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Informal Tests of the Systems Involved in Balance. 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 Diagonally Pausing 15-20 second Volitional Saccades. Frenzel lens exam: (no target).
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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
Monocular Eye Cover • looking for vertical adjustment
Passive Head Rotation • screening for bilateral weakness.
Halmagyi Head Thrust • rapid isolated unidirectional screening for low VOR gain on side turning towards.
Head Shake • “No” movement vigorously for 15-20 secs then examine with Frenzel lenses. Nyst usually away from lesion side.
Pneumatic Otoscopy • Looking for Hennebert’s sign.
Post-Rotary Nyst • in swivel chair
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.
Romberg • -- eyes closed, feet together. • Tandem (Sharpened) Romberg – eyes closed heel to toe.
Modified CTSIB • eyes open firm surface • eyes closed firm surface • eyes open compressible surface • eyes closed compressible surface
Fukuda • 50 steps in place with eyes closed. Rotate toward weaker labyrinth.
Casual Gait • walking 15 feet, with eyes open. • With and without head turns.