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Updated: Mar 18, 2026

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Modified head shake sensory organization test: Sensitivity and specificity.

Julie A Honaker1, Kristen L Janky2, Jessie N Patterson1

  • 1Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, NE, USA.

Gait & Posture
|July 4, 2016
PubMed
Summary
This summary is machine-generated.

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The modified head-shake Sensory Organization Test (HS-SOT) protocol shows promise for identifying peripheral vestibular asymmetry. Specifically, the HS-SOT5-15°/s condition demonstrated high sensitivity and specificity in detecting vestibular dysfunction.

Area of Science:

  • Neuroscience
  • Audiology
  • Vestibular System Research

Background:

  • The Sensory Organization Test (SOT) assesses balance using sensory input but has limitations in identifying peripheral vestibular dysfunction.
  • Previous studies suggested horizontal head-shake augmentation could improve SOT's diagnostic capabilities for vestibular asymmetry.
  • Methodological flaws in prior head-shake SOT research necessitate further validation.

Purpose of the Study:

  • To evaluate the sensitivity and specificity of a modified head-shake SOT (HS-SOT) protocol.
  • To determine the efficacy of HS-SOT in identifying peripheral vestibular lesions.
  • To correlate HS-SOT findings with caloric unilateral weakness (UW).

Main Methods:

  • Fifteen patients with vestibular complaints and fifteen age-matched controls participated.
Keywords:
Caloric weaknessCaloricsHead-shakeHead-shake posturographyPeripheral vestibularPeripheral vestibular asymmetryPosturographySensory organization testUnilateral weakness

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  • Participants underwent standard SOT conditions 2 and 5, with and without horizontal head-shaking at various speeds (HS-SOT2-60°/s, HS-SOT2-120°/s, HS-SOT5-15°/s, HS-SOT5-60°/s).
  • Equilibrium scores were analyzed, comparing patient and control group performance and correlating with caloric UW.

    • Main Results:

    • Equilibrium scores decreased with increasing condition difficulty in both groups, with a steeper decline in patients (slope=-11.69) versus controls (slope=-6.59).
    • The HS-SOT5-15°/s condition proved superior in identifying peripheral vestibular asymmetry, yielding an Area Under the Curve (AUC) of 0.90.
    • HS-SOT5-15°/s demonstrated 70% sensitivity and 100% specificity, with a strong correlation to caloric UW (rs=-0.743, p=0.000006).

    Conclusions:

    • The modified head-shake SOT protocol, particularly HS-SOT5-15°/s, is a promising tool for screening peripheral vestibular asymmetry.
    • HS-SOT5-15°/s shows high diagnostic accuracy and a significant correlation with established measures of vestibular function.
    • This modified protocol may enhance the clinical identification of peripheral vestibular system lesions.