestibular hypofunction often struggle with environments rich in visual stimuli, like busy streets or subway stations, where the overwhelming information can cause anxiety, dizziness, or loss of balance. Our study suggests that sound, especially in environments with dynamic visuals, should also be considered when assessing and treating balance problems.”
The study involved 69 participants, divided into two groups: healthy controls and individuals with unilateral vestibular hypofunction (which affects one ear). Participants wore virtual reality headsets that simulated the experience of being in a New York City subway station, complete with visual and auditory cues. Their body movements and head positions were tracked to measure balance.
The results revealed that participants with vestibular hypofunction experienced the most significant balance disruptions when exposed to moving visuals combined with either white noise or recorded subway sounds. These conditions caused increased sway, with participants showing significant movements in the forward and backward direction, as well as side-to-side head motions and head tilts. In contrast, the healthy control group did not show any balance issues under similar conditions.
“This study underscores the importance of including sound as a factor in both balance assessment and intervention programs,” Lubetzky said. “Balance training is known to be task-specific, so it is important to use sounds that mimic the environments these individuals regularly encounter. Using portable virtual reality headsets can be a promising tool for creating tailored and effective balance treatments.”
The study received funding from the National Institute on Deafness and Other Communication Disorders (R21DC018101), resources from the Icahn School of Medicine at Mount Sinai, and a grant from the National Center for Advancing Translational Science (UL1TR004419).
Disclaimer: The views expressed in this article are based on research conducted by Anat Lubetzky and collaborators at NYU Steinhardt School of Culture, Education, and Human Development. The information presented here is for educational purposes only and should not be considered as medical advice. Always consult a healthcare professional for concerns regarding balance disorders or vestibular hypofunction.
Source: New York University
Journal Reference: Lubetzky, A. V., et al. (2025). Real sounds influence postural stability in people with vestibular loss but not in healthy controls. PLOS ONE. doi.org/10.1371/journal.pone.0317955.
