Roll Test

Instrument Reviewers

Linda B. Horn, PT, DScPT, MHS, NCS, Karen H. Lambert, PT, MPT, NCS, and the Vestibular EDGE Task Force of the Neurology Section of the APTA (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

Variations to test procedure: 

• 30⁰ neck flexion (Fife, 1998) 
• Patient supine, amount of neck flexion omitted (Baloh, 1993; Fife, 1998) 
• 180-degree supine roll test (Lim, 2013) 
  • Starting from the end position of the Roll Test, the head is rotated 180⁰ to the opposite side 
  • Electronystagmography and a video eye movement recorder were used to measure SPV (slow phase velocity) and determine which was the affected side
  • No statistically significant difference was noted between the Roll Test and the 180-degree Supine Roll Test in the rate of positive findings. 
  • Success rate for determining the affected side when using the Roll Test, 180-degree Supine Roll Test and the Bow and Lean Test was 84.4% (91% for geotropic and 76.3% for apogeotropic)

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Bibliography

Baloh, R. W., Jacobson, K., et al. (1993). "Horizontal semicircular canal variant of benign positional vertigo." Neurology 43(12): 2542-2549. Find it on PubMed

Fife, T. D. (1998). "Recognition and management of horizontal canal benign positional vertigo." Am J Otol 19(3): 345-351. Find it on PubMed

Herdman, S. J. (1990). "Treatment of benign paroxysmal positional vertigo." Phys Ther 70(6): 381-388. Find it on PubMed  

Lim, H. J., Park, K., et al. (2013). "The significance of 180-degree head rotation in supine roll test for horizontal canal benign paroxysmal positional vertigo." Otol Neurotol 34(4): 736-742. Find it on PubMed