title: Bedside examination for vestibular screening in occupational medicine.
abstract: OBJECTIVE
  The aim of the study was to assess the usefulness of bedside examination for screening of vestibular and balance system for occupational medicine purposes. Study group comprised 165 patients referred to Audiology and Phoniatric Clinic due to vestibular and/or balance problems. Caloric canal paresis of 19% was the cut off value to divide patients into 43 caloric-positive vestibular subjects and 122 caloric-negative patients. The latter group comprised 79 subjects revealing abnormalities of videonystagmographic (VNG) oculomotor tests (central group) and 43 subjects with normal VNG.
  
  
  METHODS
  Vestibular and balance symptoms were collected. Five tests were included to bedside examination: Romberg and Unterberger tests, Head Impulse Test (HIT), Dynamic Visual Acuity (DVA) and gaze nystagmus assessment.
  
  
  RESULTS
  Vestibular and balance symptoms were reported by 82% of vestibular, 73% of central and 40% of VNG-normal patients. Thirteen out of 18 VNG-normal but symptomatic subjects (73%) had abnormal tests in clinical assessment. The sensitivity of bedside test set for vestibular pathology was 88% as compared to caloric test and 68% for central pathology as compared to VNG oculomotor tests.
  
  
  CONCLUSIONS
  The combination of 5 bedside tests reveal satisfactory sensitivity to detect vestibular abnormalities. Bedside examination abnormalities are highly correlated with vestibular/balance symptoms, regardless the normal results of VNG. Thus, this method should be recommended for occupational medicine purposes.
authors.affiliation: Nofer Institute of Occupational Medicine, Łódź, Poland (Audiology and Phoniatrics Clinic, Balance Disorders Unit). zamysewa@imp.lodz.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Zamysłowska-Szmytke
authors.affiliation: Rehabilitation Center "Repty", Tarnowskie Góry, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Szostek-Rogula
authors.affiliation: Nofer Institute of Occupational Medicine, Łódź, Poland (Audiology and Phoniatrics Clinic, Balance Disorders Unit).
authors.forename: Mariola
authors.initials: M
authors.lastname: Śliwińska-Kowalska
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D009760:Nystagmus, Physiologic; D009787:Occupational Medicine / Q000379:methods*; D010808:Physical Examination; D000067716:Point-of-Care Testing; D004856:Postural Balance; D012680:Sensitivity and Specificity; D015837:Vestibular Diseases / Q000175:diagnosis*; D014724:Vestibular Function Tests; D014787:Vision Tests; D055815:Young Adult
keywords: Balance; occupational medicine; posturography; vertigo; videonystagmography