New analyses of the sensory organization test compared to the clinical test of sensory integration and balance in patients with benign paroxysmal positional vertigo

Abstract

Objectives/hypothesis: To determine whether the Sensory Organization Test (SOT) of the computerized dynamic posturography battery or the Clinical Test of Sensory Integration and Balance (CTSIB) is more likely to indicate balance disorders in people with benign paroxysmal positional vertigo (BPPV).

Study design: Normal controls were compared to patients with unilateral BPPV of the posterior semicircular canal.

Methods: Subjects performed tests with eyes open or closed on stable and unstable surfaces, with head still or with head moving at 0.33 Hz in pitch or yaw. Dependent variables were the percent time of the standard duration each subject could perform the task, the number of head motions made, and kinematic variables measured with head- and torso-mounted inertial motion units.

Results: Because equilibrium scores of control subjects improved significantly over repeated trials on SOT, patients were given only one trial per condition. For percent time between-group differences were found on CTSIB with eyes closed, on foam, head moving in yaw showing significantly reduced performance by BPPV subjects compared to controls. Compared to controls, patients made significantly fewer head movements on CTSIB, eyes closed, on foam, head still, in pitch and yaw. Kinematic data also differed between the groups on tests with eyes closed and unstable surfaces with different head movement combinations, indicating increased instability in BPPV patients.

Conclusions: For screening, CTSIB with head movements is more likely than SOT to indicate balance deficits, especially when dependent measures include percent time as well as head movement counts and kinematic measures.

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