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The Relationship Between Sway Assessment, Dizziness Handicap Inventory and Videonystagmography Tests in Dizzy Patients

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AUTHORS: Kristine Sonstrom MS, Jennifer Franson-Hopper AuD, and Elias Michaelides MD, Yale Hearing and Balance Center, Department of Otolaryngology, School of Medicine, New Haven, CT

INTRODUCTION: The evolution of smartphone technology has provided patients with an ability to self evaluate and quantify their physical symptoms prior to an evaluation by a medical professional. Modern mobile devices employ accelerometers which function to measure postural sway. The introduction of a new technology, SWAY BalanceTM, operates through a software platform utilizing a tri-axial accelerometer measuring postural sway. To our knowledge, this technology has not been utilized in patients with vestibular related disorders. Two current assessments used to evaluate patient dizziness include Videonystagmography (VNG) and the Dizziness Handicap Inventory (DHI). Presently used force platforms can be challenging due to equipment cost, size, mobility, accessibility, duration of use and need for specialized personnel. SWAY BalanceTM provides an attractive means of screening dizzy patients for quantitative information associated with their dizziness and balance.

CONCLUSION: The SWAY BalanceTM mobile application provides a convenient and attractive means of obtaining quantitative information on dizzy patients by measuring postural sway while isolating each component of the balance system. Our findings suggest there is no significant relationship between the VNG, DHI and SWAYTM Balance Assessment and no significant difference between test subjects and controls on the fall and mBESS assessment. Our results demonstrated the ceiling effect among different portions of the SWAYTM fall assessment and no significant differences between our test subjects and controls. It is suggested that modifications to the SWAYTM Balance protocol specific for those with vestibular related disorders could make the test more sensitive to asymptomatic and symptomatic dizzy patients. Although this pilot study did not indicate a significant relationship between these three measures, further research is warranted under specific conditions modified for those patients with vestibular related disorders.