Balance Laboratory Investigations (some of the methods we use to identify how severe is the balance problem and what balance systems are causing the symptoms.)

Test of Balance Capacity:

Computer Analysis of :

Image courtesy of Natus Medical Inc.

Dynamic Posturography:  Includes changes in stability with head movement at velocities of everyday life.

Dynamic Posturography Video

(Physiologic Velocity): Ability to maintain stability when what you stand on(support surface) or what you see moves.

Dynamic Visual Acuity
Image courtesy of: Natus Medical, Inc.

Dynamic Visual Acuity: Ability to see clearly when your head moves at physiologic velocities

Dynamic Visual Acuity Video

Postural Evoked Response:  Timing of muscle response to sudden shifts in support surface


Tests of specific balance system sensors:

Computer analysis of :

Stimulation of each semicircular canal: (anterior, posterior, lateral) at speeds that occur in everyday  life (physiologic velocities) (Physiologic Heat Thrust)
See Video

Utricular function:

Centrifuge: stimulation of each side’s utricle with measurement of visual vertical and eye torsion.

Ocular Vestibular Evoked Myogenic Potential: sound stimulus of each side’s utricle with measurement of eye muscle response.

Saccular Function: 

Cervical Vestibular Evoked Myogenic Potential: sound stimulus of each side’s saccule with measurement of neck muscle response.

See Video

Central(Brain) Function:

Rotary Chair:  Evaluation of phase of vestibular ocular reflex (VOR)and of time constant.

Balance Testing
Image courtesy of: Neuro Kinetics, Inc.

See Rotary Chair Video

VOR with fixation and with enhancement

Response of slow and fast phase of eye movement to optokinetic stimulus

See Video

Presence of Optokinetic After Nystagmus

Video Nystagmography:

Balance Analysis

Evaluation of cervical nystagmus

Transtympanic  electrocochleography

Evaluation of Volume status of endolymph and indirectly integrity of closure of inner ear fluids.

See Video