Dynamic posturography assesses posture control in changing environments using computerized tests to evaluate sensory organization, motor control, and adaptation. It is used to diagnose and treat patients suffering from vertigo and associated dizziness. Computerized dynamic posturography is the most widely used diagnostic tool, and therapy is designed based on the findings of the test.
The assessment of posture control in a changing environment is called dynamic posturography. Balance is maintained through the combined input of the sense of touch through the feet and legs, vision, and the vestibular system, composed of the balance sensing structures in the ear. When any or all of these systems are disrupted, the result is dizziness, instability, and a tendency to fall. Dynamic posturography evaluates these problems, usually using computerized dynamic posturography (CDP), and develops a treatment plan aimed at correcting these problems.
Dynamic posturography is used for any patient suffering from vertigo. Before this treatment is prescribed, dizziness should have been present for more than a year, the cause should be unknown, it should impair or limit walking and standing, or the dizziness should be exacerbated by anxiety about falling. Many clinical studies have demonstrated that dynamic posturography using CDP and focused CDP therapy improve vertigo and associated dizziness.
The three areas tested during dynamic posturography are sensory organization, motor control, and adaptation. During the sensory organization test, the patient’s ability to use and discard sensory information is tested to determine whether a patient can use sensory information effectively or is making adaptive responses incorrectly. The motor control test evaluates the ability and speed with which a patient can regain stability after a rapid or sudden change. A fit test tests how well a patient controls his swing when faced with an unpredictable forward or backward lean. The patient’s reaction during these tests is the basis of therapy to improve balance and stability in the necessary areas.
Computerized dynamic posturography is the most widely used diagnostic tool for dynamic posturography. For a CDP evaluation, the patient stands facing inward within an open-bottomed mobile case painted with a simple scene to help orient the patient. The platform under the patient rotates and moves sideways. A life jacket-type harness is placed on the patient and is secured to supports so that, in the event of loss of balance, the subject can never fall. During an exam, choreographed movements of the enclosure and platform challenge the patient’s stability and cause a physical reaction.
The patient’s physical movements in response to changes in the footplate and shell are recorded during the CDP exam. These recorded movements are then analyzed to assess the patient’s balance control. Therapy is designed based on these findings. Periodically during therapy sessions, the patient will be retested on the CDP machine to determine if balance control is improving or if therapy needs to be changed. Once the performance of the CDP has improved to a certain level, the therapy will be discontinued.
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