Vestibular Outcome Measures Flashcards
Stand with feet together, arms crossed
Start eyes open -> eyes closed
30-60 sec normal
Observe sway and balance reactions
Romberg test
Stand with feet in line, arms crossed
Start eyes open -> closed
30 sec normal
Observe sway and balance reactions
Sharpened Romberg/Tandem stand
Stand on 1 foot
Start eyes open -> eyes closed
Observe and document balance quality
Single leg stand
Age 20-49: 28.8 open, 20.7 closed
Age 50-59: 24.2 open, 6.1 closed
Age 60-60: 27.1 open, 2.1 closed
Age 70-79: 18.2 open, 1.0 closed
Norms for single leg stand
Quantifies postural control under various sensory conditions
4 stages: firm and foam surface, eyes open and closed (double leg stand)
Goal = 30 second each, document time to LOB
Modified clinical test of sensory integration for balance (mCTSIB)
Test of dynamic balance and coordination (ability to step over objects forward, laterally, backward)
Pt asked to step as fast as possible into each square 2->3->4->1->4->3->2->1
Cutoff for vestibular impairment >12 sec =risk of falls
4-square step test
Assess ability to modify balance while walking in response to external demands, 8 components max score =24
<19/24 =predictive of fall risk in community dwelling elderly
MCID: 2 points
Dynamic gait index
-Gait on level surface
-Changes in gait speed
-Gait with horizontal head turns
-Gait with vertical head turns
-Gait and pivot turn
-Step over obstacle
-Step around obstacle
-Stair ascend/descend
Components to dynamic gait index
Assess ability to modify balance while walking in response to external demands, 10 components max score 30
MCID 2-4 points
< 22/30=predictive of fall risk in community dwelling elderly
Functional gait assessment
Improved reliability, reduced ceiling effect, removed ambulation around objects, added tandem gait, ambulation backwards, gait with eyes closed
Benefits to functional gait assessment compared to dynamic gait index
-Gait on level surface
-Changed in gait speed
-Gait with horizontal head turns
-Gait with vertical head turns
-Gait and pivot turn
-Step over obstacle
-Gait with narrow BOS (tandem)
-Gait with eyes closed
-Ambulating backwards
-Stair ascent/descent
Components to functional gait assessment
14 item measure of static/dynamic balance and fall risk
Max score = 56
< 46 = increased fall risk
< 40 = almost 100% fall risk
Berg balance scale
Assess gait speed
2m acceleration, 6m testing, 2m deceleration (6m timed)
Timed 10 meter walk test
Assess mobility, balance, and fall risk in older adults
Patient stands from chair, walks 10 feet, returns to sitting
>13.5 = fall risk for community dwelling adults
> 11.1 = fall risk for vestibular disorders**
Timed up and go (TUG)
Assess functional LE strength, transfers ability, dynamic balance
> 10 sec =fall risk for younger adults
>14.2 sec=fall risk for older adults >60 y/o
MCID: 2.3 sec in vestibular population
5-times sit to stand
Measures motion-provoked dizziness during head/body movements
0-10% =mild motion sensitivity
11-30% =moderate motion sensitivity
31-100% =severe motion sensitivity
Note: exam results can drive habituation tx
Good for vestibular migraine and Menier’s pts, also useful for vestibular neuritis
Modified-motion sensitivity quotient
25 item self assessment to evaluate self-perceived handicapping effect of dizziness
0-30 =mild impairment
31-60 =moderate impairment
61-100 =severe impairment
MCID: 17-18 points for vestibular population
Good for BPPV diagnosis
Dizziness handicap inventory
Self-report measure of balance confidence in performing various activities
<67% =indicates fall risk
Activity-specific balance confidence scale
