Standing balance tests for screening people with vestibular impairments

Authors

  • Helen S. Cohen EdD,

    Corresponding author
    1. Bobby R. Alford Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, U.S.A
    • Send correspondence to Helen S. Cohen, EdD, Department of Otolaryngology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030. E-mail: hcohen@bcm.edu

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  • Ajitkumar P. Mulavara PhD,

    1. Universities Space Research Association, Houston, Texas, U.S.A
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  • Brian T. Peters PhD,

    1. Wyle Science, Technology and Engineering Group, Houston, Texas, U.S.A
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  • Haleh Sangi-Haghpeykar PhD,

    1. Bobby R. Alford Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, U.S.A
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  • Jacob J. Bloomberg PhD

    1. Neuroscience Research Laboratories, National Aeronautics and Space Administration/Johnson Space Center, Houston, Texas, U.S.A
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  • Preliminary analyses were presented as posters at the Association for Research in Otolaryngology MidWinter Meeting, Baltimore, Maryland, U.S.A., February 20, 2011, and the Society for Neuroscience Annual Meeting, Washington, District of Columbia, U.S.A., November 15, 2011.

  • Data were collected at the Bobby R. Alford Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine.

  • Supported by National Institutes of Health/National Institute on Deafness and Other Communication Disorders grant 1R01DC009031 to h.s.c. and by a grant from the National Space Biomedical Research Institute through National Aeronautics and Space Administration NCC 9-58 (SA02001) to a.p.m.

  • The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

To improve the test standards for a version of the Romberg test and to determine whether measuring kinematic variables improved its utility for screening.

Study Design

Healthy controls and patients with benign paroxysmal positional vertigo, postoperative acoustic neuroma resection, and chronic peripheral unilateral weakness were compared.

Methods

Subjects wore Bluetooth-enabled inertial motion units while standing on the floor or medium-density, compliant foam, with eyes open or closed, with head still or moving in pitch or yaw. Dependent measures were time to perform each test condition, number of head movements made, and kinematic variables.

Results

Patients and controls did not differ significantly with eyes open or with eyes closed while on the floor. With eyes closed, on foam, some significant differences were found between patients and controls, especially for subjects older than 59 years. Head movement conditions were more challenging than with the head still. Significantly fewer patients than controls could make enough head movements to obtain kinematic measures. Kinematics indicated that lateral balance control is significantly reduced in these patients compared to controls. Receiver operator characteristics and sensitivity/specificity analyses showed moderately good differences with older subjects.

Conclusions

Tests on foam with eyes closed, with head still or moving, may be useful as part of a screening battery for vestibular impairments, especially for older people.

Level of Evidence

3b Laryngoscope, 124:545–550, 2014

Ancillary