Roma AA; Kauffman Gamber Physical Therapy, Lancaster, PA. alonteroma@peoplepc.com.

PURPOSE. The purpose of this case report is to highlight the Headshake Sensory Organization Test (HS-SOT) as an outcome measure in the rehabilitation intervention of a patient with head movement provoked symptoms of dysequilibrium. FOUNDATION. There are numerous objective tools which measure balance and postural control. Outcome measures for successful rehabilitation of individuals with balance problems are imperative for good care, documentation, and reimbursement issues. Common activities which can disrupt balance and equilibrium during stance and ambulation include crossing the street or turning around in a room. 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 Berg Functional Balance Test and Sensory Organization Testing (SOT). The head shaking modification to the SOT can objectively identify abnormal vestibular inputs associated with head motion and maintaining balance. DESCRIPTION. This case report describes an evaluation, treatment, and outcome measures including the use of the HS-SOT for an individual presenting with dysequilibrium. The individual was a 71 year old female with a two year history of imbalance and decreased ambulatory endurance. Her evaluation included: cervical active range of motion, lower extremity strength testing, gait assessment, the Berg Functional Balance Test, gaze stabilization, SOT and HS-SOT. Her treatment regimen included balance retraining, dynamic gait activities, lower extremity strengthening, and instruction in a home exercise program. During the last session, she was reassessed. OBSERVATIONS. Improvement was noted from pre-treatment to post-treatment scores. Berg scores improved from 45 to 55 out of 56 possible points. Initially, during the HS-SOT, she fell during all six trials of the head shaking modification to condition 5 (sway referenced surface with eyes closed) and her overall equilibrium composite score was 12. Post treatment, she was able to maintain her balance in 5 out of 6 trials with head shaking modification to condition 5. Her composite equilibrium score was then 55. The client reported increased ambulatory endurance and independence with functional activities i.e. walking and turning her head, and stair negotiation without use of a railing. She also reported feeling more comfortable walking outdoors and in open spaces. CONCLUSIONS. The HS-SOT quantified the complaint of head movement provoked symptoms for this individual with dysequilibrium. This case report implemented the HS-SOT, pre- and post- treatment, as an outcome measure for the success of an intervention. Further investigations utilizing the HS-SOT in clinical settings are needed. FUNDING SOURCE: None.

Copyright 2004 by the American Physical Therapy Association

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