What is Involved in a Vestibular Assessment: Common Vestibular Tests
By Cheryl Wylie, MSc (PT)
Vestibular tests are diagnostic evaluations that assess the
function of the vestibular system, which contributes to balance and spatial
orientation. These tests discussed below are tests done in a vestibular
physiotherapy assessment both in clinic and as well as virtually.
Procedure: The patient is quickly moved from a sitting to a
lying position with the head turned to the side and tilted backward, causing
dizziness and nystagmus (involuntary eye movement). If this test is positive,
it will make the patient feel dizzy or experience vertigo lasting 10-20 seconds
typically. During this time your practitioner will observe your eyes for
nystagmus.
Dynamic Visual Acuity
Purpose: Used to assess the vestibulo-ocular reflex, which is
the patients ability to stabilize gaze
Procedure: The patient is asked to read an eye chart with
their head still and then again with their head moving. The examiner is looking for the difference between the two scenarios as well as symptom provocation.
Head Impulse Test*
Purpose: used to assess the function of the vestibulo-ocular
reflex (VOR), which helps stabilize gaze and maintain visual focus during head
movements.
Procedure: The examiner delivers rapid, unpredictable, and
brief horizontal head movements to either side, typically rotating the
patient's head about the vertical axis. The examiner observes the patient's eye
movements for any corrective saccades (rapid, involuntary eye movements) that
may occur.
*This test is not done virtually
Clinical Test of Sensory Interaction in Balance (CTSIB)
Purpose: Assesses how different sensory inputs (visual,
vestibular, and somatosensory) affect balance.
Procedure: Patients perform balance tasks under various
sensory conditions, such as eyes open or closed, on a stable or unstable
surface, holding your head in a certain positions, moving your head, or holding
weights. This is done both statically (standing still) and dynamically (e.g.
walking, banding, turning)
Motion Sensitivity Testing
There are two forms of motion sensitivity: visual motion sensitivity and vestibular motion sensitivity.
Visual motion sensitivity refers to
an enhanced sensitivity or heightened response to visual stimuli, such as
movement in the environment, scrolling text, flashing lights, or rapid changes
in visual scenes.
Vestibular motion sensitivity refers to increased sensitivity
to movement. This can occur with changes in head or body positions, being in a
moving vehicle, and walking.
Each of these motion sensitivities are tested differently.
Visual Motion Sensitivity Testing
Purpose: Evaluates how visual stimuli, such as moving
patterns or scrolling text, affect an individual's symptoms.
Procedure: The patient may be asked to view moving visual
stimuli on a screen or perform specific tasks while exposed to visual motion.
The examiner observes and assesses the patient's response, including the onset
of symptoms.
Vestibular Motion Sensitivity Testing
Purpose: Assesses the impact of head and body movements on
symptoms.
Procedure: Patients may be instructed to perform various
head and body movements, such as turning the head, bending forward, or standing
up from a seated position. The examiner observes for any motion-induced
symptoms.
These tests, along with the subjective interview, aim to
assess and address the specific impairments and symptoms associated with
vestibular disorders. Vestibular physiotherapists, such as those at Healing
Vertigo, will design an individualized treatment plan based on the results of these
assessments to improve the patient's overall function and reduce symptoms of
dizziness and imbalance. Contact us today to learn more about in-person or virtual vestibular physiotherapy testing and how vestibular rehabilitation can help you.
About the Author
Cheryl Wylie, is a vestibular physiotherapist and owner of Healing Vertigo. She is also the creator of our Vertigo Treatment App, and instructs vestibular courses to other healthcare professionals.
She offers vestibular therapy for all Ontario Residents. If you're interested in working with Cheryl, connect below!
Disclaimer: This advice is not meant to be a substitute for advice from a medical professional regarding diagnosis, prognosis, or treatment. Always seek advice from your physician, physiotherapist, or other qualified healthcare provider with questions you may have regarding a healthcare condition. The information of this website and email, including but not limiting to text, graphics, videos, images, and other materials are for informational purposes only. Reliance on the information on this website and email is soley at your own risk.