Diagnoses Benign Paroxysmal Positional Vertigo (BPPV) of the anterior semicircular canals.
1
Less than 5 minutes
Child
6 - 12
yearsAdolescent
13 - 17
yearsAdult
18 - 64
yearsElderly Adult
65 +
yearsKaren Lambert, PT, MPT, NCS and Linda B. Horn PT, DScPT, MHS, NCS of the Vestibular EDGE task force for the Neurology section of the APTA in 2013.
The parameters for this test are not defined in the literature.
Cambi et al. (2013) evaluated 50 patients with positional downbeating nystagmus of peripheral origin using bilateral Dix-Hallpike (D-H) and Supine Head Hanging Tests (SHHPT):
In 10% of patients (5 of 50) a downbeating nystagmus was detected with the SHHPT and not with the D-H .
Include the SHHPT in patients with history of BPPV in which the evaluator has failed to elicit nystagmus in either D-H or Roll Test.
SHHPT should be administered at the beginning of vestibular battery in order to alert to the presence of multiple canal involvement.
Patients who are positive using the supine head hanging test tended were more likely to have multiple canal involvement, identifying that the anterior canal is affected at the beginning of the battery of vestibular tests may assist clinicians to determine if there are multiple canals affected and will allow for more accurate predictions of how long the patient's BPPV will need to be treated (Yetiser & Ince, 2014)
Be aware of patient history including history of trauma, use of ototoxic medications, and use of vestibular suppressants as this may affect the results of this assessment (Swan & Yorke, 2013)
Non-Specific Patient Population: (Akin & Davenport, 2003; N = 25; n = 15, patients with motion-provoked dizziness during routine daily living movements, mean age = 65 years; n = 10, patients with no complaints of motion-provoked dizziness during routine daily living movements, mean age = 66 years)
Excellent test-retest reliability for monitoring movement induced dizziness in patient for 90 minutes (ICC = 0.98)
Excellent test-retest reliability for monitoring movement induced dizziness in patient for 24 hours (ICC = 0.96)
Non-Specific Patient Population: (Akin & Davenport, 2003)
Trauma Patients: (Yetiser & Ince, 2014; N = 190 patients with BPPV symptoms; n = 12 with positional up-beating vertical nystagmus selected)
Non-Specific Patient Population: (Akin & Davenport, 2003)
Convergent Validity
SHHP is very similar to other measurements commonly used to diagnose anterior canal BPPV
The Motion Sensitivity Test begins with the long sit to supine with head hanging movement of the SHHP
The Yacovino maneuver uses long sit to supine movement with head hanging movement, the client's neck is then flexed 30 degrees and eyes observed
Neurologic Population: (Anagnostou, Varaki, & Anastasopoulous, 2008; case study; female, aged 55; demyelinating brain lesion)
Downbeating nystagmus looked for during the SHHPT may occur in brainstem or cerebellar lesions.
Neurologic Population: (Imai et al., 2008)
Akin, F., Davenport, M., (2003). "Validity and reliability of the Motion Sensitivity Test" Journal of Rehabilitation Research & Development, 40(5): 415-422. Find it on PubMed
Anagnostou, E., Kouzi, I., & Spengos, K. (2015). Diagnosis and treatment of anterior canal benign paroxysmal positional vertigo: A systematic review. Journal of Clinical Neurology (Seoul, Korea), 11(3), 262–267. Find it on PubMed
Anagnostou E, Varaki K, & Anastasopoulos D. (2008). A minute demyelinating lesion causing acute positional vertigo. Journal of Neurological Science;266:187–189. Find it on PubMed
Califano L, Salafia F, Mazzone S, Melillo MG, Califano M. (2014). Anterior canal BPPV and apogeotropic posterior canal BPPV: Two rare forms of vertical canalolithiasis. Acta Otorhinolaryngol Ital, 34: 189–197. Find it on PubMed
Cambi, J., Astore, S., et al. (2013). "Natural course of positional down-beating nystagmus of peripheral origin." J Neurol 260(6): 1489-1496. Find it on PubMed
Dix, M. and Hallpike, C. (1952). "The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system." Proceedings of the Royal Society of Medicine 45(6): 341.
Imai T, Takeda N, Sato G, Sekine K, Ito M, Nakamea K et al. Differential diagnosis of true and pseudo-bilateral benign positional nystagmus. Acta Otolaryngol 2008;128:151–8.
Swan, L., Yorke, A. (2013) 'An introduction to vestibular rehabilitation.' Great Lakes Seminars.
Yetiser, S., Ince, D. (2014) ‘Vertical nystagmus during the seated–supine positional (straight head-hanging) test in patients with benign paroxysmal positional vertigo’, The Journal of Laryngology & Otology, 128(8), pp. 674–678.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.