Normative Values for the Head Shake Sensory Organization Test in an Active Duty Military Cohort

Holly J Roberts; Carrie W Hoppes; Yadira M Del Toro; Karen H Lambert; Barbara A Springer

doi:10.1093/milmed/usae086

Normative Values for the Head Shake Sensory Organization Test in an Active Duty Military Cohort

Mil Med. 2024 Mar 30:usae086. doi: 10.1093/milmed/usae086. Online ahead of print.

Authors

Holly J Roberts^{1

2}, Carrie W Hoppes³, Yadira M Del Toro⁴, Karen H Lambert⁵, Barbara A Springer⁶

Affiliations

¹ School of Physical Therapy, University of Puget Sound, Tacoma, WA 98416, USA.
² Soldier Performance Division, Office of the Surgeon General of the Army, Falls Church, VA 22042, USA.
³ U.S. Army Medical Department Center of Excellence, Army-Baylor Doctoral Program in Physical Therapy, Joint-Base San Antonio, TX 78234, USA.
⁴ FYZICAL Therapy and Balance Centers, Shavano Park, TX 78231, USA.
⁵ Hearing Center of Excellence, Defense Health Agency, Lackland Air Force Base, TX 78236, USA.
⁶ Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.

PMID: 38554259
DOI: 10.1093/milmed/usae086

Abstract

Introduction: The Head Shake Sensory Organization Test (HS-SOT) assesses postural stability while the head is moving and may also identify deficits in attention associated with the dual task conditions of moving the head at a specified speed while maintaining balance. Normative values for the HS-SOT have not been established in a healthy military population or other highly trained populations such as athletes. Establishing normative values in a military population will enable clinicians to compare the scores of patients with medical conditions that affect postural stability and sensory integration such as concussion or traumatic brain injury, vestibular dysfunction, or migraine to those of a healthy population to determine a need for intervention and for return to duty considerations. The purposes of this cross-sectional study were to establish normative values for the HS-SOT within the military population, to determine whether HS-SOT scores differed between men and women or among age groups, and to determine whether HS-SOT scores differed from scores on similar conditions of the Sensory Organization Test (SOT).

Materials and methods: Active duty service members (n = 237, 54 female) at Joint Base Lewis-McChord, Washington, Fort Campbell, Kentucky, and the National Capitol Region (Washington, D.C, Maryland, and Virginia) completed the SOT and HS-SOT on the NeuroCom® Balance Master™. Parametric and non-parametric comparisons were analyzed for the equilibrium scores for the SOT and HS-SOT conditions 2 (SOT-2, HS-SOT-2, respectively) and 5 (SOT-5, HS-SOT-5, respectively) and the equilibrium score ratios (ESRs) for HS-SOT-2 and HS-SOT-5 for the total sample, men and women, and age group categories (18-26 years, 27-35 years, and 36-45 years).

Results: There were no differences in HS-SOT-2 or HS-SOT-5 equilibrium ratio scores between men (0.99 ±.029 and 0.83 ±0.25, respectively) and women (1.00 ±0.03 and 0.81 ±0.21, respectively). There were no differences in the SOT-2 equilibrium scores (F = 2.29, P = 0.10) or SOT-5 equilibrium scores (Kruskal-Wallis H = 3.26, P = 0.20) among the different age groups. SOT-2 equilibrium scores were higher than the HS-SOT-2 equilibrium scores (Z = -4.10, P < 0.001). SOT-5 equilibrium scores were also higher than HS-SOT-5 equilibrium scores (Z = -12.22, P < 0.001), and the HS-SOT-2 and HS-SOT-5 equilibrium scores differed from each other (Z = -13.26, P < 0.001).

Conclusions: This study established normative values for the HS-SOT in a military population. Equilibrium scores did not differ between men and women or among age groups, suggesting that these values can be used as reference points for most service members. Postural stability was found to be significantly challenged during head motion, indicating the HS-SOT is a valuable tool for identifying subtle impairments in postural stability. These findings have important implications for early detection and intervention in individuals with medical conditions affecting balance, particularly concussions or vestibular disorders.

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Abstract

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