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RehabMeasures Instrument

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Purpose

Assesses static standing balance. It was developed to screen for myelopathies and neuropathies with associated sensory dysfunction, yet has become used as a part of the suit of static balance tests.

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Instrument Details

Area of Assessment

Balance – Vestibular
Balance – Non-vestibular

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Vestibular Disorders

Key Descriptions

  • The client stands on the floor, preferably with shoes off, feet together.
  • They are asked to maintain the position with eyes open and then closed.
  • Clinically, it has been adapted to the maximum time (upper limit typically = 30 seconds) able to maintain the position with eyes open then retested with eyes closed.
  • Arm position is not standardized, yet is suggested that the clients cross their arms.

Number of Items

1

Equipment Required

  • Stopwatch

Time to Administer

2 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Elizabeth Dannenbaum MscPT for the Vestibular EDGE task force of the Neurology section of the APTA

ICF Domain

Body Function

Measurement Domain

Motor
Sensory

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

 

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

(Vestibular > 6 weeks post)

VEDGE

LS

LS

LS

 

Recommendations based on vestibular diagnosis

 

Peripheral

Central

Benign Paroxysmal Positional Vertigo (BPPV)

Other

VEDGE

LS

LS

LS

LS

  

 

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

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

VEDGE

Yes

Yes

No

Yes

Considerations

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Vestibular Disorders

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Normative Data

Romberg is often included in the suite of tests used to asses balance in the vestibular and non vestibular clientèle  (Gottshal 2011, Whitney S,  2007)

(Bohannon et al, 1984)

184 volunteers performed the Romberg test (eyes open and closed): All were able to maintain balance for 30 sec.

(Gill-Body et al, 2000)

EYES CLOSED: Bilateral vestibular hypofunction (n = 18) Mean: 43.41/60 sec, SD 24.26, range 1.1-60.0 sec, Unilateral vestibular hypofunction (n = 34) Mean: 54.03, SD 12.57, range 17.8-60

Construct Validity

Romberg is often included in the suite of tests used to asses balance in the vestibular and non vestibular clientèle  (Gottshal 2011, Whitney S,  2007)

 

(Karapolat et al, 2010)

In people with unilateral vestibular hypofunction (= 33) there is no correlation between the Romberg test and the Activities-specific Balance Confidence scale (ABC)

Bibliography

Bohannon, R. W., Larkin, P. A., et al. (1984). "Decrease in timed balance test scores with aging." Physical Therapy 64(7): 1067-1070. 

Gill-Body, K. M., Beninato, M., et al. (2000). "Relationship among balance impairments, functional performance, and disability in people with peripheral vestibular hypofunction." Physical Therapy 80(8): 748-758. 

Gottshall, K. (2011). "Vestibular rehabilitation after mild traumatic brain injury with vestibular pathology." NeuroRehabilitation 29(2): 167-171. Find it on PubMed

Karapolat, H., Eyigor, S., et al. (2010). "Reliability, validity, and sensitivity to change of Turkish Activities-specific Balance Confidence Scale in patients with unilateral peripheral vestibular disease." International Journal of Rehabilitation Research 33(1): 12-18.