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Vestibular Testing Methods for Balance Disorders Evaluation

Explore various vestibular testing methods including autorotation, rotary chair, passive and active rotation, head shake, dynamic visual acuity test, and measures such as gain, phase, symmetry, and time constant. These tests help diagnose balance disorders effectively.

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Vestibular Testing Methods for Balance Disorders Evaluation

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  1. Rotary Testing Vestibular Autorotation Test & Rotary Chair Testing

  2. Passive and Active Rotation • Passive– pt is moved (head or whole body) by examiner. • Halmagyi Head Thrust • Rotary Chair tests • Active—pt is asked to turn their own head. • Head Shake • VAT

  3. Passive Tests • Sinusoidal Acceleration Test: • Oscillating (left-right) in rotary chair • Freqs from 0.01 to 0.64 Hz • Peak angular velocities 50° per sec • Velocity Step Tests: • Sudden Accelerations (to left or right) • Of 100° per sec for 1 second • Responses recorded for following minute, or so.

  4. Vestibular Autorotation Test (VAT) • “no” & “yes” gestures in time with metronome • Frequencies from 0.5 to 6 Hz over 18 seconds • While pt. fixates visually • Head motion recorded by accelerometer • Eye motion recorded via video or electrodes

  5. Head Shaking Test • Pt shakes head for 20 seconds • With Frenzel lenses in dark room • Look for post-shaking nystagmus

  6. Measures from Rotational Tests • Gain: Ratio of eye velocity to head velocity • Phase: (in SAT/VAT) lag between head and eye movements (away from 180°) • Symmetry: Ratio of rightward to leftward eye velocity. • Time Constant: (in Vel. Step) time taken for eye velocity to decline to 37% of peak value.

  7. VAT Gain and Phase Measures

  8. Dynamic Visual Acuity Test • Visual Acuity—discrimination of shapes of different sizes • during active head movement. • Packaged systems / Snellen Chart

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