Usefulness of some current balance tests for identifying individuals with disequilibrium due to vestibular impairments.

The goal of this study was to determine which of several clinical balance tests best identifies patients with vestibular disorders. We compared the scores of normals and patients on the Berg Balance Scale (Berg), Dynamic Gait Index (DGI), Timed Up and Go (TUG), Computerized Dynamic Posturography Sensory Organization Test (SOT), and a new obstacle avoidance test: the Functional Mobility Test (FMT). The study was performed in an out-patient balance laboratory at a tertiary care center. Subjects were 40 normal adults, and 40 adults with vestibular impairments. The main outcome measures were the sensitivity of tests to patients and specificity to normals. When adjusted for age the Berg, TUG, DGI and FMT had moderate sensitivity and specificity. SOT had moderately high sensitivity and specificity. SOT and FMT, combined, had high sensitivity and moderate specificity. Therefore, the kinds of tests of standing and walking balance that clinicians may use to screen patients for falling are not as good for screening for vestibular disorders as SOT. SOT combined with FMT is better. When screening patients for vestibular disorders, when objective diagnostic tests of the vestibular system, itself, are unavailable, tests of both standing and walking balance, together, give the most information about community-dwelling patients. These tests may also indicate the presence of sub-clinical balance problems in community-dwelling, asymptomatic adults.