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. 2014 Feb;124(2):545-50.
doi: 10.1002/lary.24314. Epub 2013 Oct 2.

Standing balance tests for screening people with vestibular impairments

Helen S Cohen  1 , Ajitkumar P Mulavara, Brian T Peters, Haleh Sangi-Haghpeykar, Jacob J Bloomberg
Affiliations

Standing balance tests for screening people with vestibular impairments

Helen S Cohen et al. Laryngoscope. 2014 Feb.

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.

Keywords: Balance testing; Romberg; screening; vestibular testing.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1
Mean time scores of normal controls on head still and head pitch trials on foam with eyes closed across the age range in 5-year increments. Error bars are standard errors.
Figure 2
Figure 2
Time scores of controls and patient groups on foam with eyes closed. A. Head still condition. B. Head pitch condition. Center horizontal bars are medians; rectangle ends are interquartile ranges, error bars are 10th and 90th declines, and circles are outliers.
See this image and copyright information in PMC

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