Article  |   June 2009
Head Shake Computerized Dynamic Posturography in Peripheral Vestibular Lesions
Author Affiliations & Notes
  • Anupam Mishra
    K.G. Medical College, Lucknow, India
  • Sherrie Davis
    Hospital of the University of Pennsylvania, Philadelphia
  • Rosemary Speers
    CNA Corporation, Alexandria, VA
  • Neil T. Shepard
    Mayo Clinic, Rochester, MN
  • Contact author: Neil T. Shepard, Mayo Clinic, Department of Otorhinolaryngology, 200 1st Street SW, Rochester, MN 55902. E-mail: shepard.neil@mayo.edu.
Balance & Balance Disorders
Article   |   June 2009
Head Shake Computerized Dynamic Posturography in Peripheral Vestibular Lesions
American Journal of Audiology June 2009, Vol.18, 53-59. doi:10.1044/1059-0889(2009/06-0024)
History: Accepted 21 Jan 2009 , Received 12 Oct 2006 , Revised 23 Jul 2007
American Journal of Audiology June 2009, Vol.18, 53-59. doi:10.1044/1059-0889(2009/06-0024)
History: Accepted 21 Jan 2009 , Received 12 Oct 2006 , Revised 23 Jul 2007

Purpose: To determine the sensitivity of a head shake modification to the Sensory Organization Test (SOT) of dynamic posturography in identifying (a) those patients with unilateral, peripheral vestibular hypofunction as indicated by caloric irrigation findings and (b) those patients who report that head movements provoke disruption in postural control.

Method: A prospective, single-blinded, random selection methodology was used with 91 patients stratified by the presence or absence of a significant caloric asymmetry and by the presence or absence of head movement provoked symptoms (independent variables). Postural control performance, as measured by EquiTest during the standard test and a head shake modification, served as the dependent variables.

Results: Receiver operating characteristic curves demonstrated only minor improvement in sensitivity (a) with the head shake modification for unilateral peripheral asymmetry and (b) for identification of those with complaints of head movement provoked imbalance.

Conclusions: The head shake modification to standard SOT increased the test sensitivity to identification of patients with unilateral, peripheral vestibular hypofunction and those with head movement provoked symptoms. However, this occurred with low specificity, resulting in no significant improvement in overall performance with this head shake protocol. Suggestions for further research to improve the performance of the head shake modification of SOT for clinical application are discussed.

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