Bow and Lean Test

Instrument Reviewers

Linda B. Horn, PT, DScPT, MHS, NCS, Karen H. Lambert, PT, MPT, NCS, and the Vestibular EDGE Task Force of the American Physical Therapy Association (2013).

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Recommendations for use based on acuity level of the patient:

Recommendations based on vestibular diagnosis

Recommendations for entry-level physical therapy education and use in research:

Considerations

Testing prior to performing Bow and Lean Test:

• Roll Test must be completed prior to performing the Bow and Lean Test to determine if BPPV is canalithiasis or cupulolithiasis
• Vascular – determine integrity of vertebral artery
• Orthopedic – determine stability of cervical spine

Determining when to use Bow and Lean Test:

If the Roll Test is positive, this test has good clinical utility to assist in determining side of involvement if the Roll Test is inconclusive .

This tool is not appropriate for differential diagnosis.

Efficacy as determined by remission rates

(Lee, 2010; n = 211; mean age = 50.7 (15.5) years)

• ·Remission rate (determined by negative Head Roll Test) for horizontal canalilithiasis was 83.1% in the Bow and Lean Test Group compared to 67.4% in the Head Roll Test Group (p = 0.041).

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Bibliography

Lee, J. B., Han, D. H., et al. (2010). "Efficacy of the “bow and lean test” for the management of horizontal canal benign paroxysmal positional vertigo." The Laryngoscope 120(11): 2339-2346.