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Informal Tests of the Systems Involved in Balance

Informal tests involving target movements, saccades, head rotation, and otoscopy to assess balance and gaze stability. Includes maneuvers like Halmagyi Head Thrust and Post-Rotary Nyst to check for vestibular function. Postural control evaluated with Romberg and Fukuda tests. Comprehensive evaluation of balance and ocular range of motion.

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Informal Tests of the Systems Involved in Balance

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  1. Informal Tests of the Systems Involved in Balance

  2. Ocular Range of Motion/Gaze Stability • Move a target (18” from nose)35-40 degrees Left and Right.30-35 degrees Up and Down.25-30 degrees DiagonallyPausing 15-20 second • Volitional Saccades

  3. Frenzel lens exam: (no target)

  4. Monocular Eye Cover • looking for vertical adjustment

  5. Passive Head Rotation • screening for bilateral weakness.

  6. Halmagyi Head Thrust • rapid isolated unidirectional screening for low VOR gain on side turning towards.

  7. Head Shake • “No” movement vigorously for 15-20 secs then examine with Frenzel lenses. Nyst usually away from lesion side.

  8. Pneumatic Otoscopy • Looking for Hennebert’s sign.

  9. Post-Rotary Nyst • in swivel chair

  10. Hallpike maneuver

  11. VSR/Postural Control • Past-Pointing – arms out pointing with index fingers to examiners hands, then up and back to examiner’s hands 2 to 3 times w/ eyes open and several times with eyes closed. Both arms move toward weaker ear.

  12. Romberg • -- eyes closed, feet together. • Tandem (Sharpened) Romberg – eyes closed heel to toe.

  13. Modified CTSIB • eyes open firm surface • eyes closed firm surface • eyes open compressible surface • eyes closed compressible surface

  14. Fukuda • 50 steps in place with eyes closed. Rotate toward weaker labyrinth.

  15. Casual Gait • walking 15 feet, with eyes open. • With and without head turns.

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