Dynamic Posturography in the Assessment of Balance
DESCRIPTION
Dynamic posturography (i.e., computerized dynamic posturography) tests balance control in situations intended to isolate the factors that affect balance in everyday experiences. The individual wears a harness to prevent falls and stands on an enclosed platform surrounded by a visual field. By altering the angle of the platform or shifting the visual field, the test is intended to assess movement coordination and the sensory organization of visual, somatosensory, and vestibular information relevant to postural control.
An example of a U.S. Food and Drug Administration (FDA) approved dynamic posturography device is NeuroCom EquiTest®.
POLICY
Dynamic posturography as a method of assessing balance control is considered investigational.
ADDITIONAL INFORMATION
Existing studies fail to provide adequate data to evaluate this technology as a diagnostic test. Published studies have not addressed the health outcome effects of treatment decisions based on dynamic posturography.
Dynamic posturography as a method of assessing balance control does not meet the following technology evaluation criteria:
The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes.
The technology must improve the net health outcome.
The technology must be as beneficial as any established alternatives.
The improvement must be attainable outside of the investigational settings.
SOURCES
Baloh, R. W., Jacobson, K. M., Enrietto, J. A., Corona, S., & Honrubia, V. (1998). Balance disorders in older persons: quantification with posturography. Otolaryngology - Head and Neck Surgery, 119 (1), 89-92. Abstract retrieved August 2, 2001 from PubMed database.
BlueCross BlueShield Association. Medical Policy Reference Manual. (2:2007). Dynamic Posturography (2.01.02). Retrieved June 25, 2007 from BlueWeb.
Di Fabio, R. P. (1996). Meta-analysis of the sensitivity and specificity of platform posturography. Archives of Otolaryngology - Head and Neck Surgery, 122 (2), 150-156. Abstract retrieved August 2, 2001 from PubMed database.
Evans, M. K. & Krebs, D. E. (1999). Posturography does not test vestibulospinal function. Otolaryngology - Head and Neck Surgery, 120 (2), 164-173. Abstract retrieved August 2, 2001 from PubMed database.
Gouveris, H., Stripf, T., Victor, A., & Mann, W. (2007). Dynamic posturography findings predict balance status in vestibular schwannoma patients. Otology and Neurotology, 28 (3), 372-5. Retrieved June 26, 2007 from PubMed database.
O'Neill, D. E., Gill-Body, K. M., & Krebs, D. E. (1998). Posturography changes do not predict functional performance changes. The American Journal of Otology, 19 (6), 797-803. Abstract retrieved February 24, 2003 from PubMed database.
The Technology Evaluation Center. (1996, September). Dynamic posturography in the assessment of vestibular dysfunction (Vol. 11, No. 11). Chicago: BlueCross BlueShield Association.
U.S. Food and Drug Administration. (1995, August). Center for Devices and Radiological Health. Premarket notification database. Retrieved October 24, 2005 from http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?ID=92984.
ORIGINAL EFFECTIVE DATE: 9/1992
MOST RECENT REVIEW DATE: 7/26/2007
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