ORIGINAL PAPER
Bedside examination for vestibular screening in occupational medicine
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1
Nofer Institute of Occupational Medicine, Łódź, Poland
(Audiology and Phoniatrics Clinic, Balance Disorders Unit)
2
Rehabilitation Center “Repty”, Tarnowskie Góry, Poland
Corresponding author
Ewa Zamysłowska-Szmytke
Nofer Institute of Occupational Medicine, Audiology and Phoniatrics Clinic, Balance Disorders Unit, św. Teresy 8,
91-348 Łódź, Poland
Int J Occup Med Environ Health. 2015;28(2):379-87
KEYWORDS
ABSTRACT
Objectives: 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. Material and 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.