Assessment of Subjective Visual Vertical (SVV) Using the “Bucket Test” and the Virtual SVV System Objective The purpose of this study was to describe the variability and test–retest reliability of a commercially available subjective visual vertical (SVV) system known as Virtual SVV (Interacoustics). In addition, the study aimed to compare the reliability of the Virtual system with a previously established bucket test of SVV. ... Research Article
Research Article  |   September 12, 2018
Assessment of Subjective Visual Vertical (SVV) Using the “Bucket Test” and the Virtual SVV System
 
Author Affiliations & Notes
  • Patricia L. Michelson
    Division of Vestibular Sciences, Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
  • Devin L. McCaslin
    Vestibular and Balance Laboratory, Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN
  • Gary P. Jacobson
    Division of Vestibular Sciences, Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
  • Michelle Petrak
    Interacoustics, Middelfart, Denmark
  • Lauren English
    Division of Vestibular Sciences, Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
  • Kelsey Hatton
    Division of Vestibular Sciences, Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Patricia Michelson: trish.michelson@gmail.com
  • Editor-in-Chief: Sumitrajit Dhar
    Editor-in-Chief: Sumitrajit Dhar×
Article Information
Balance & Balance Disorders / Research Issues, Methods & Evidence-Based Practice / Research Articles
Research Article   |   September 12, 2018
Assessment of Subjective Visual Vertical (SVV) Using the “Bucket Test” and the Virtual SVV System
American Journal of Audiology, September 2018, Vol. 27, 249-259. doi:10.1044/2018_AJA-17-0019
History: Received February 19, 2017 , Revised July 10, 2017 , Accepted February 5, 2018
 
American Journal of Audiology, September 2018, Vol. 27, 249-259. doi:10.1044/2018_AJA-17-0019
History: Received February 19, 2017; Revised July 10, 2017; Accepted February 5, 2018

Objective The purpose of this study was to describe the variability and test–retest reliability of a commercially available subjective visual vertical (SVV) system known as Virtual SVV (Interacoustics). In addition, the study aimed to compare the reliability of the Virtual system with a previously established bucket test of SVV.

Study Design Fifteen participants with normal hearing, normal middle ear function, and normal utricular function were included in the study. Each participant underwent static SVV testing using both the Virtual system and the bucket test. Subjects completed 2 testing sessions to determine test–retest reliability. For each test, data were collected with the head at 0°, tilted 45° to the right, and tilted 45° to the left.

Setting This study was conducted in a balance function laboratory embedded in a large, tertiary care otology clinic.

Results The mean SVV values obtained with the Virtual system were within 1°–2° from 0 with the head positioned at 0°, which is in agreement with many other studies of SVV with the head at 0° (Akin & Murnane, 2009; Halmagyi & Curthoys, 1999; Zwergal, Rettinger, Frenzel, Dieterich, & Strupp, 2009). Using the intraclass correlation coefficient, test–retest reliability of the Virtual system was excellent in the 45° left position and fair to good in the 45° right and 0° position. Test–retest reliability of the bucket test was poor in all head positions.

Conclusions The Virtual system is a more reliable measure of static SVV than the bucket test. Therefore, the Virtual system could be utilized as a screening device for utricular dysfunction in busy clinical settings.

Acknowledgments
This research was funded in part by a grant from Interacoustics, awarded to Vanderbilt University Division of Hearing and Speech Sciences.
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