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Performance of Fukuda Stepping Test as a function of the severity of caloric weakness in chronic dizzy patients
Julie A Honaker1, Neil T Shepard
1Department of Special Education and Communication Disorders, University of Nebraska, Lincoln, NE, USA.
Background:
The purpose of the Fukuda Stepping Test (FST) is to measure asymmetrical vestibulospinal reflex tone resulting from labyrinthine dysfunction. The FST is a low cost evaluation for dizzy patients; however, when compared with gold standard caloric irrigation unilateral weakness (UW) value ≥25%, the FST has not been shown to be a sensitive tool for identifying unilateral vestibular hypofunction.
Purpose:
The purpose of this technical report is to further evaluate the clinical utility of FST with and without headshake as a function of increased caloric asymmetry for individuals with unilateral peripheral vestibular pathology.
Research Design:
Retrospective review of FST results with and without head shaking component as compared to gold standard, caloric irrigation UW outcome values at four severity levels: 0-24% UW (normal caloric value); 25-50% UW (mild caloric UW); 51-75% UW (moderate caloric UW); 76-100% UW (severe caloric UW).
Study Sample:
736 chronic (≥8 wk symptom complaints) dizzy patients.
Results:
Standard FST and FST following a head shake task are insensitive to detecting mild to moderate peripheral vestibular paresis. Increased test performance was observed for patients with severe canal paresis (>76% UW); however, continued inconsistencies were found in turn direction toward the severe unilateral vestibular dysfunction.
Conclusions:
Overall, the FST provides little benefit to clinicians when used in the vestibular bedside examination.