The Head Shake Sensory Organization Test And Screening Individuals With Self-reported History Of Concussion

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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The Influence of Caffeine on the Sensory Organization Test

Journal of the American Academy of Audiology ◽

10.3766/jaaa.25.6.2 ◽

2014 ◽

Vol 25 (06) ◽

pp. 521-528 ◽

Cited By ~ 4

Author(s):

Kathleen M. McNerney ◽

Mary Lou Coad ◽

Robert F. Burkard

Keyword(s):

Statistical Significance ◽

Group Versus ◽

Composite Score ◽

Caffeine Intake ◽

Sensory Organization Test ◽

Eyes Closed ◽

Sensory Organization ◽

Somatosensory Information ◽

Significant Difference ◽

History Of

Background: Clinicians often request that patients refrain from consuming caffeinated beverages 24 h before vestibular function testing. However, there is limited research regarding how caffeine may affect the results of these tests. The sensory organization test (SOT) evaluates how well an individual is able to maintain his or her balance during several different conditions that manipulate vestibular, visual, or somatosensory information. Purpose: This study evaluated whether caffeine consumption affects the results of the SOT in a group of healthy young adults. Research Design: Individuals were evaluated under two conditions: (1) after consuming ˜300 mg of caffeine before testing, and (2) without consuming a caffeinated beverage for 24 h before testing. Regular caffeine intake and caffeine withdrawal symptoms were assessed in these individuals. Participants were stratified into a no/low or a moderate/high caffeine intake group through the use of a self-reported 1-week caffeine diary. Study Sample: Thirty healthy control participants (mean age = 23.28 yr; males = 9) without any history of vestibular or balance impairment participated in the present study. Data Collection/Analysis: The NeuroCom SMART Equitest was used to administer the SOT, whereas paired t-tests, completed with IBM SPSS Statistics 20, were used to analyze the data for statistical significance. Results: Analysis of the data revealed a statistically significant difference between the caffeine and no-caffeine sessions during (1) condition 5 (C5): eyes closed, platform sway-referenced; and (2) the total composite score. Statistically significant differences were also noted for the vestibular and somatosensory preference ratios. In general, the participants performed better (i.e., higher equilibrium/composite scores) during the caffeine session. When significant results were found, the participants were stratified by weekly caffeine intake into a no/low caffeine (LC) intake group versus a moderate/high caffeine (HC) intake group. After this stratification, a statistically significant difference remained for C5, the composite score, and the somatosensory/vestibular preference ratios for the LC intake group, whereas no statistically significant results were found in the HC intake group. In addition, further analysis revealed less of a change in the equilibrium score as the amount of weekly caffeine intake increased. Despite these significant results, the mean differences were small in magnitude, and C5, the composite score, as well as the sensory analysis ratios, fell within normal limits for all participants during both sessions. Conclusions: The ingestion of caffeine did not produce a clinically significant effect in healthy young control participants. Future research is needed to determine if these same results occur in older adults, or in individuals with a history of vestibular impairment.

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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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