A Head Shake Sensory Organization Test to Improve the Sensitivity of the Sensory Organization Test in the Elderly

Context: Current tools for sideline assessment of balance following a concussion may not be sufficiently sensitive to identify impairments, which may place athletes at risk for future injury. Quantitative field-expedient balance assessments are becoming increasingly accessible in sports medicine and may improve sensitivity to enable clinicians to more readily detect these subtle deficits. Objective: To determine the validity of the postural sway assessment on the Biodex BioSway™ compared with the gold standard NeuroCom Smart Equitest System. Design: Cross-sectional cohort study. Setting: Clinical research laboratory. Participants: Forty-nine healthy adults (29 females: 24.34 [2.45] y, height 163.65 [7.57] cm, mass 63.64 [7.94] kg; 20 males: 26.00 [3.70] y, height 180.11 [7.16] cm, mass 82.97 [12.78] kg). Intervention(s): The participants completed the modified clinical test of sensory interaction in balance on the Biodex BioSway™ with 2 additional conditions (head shake and firm surface; head shake and foam surface) and the Sensory Organization Test and Head Shake Sensory Organization Test on the NeuroCom Smart Equitest. Main Outcome Measures: Interclass correlation coefficient and Bland–Altman limits of agreement for Sway Index, equilibrium ratio, and area of 95% confidence ellipse. Results: Fair–good reliability (interclass correlation coefficient = .48–.65) was demonstrated for the stance conditions with eyes open on a firm surface. The Head Shake Sensory Interaction and Balance Test condition on a firm surface resulted in fair reliability (interclass correlation coefficient = .50–.59). The authors observed large ranges for limits of agreement across outcome measures, indicating that the systems should not be used interchangeably. Conclusions: The authors observed fair reliability between BioSway™ and NeuroCom, with better agreement between systems with the assessment of postural sway on firm/static surfaces. However, the agreement of these systems may improve by incorporating methods that mitigate the floor effect in an athletic population (eg, including a head shake condition). BioSway™ may provide a surrogate field-expedient measurement tool.

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The Test- Retest Reliability and Minimal Detectable Change of the Sensory Organization Test and Head- Shake Sensory Organization Test

Journal of Sports Medicine and Allied Health Sciences Official Journal of the Ohio Athletic Trainers Association ◽

10.25035/jsmahs.02.02.02 ◽

2016 ◽

Vol 2 (2) ◽

Author(s):

Andrea Cripps ◽

Scott Livingston ◽

Brandon Desantis

Keyword(s):

Minimal Detectable Change ◽

Detectable Change ◽

Sensory Organization Test ◽

Retest Reliability ◽

Sensory Organization ◽

Head Shake ◽

Test Retest Reliability

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Postural control among normal population of different age groups

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20164804 ◽

2016 ◽

Vol 3 (1) ◽

pp. 17

Author(s):

Naema Ismail ◽

Gehan S. Abd El-Salam ◽

Asmaa Fathi

Keyword(s):

Postural Control ◽

Age Groups ◽

The Elderly ◽

Sensory Organization Test ◽

Dynamic Posturography ◽

Limits Of Stability ◽

Sensory Organization ◽

Directional Control ◽

Significant Difference ◽

Weight Shift

Background: Postural control continues to change in later stages of life. Age-related changes may occur within or between sub-systems involved in postural control. It is thought clinically that these changes are important as they often result in falls & injury. The aim of the work was to compare the balance characteristics among different age groups using computerized dynamic posturography to provide clinicians with normal references. Methods: Inclusion criteria were study group consisted of (30) normal healthy individuals, age range 16-79 years, with neither hearing nor vestibular complaints. It was divided into 3 age groups, each group consisted of 10 patients. Group (A) young- 16-39 years, group (B) middle- 40-59 years and group (C) elderly- 60-79 years. Exclusion criteria were history of neuromuscular or neuroskeletal disease, symptoms of unsteadiness, dizziness or vertigo, symptoms of impaired sensory function, symptoms of arthritis or lower limb problem, symptoms of uncorrected visual problems, symptoms of postural hypotension or diabetes, medication intake such as sedatives, hypnotics, anxiolytics & antidepressants. All participants were subjected to full history taking, otologic examination, basic audiologic evaluation, computerized dynamic posturography which included sensory organization test, limits of stability and rhythmic weight shift. Results: Sensory organization test: The elderly group (C) had lowest equilibrium score with eyes open, closed & with conflicted visual cues on swayed surface (condition 6) and also this group have lowest percentage of SOT strategy. There was a statistically significant difference among A & C groups when using sensory organization test strategy in all conditions. Limits of stability test: The elderly group has higher overall reaction time. There was statistically significant difference in all conditions of limits of stability as regards directional control. Rhythmic weight shift right and left test: There was a statistically significant difference between groups A & C in low & medium speed on on-axis velocity & directional control. Rhythmic weight shift front & back test: There was no statistically significant difference between all groups as regards on-axis velocity. There was highly statistically significant difference between all groups in all trials as regards directional control.Conclusions: Postural instability occurs frequently in healthy elderly subjects. Sensory organization test is the most effective test to compare balance function among different age groups.

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A Comparison of Balance Performance of the Sensory Organization Test to the Head Shake Sensory Organization Test in Healthy Adults

Neurology ◽

10.1212/01.wnl.0000801764.85785.65 ◽

2021 ◽

Vol 98 (1 Supplement 1) ◽

pp. S3.3-S4

Author(s):

John Heick

Keyword(s):

Healthy Adults ◽

Head Movements ◽

Balance Performance ◽

Sensory Organization Test ◽

Dynamic Posturography ◽

Mean Values ◽

Sensory Organization ◽

Significant Difference ◽

Balance Deficits ◽

Head Shake

ObjectiveTo compare equilibrium scores between computerized dynamic posturography tests of the Sensory Organization Test (SOT) to the Head Shake-Sensory Organization Test (HS-SOT) in healthy adults.BackgroundApproximately 50% of the brain's pathways are related to vision and many of these pathways are susceptible to injury in concussion. Visual-motor disruptions occur in 65%–90% of concussed patients. These disruptions impair balance and can be measured. The SOT is a computerized postural test that evaluates balance by altering visual, proprioceptive, and vestibular cues. The HS-SOT modifies 2 of the standard SOT conditions by including dynamic head motions that stimulate the semicircular canals within the vestibular system.Design/MethodsParticipants completed the Dizziness Handicap Inventory, Activities of Balance Confidence Scale, SOT, and HS-SOT in one session.ResultsTwenty-five individuals (17 females, 8 males; mean age, 21.08 ± 4.10 years, range, 18–33 years) completed outcome measures and 3 trials of testing. There was a significant difference in mean values between the SOT and the HS-SOT for both condition 2 (t(16) = 3.034, p = 0.008) and 5 (t(16) = 5.706, p < 0.001). Additionally, there was a significant difference in mean values between the SOT and the foam HS-SOT for condition 2 (t(16) = 4.673, p < 0.001) and condition 5 (t(16) = 7.263, p < 0.001). There was not a significant difference in means between the foam and without foam for HS-SOT for condition 2 (t(16) = 1.77, p = 0.095) and condition 5 (t(16) = 1.825, p = 0.087).ConclusionsThe HS-SOT may quantify subtle balance deficits and enhance the clinical standard use of the SOT. Unlike the SOT where the head is static, the HS-SOT requires head movements, as if saying no repeatedly at approximately 100°/second as measured by an accelerometer. The HS-SOT may quantify subtle balance deficits and enhance the clinical standard use of the SOT.

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Modified head shake sensory organization test: Sensitivity and specificity

Gait & Posture ◽

10.1016/j.gaitpost.2016.06.024 ◽

2016 ◽

Vol 49 ◽

pp. 67-72 ◽

Cited By ~ 6

Author(s):

Julie A. Honaker ◽

Kristen L. Janky ◽

Jessie N. Patterson ◽

Neil T. Shepard

Keyword(s):

Sensitivity And Specificity ◽

Sensory Organization Test ◽

Test Sensitivity ◽

Sensory Organization ◽

Head Shake

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EquiTest modification with shank and hip angle measurements: differences with age among normal subjects

Journal of Vestibular Research ◽

10.3233/ves-1999-9605 ◽

1999 ◽

Vol 9 (6) ◽

pp. 435-444

Author(s):

Rosemary A. Speers ◽

Neil T. Shepard ◽

Arthur D. Kuo

Keyword(s):

Age Groups ◽

Phase Relationship ◽

Normal Subjects ◽

Body Sway ◽

Feedback Signal ◽

Proprioceptive Information ◽

Sensory Organization Test ◽

Test Protocol ◽

Ankle Motion ◽

Sensory Organization

The Sensory Organization Test protocol of the EquiTest system (NeuroCom International, Clackamas Oregon) tests utilization of visual, vestibular, and proprioceptive sensors by manipulating the accuracy of visual and/or somatosensory inputs during quiet stance. In the standard Sensory Organization Test, both manipulation of sensory input (sway-referencing) and assessment of postural sway are based on ground reaction forces measured from a forceplate. The purpose of our investigation was to examine the use of kinematic measurements to provide a more direct feedback signal for sway-referencing and for assessment of sway. We compared three methods of sway-referencing: the standard EquiTest method based on ground reaction torque, kinematic feedback based on servo-controlling to shank motion, and a more complex kinematic feedback based on servo-controlling to follow position of the center of mass (COM) as calculated from a two-link biomechanical model. Fifty-one normal subjects (ages 20–79) performed the randomized protocol. When using either shank or COM angle for sway-referencing feedback as compared to the standard EquiTest protocol, the Equilibrium Quotient and Strategy Score assessments were decreased for all age groups in the platform sway-referenced conditions (SOT 4, 5, 6). For all groups of subjects, there were significant differences in one or more of the kinematic sway measures of shank, hip, or COM angle when using either of the alternative sway-referencing parameters as compared to the standard EquiTest protocol. The increased sensitivities arising from use of kinematics had the effect of amplifying differences with age. For sway-referencing, the direct kinematic feedback may enhance ability to reduce proprioceptive information by servo-controlling more closely to actual ankle motion. For assessment, kinematics measurements can potentially increase sensitivity for detection of balance disorders, because it may be possible to discriminate between body sway and acceleration and to determine the phase relationship between ankle and hip motion.

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