title: Automated Romberg testing in patients with benign paroxysmal positional vertigo and healthy subjects.
abstract: OBJECTIVE
  Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness. The underlying pathomechanism responsible for the recurrent vertigo attacks has been elucidated in detail and highly effective treatment strategies (liberation maneuvers) have been developed. However, many BPPV patients complain about problems of balance especially following liberation maneuvers.
  
  
  OBJECTIVE
  To objectively demonstrate differences in balance performance in BPPV patients compared to healthy subjects both prior and after BPPV liberation maneuvers.
  
  
  METHODS
  Seven patients with BPPV of the posterior semicircular canal and nine healthy subjects participated. To assess balance while standing, we analyzed the location and temporal stability of the center of pressure recorded by pressure-sensitive electronic soles during Romberg testing (on stable ground and on foam) and tandem stand. To assess regularity of gait, we analyzed the step frequency during walking of 50 m. All tests were performed prior and after liberation maneuvers in both groups.
  
  
  RESULTS
  Healthy subjects and patients differ significantly in their balance performance and use different stabilization strategies both prior and after liberation maneuvers. Both Romberg tests indicated poorer balance in BPPV patients (mean COP shifted towards toes), especially in posttreatment tests, while tandem stand appeared unaltered. We did not observe differences in escorted (by an experimenter) walking regularities between patients and healthy subjects and between pre- and post-maneuver testing.
  
  
  CONCLUSIONS
  Our findings confirm the typical clinical observation of a further posttreatment deterioration of already impaired postural performance in BPPV patients. While the etiology and the time course of this peculiar problem warrants further studies, the treating physician should be familiar with this transient side effect of therapeutic maneuvers to provide adequate counseling of patients. Finally, we successully demonstrated the pressure-sensitive electronic soles as a new and potentially useful tool for both clinical and research purposes.
authors.forename: Rolf
authors.initials: R
authors.lastname: Adelsberger
authors.forename: Yulia
authors.initials: Y
authors.lastname: Valko
authors.forename: Dominik
authors.initials: D
authors.lastname: Straumann
authors.forename: Gerhard
authors.initials: G
authors.lastname: Tröster
mesh_terms: D000328:Adult; D000465:Algorithms; D001185:Artificial Intelligence; D065635:Benign Paroxysmal Positional Vertigo / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014724:Vestibular Function Tests / Q000295:instrumentation* / Q000379:methods*