Use of the head shake-sensory organization test as an outcome measure in the rehabilitation of an individual with head movement provoked symptoms of imbalance.

BACKGROUND AND PURPOSE: The purpose of this case report is to highlight the Head Shake (HS) Sensory Organization Test (SOT) (HS-SOT) as an outcome measure in the rehabilitation of a patient with head movement provoked symptoms of dysequilibrium. Despite complaints of imbalance and head movement provoked symptoms, there are individuals who are able to score within normal limits on measures such as the SOT and Berg Functional Balance Test. The HS modification to the SOT can objectively identify abnormal vestibular inputs associated with head motion and maintaining balance.

METHODS: This case report describes the examination, intervention, and outcomes for a 71-year old female with a history of imbalance and decreased ambulatory endurance. During examination, the patient presented with SOT scores within functional limits. The HS-SOT was then implemented to assess vestibular function during head motion in standing, with eyes closed. The intervention included balance retraining, dynamic gait activities, lower extremity strengthening, and instruction in a home exercise program.

RESULTS: Improvements were noted for all measures. Initially, during the HS-SOT, the patient fell during all 6 trials of the HS modification to condition 5 and her equilibrium score was 12.Posttreatment, she was able to maintain her balance in 5 out of 6 trials and her score increased to 55. The patient reported increased ambulatory endurance and independence with functional activities (ie, walking and turning her head, and stair negotiation without use of a railing).

CONCLUSIONS: The HS-SOT quantified the complaint of head movement provoked symptoms for this individual with dysequilibrium and was useful in measuring success of an intervention.