Enhancement of posturography testing with head tilt and energy measurements.

We have attempted to increase the sensitivity of dynamic posturography testing by adding head extension and sway energy measurement to the standard Equitest protocol. Both procedures were applied to 121 patients and to 89 normal subjects. A portion of the standard protocol was repeated with the patient's head extended 55 degrees. Head extension significantly increases the number of "falls" or losses of balance experienced by normal subjects 50 years or older. Using the formula, Energy = Force x Distance, and appropriate corrections for platform tilt and body weight, any previously recorded test can be analyzed with computer programming to give energy values in joules per kilogram. Adding the two criteria of head extension and sway energy to the standard protocol increased the percentage of patients classified as abnormal from 48 to 68 percent. The two added criteria are useful in separating symptomatic from asymptomatic subjects and patients.