Fukuda Stepping Test (Unterberger Step Test)

Healthy Controls:

(Bonanni and Newton, 1998; n = 30, aged 24-56 years, mean age 32.8 ± 8.4 years, tested 2 days apart)

• Angle of rotation SEM = 26° (50 steps); 69° (100 steps)
• Angle of displacement SEM = 18° (50 steps); 35° (100 steps)
• Distance of displacement SEM = 24 cm (50 steps); 54 cm (100 steps)

Healthy Controls:

(Calculated based on SEM from Bonanni and Newton 1998)

• Angle of rotation MDC (95%) = 14.1° (50 steps) and 23° (100 steps)
• Angle of displacement MDC (95%) = 11.8° (50 steps) and 16.4° (100 steps)
• Distance of displacement MDC (95%) = 13.6 cm (50 steps) and 20.4 cm (100 steps)

Fukuda, 1959, 500 normal subjects, rotation > 30° or displacement of 0.5 meter (50 steps) and rotation > 45° or displacement of > 1.0 meter (100 steps) indicates asymmetrical labyrinthine function Honaker et al, 2009 736 patients with chronic dizziness, 213 with unilateral caloric weakness. Used cut-off of rotation of 45° for a sensitivity of 0.43, specificity of 0.65° and a likelihood ratio of 1.24.

Healthy Volunteers

(Nyabenda et al 2004, 120 healthy volunteers aged 20-79 years (no known balance or orthopedic disorders))

Healthy Controls:

(Bonanni and Newton 1998; n = 30, aged 24-56 years, mean age 32.8 ± 8.4 years, tested 2 days apart)

• Angle of rotation ICC = 0.66 (50 steps); 0.52 (100 steps)
• Angle of displacement ICC = 0.66 (50 steps); 0.45 (100 steps)
• Distance of displacement ICC = 0.69 (50 steps); 0.47 (100 steps)

Honaker et al 2009, retrospective chart review: 736 charts of patients with chronic dizziness, 213 with caloric weakness, age 15-89 years; FST independent of turn direction yielded an area under the curve of 0.54, with a cut score of 45° found sensitivity of 0.43, specificity of 0.65 and a likelihood ratio of 1.24, retrospective chart review of 736 patients with chronic dizziness, all able to perform Romberg. 533 without caloric weakness, 147 with mild caloric weakness (25-50%); 44 with moderate caloric weakness (50-75%) and 22 with severe caloric weakness (75-100%). For mild weakness FST independent of turn direction revealed an area with under the curve (AUC) of 0.47, for a cut score of 22.5 sensitivity was 0.25, specificity was 0.76 with a likelihood ratio (LR) of 1.04; For moderate weakness FST independent of turn direction revealed an AUC of 0.52, for a cut score of 27.5° the sensitivity was 0.34, specificity 0.76 with an LR of 1.42; For severe weakness the FST independent of turn direction revealed an AUC of 0.53, using a cut score of 37.5° the sensitivity was 0.37 and specificity 0.79 with a LR of 1.76.

Zhang and Wang 2011 evaluated 126 patients with unilateral vestibular dysfunction (idiopathic sudden sensorineural hearing loss, temporal bone trauma, vestibular neuritis) 20-70 years, mean age 46.8 ± 13 years

Hickey et al 1990 evaluated 49 healthy control subjects (mean age 37 ± 12 years) and 26 patients with suspected peripheral vestibular dysfunction (mean age 50 ± 16 years) 16 of which had significant canal paresis. There was no significant difference between the 2 groups in angle of rotation, angle of displacement or distance traveled. No correlation was found between angle of rotation and amount of canal paresis. No significant differences in performance were found with increasing age.

Healthy Controls:

(Gordon et al, 1995) Subjects exhibited rotation in same direction relative to the direction of the treadmill after walking 2 hours on a circular treadmill suggesting that the somatosensory/locomotor stimulation caused more consistent and marked rotation in the stepping test than physiologic and pathologic vestibular stimuli.