Screening and diagnostic tests can provide answers to balance problems

Screening Tests

Clinical Test of Sensory Integration of Balance (CTSIB)

The CTSIB is used as a screening test of balance, and it includes four conditions: 1) standing eyes open, 2) standing eyes closed, 3) standing eyes open, unstable surface, and 4) standing eyes closed, unstable surface.

Limits of Stability (LOS)

The LOS quantifies the maximum distance a person can intentionally displace their Center of Gravity (COG) (i.e., lean their body in a given direction without losing balance, stepping, or reaching for assistance).

Dynamic Visual Acuity (DVA)

The DVA test assesses impairments in a patient’s ability to perceive objects accurately while actively moving the head.

Gaze Stabilization Test (GST)

In contrast to the DVA that examines changes in visual acuity with fixed velocity head movements, the GST quantifies the head movement velocities over which the patient is able to maintain an acceptable level of visual acuity.

Diagnostic Tests

Computerized Dynamic Posturography (CDP)

CDP is a test of postural stability, and involves standing on a platform which is sensitive to body movements and changes in position. CDP tests the relationship among three key balance systems – the eyes, the somatosensory system (sense of touch), and the vestibular system (inner ear).

Rotational Chair Testing

Rotational chair testing is used to determine whether dizziness may be due to a disorder of the inner ear or brain. During the test, eye movements are measured while the patient is slowly turned in a motorized chair.

Videonystagmography (VNG)

The VNG test is also used to determine whether dizziness is caused by an inner ear (vestibular) disorder. The test typically consists of three parts:

• Oculomotor Evaluation – to assess targeted eye movements
• Positional Evaluation – to determine if position changes invoke symptoms
• Caloric Testing – to evaluate the inner ears separately

Vestibular Evoked Myogenic Potential (VEMP)

The VEMP is an electrophysiological test used to assess the lower portion of the balance nerve, as well as specialized structures within the vestibular system. The test involves the placement of electrodes on the head and neck. Patients are instructed to turn their head to the extreme right and left directions. A waveform is generated in response to muscle contractions and sound stimulation.

Electrocochleography (ECochG)

The electrocochleography test is an objective measure of the electrical potentials generated in the inner ear in response to sound. The EcochG is most often used to assess the pressure inside the inner ear. Excessive inner ear pressure can cause symptoms such as hearing loss, tinnitus, dizziness, and a sensation of force or weight within the ear.