BlueCross BlueShield of Tennessee Medical Policy Manual

Dynamic Posturography in the Assessment of Balance

DESCRIPTION

Dynamic posturography tests balance control in situations intended to isolate factors that affect balance in everyday experiences. Posturography (e.g. NeuroCom EquiTest®) proposes to provide quantitative information on the degree of imbalance present in an individual but is not intended to diagnose specific types of balance disorders.

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. The individual undergoes six different testing situations designed to evaluate the vestibular, visual, and proprioceptive/somatosensory components of balance. In general terms, the test measures an individual’s balance while visual and somatosensory cues are altered.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION  

Randomized controlled studies are lacking for this technology. In addition, the existing studies fail to demonstrate clinical utility of this test that would lead to changes in management that improve outcomes.  

SOURCES

Alahmari, K., Marchetti, G., Sparto, P, Furman, J., & Whitney, S. (2014). Estimating postural control with the balance rehabilitation unit: measurement consistency, accuracy, validity, and comparison with dynamic posturography. Archives of Physical Medicine and Rehabilitation, 95 (1), 65-73. (Level 4 evidence)

American Academy of Otolaryngology-Head and Neck Surgery Foundation. (2014, September). Position statement: Posturography. Retrieved March 29, 2016 from http://www.entnet.org.

BlueCross BlueShield Association. Evidence Positioning System. (2:2018). Dynamic posturography (2.01.02). Retrieved December 6, 2018 from https://evidencepositioningsystem.com/.  (22 articles and/or guidelines reviewed)

CMS.gov. Centers for Medicare & Medicaid Services. Palmetto GBA. (2018, June). Local Coverage Determination (LCD): Vestibular Function Testing (L34537). Retrieved December 6, 2018 from https://www.cms.gov.

Ferrazzoli, D., Fasano, A., Maestri, R., Bera, R., Palamara, G., & Frazzitta, G., et al. (2015). Balance dysfunction in parkinson’s disease: the role of posturography in developing a rehabilitation program. Parkinson’s Disease, 520128. (Level 3 evidence)

Fritz, N., Newsome, S., Eloyan, A., Evans, R., Marasigan, R., Calabresi, P., & Zackowski, K. (2015). Longitudinal relationships among posturography and gait measures in multiple sclerosis. Neurology, 84 (20), 2048-2056. (Level 4 evidence)

Olchowik, G., Tomaszewski, M., Olejarz, P., Warchol, J., & Rozanska-Boczula, M. (2014). The effect of height and BMI on computer dynamic posturography parameters in women. Acta of Bioengineering and Biomechanics, 16 (4), 53-58. Abstract retrieved March 29, 2016 from PubMed database.

Vanicek, N., King, S. A., Gohil, R., Chetter, I. C., & Coughlin, P. A. (2013). Computerized dynamic posturography for postural control assessment in patients with intermittent claudication. Journal of Visualized Experiments, 2013 (82). (Level 4 evidence)

ORIGINAL EFFECTIVE DATE:  9/1992

MOST RECENT REVIEW DATE:  1/10/2019  

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