Computerized Dynamic Posturography (CDP) and the Assessment of Balance with Active Head Movements

Of the numerous tools available for assessing patients with imbalance, the most clinically effective one is an accurate clinical history i.e., the patient’s past and presenting symptoms. Once the symptoms have been established, then one can select the appropriate laboratory studies which when interpreted in conjunction with that history should offer information relative to site-of-lesion, narrow the etiological possibilities, and provide information relative to the functional impact of the problem. The functional information provided by CDP plays a key role in contributing to treatment design, particularly to a Vestibular and Balance Rehabilitation Therapy (VBRT) protocol and in monitoring the patient’s progress. In fact, when Stewart and colleagues 24) examined the cost effectiveness of the diagnostic evaluation of the dizzy patient within the context of this model, CDP proved to be the most cost-effective test of balance. This finding is enhanced by the role of CDP in differentiating between true and exaggerated abnormal symptoms. Other prospective studies involving patients with idiopathic Parkinson’s disease have shown that CDP impairment information can be of significant value in identifying patients likely to benefit from surgical, deep brain stimulation, and medication treatments.