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IntroductionThe Computerized Dynamic Posturography (EquiTest) sensory organization test (SOT) is a useful test for the evaluation of patients with disequilibrium. However, studies of the sensitivity of SOT have reported its values to be as low as 50%. The head shake sensory organization test (HS-SOT) is an expansion of SOT to increase the sensitivity of SOT. The purpose of this investigation was to study the values of HS-SOTs in a healthy population with respect to age and compare the sensitivity of HS-SOT with SOT and dizziness handicap inventory(DHI) in detecting balance problems in vestibular neuritis(VN) patients.Materials & MethodsTo study the values of HS-SOT in a healthy population, one hundred and two (n=102) subjects were recruited from the community and volunteers at this medical center. After initial screening by history (i.e., to confirm or exclude no dizziness) and normal neuro-otologic evaluation including pure tone audiometry and Caloric tests, the study population was selected with an equal number of males and females included. To compare the sensitivity of HS-SOT with DHI, thirty-two(n=32) patients with uncompensated vestibular neuritis patient were enrolled in this study. Patients with acute symptoms of dizziness, orthopedic problems, or any other severe underlying conditions were excluded.

The balance tests were consisted of the SOT and HS-SOT. The Equitest Balance Master® (Neurocom international Inc., Portland) was used in this study. For HS-SOT, patients were instructed to shake their head only along the yaw (horizontal) axis. Horizontal rotatory head motion was performed through an arc of about 30° to both sides, with an auditory beep provided with the tracking system at 1 Hz with the neck flexed for about 30°. This procedure was performed for both SOT conditions 2 and 5. Each condition was measured 3 times and the average score calculated. Composite equilibrium scores and equilibrium score ratios for HS-SOT/SOT at each condition was acquired.

Vestibular neuritis patients were scheduled for re-evaluation at 1 week, 1 month, 2 months and 6 months after the first evaluation with SOT, HS-SOT, and DHI. All patients were allowed vestibular suppressants for the acute phase and underwent vestibular rehabilitation with an identical protocol as soon as possible.

ResultsConclusions1. The results from our study suggest that HS-SOT can increase the sensitivity of SOTs in the elderly.

2. The HS-SOT is a useful tool to evaluate vestibular neuritis patients in the compensation period. Ratio of HS-SOT condition 5 is more correlated than ratio of HS-SOT condition 2 with the DHI in the compensated period of patients with vestibular neuritis.