The Gait Disorientation Test: A New Method for Screening Adults With Dizziness and Imbalance.
Colin R Grove, Bryan C Heiderscheit, G Mark Pyle and 2 others
PMID 33338462WHAT IT FOUND
Walking eyes closed took much longer than eyes open in adults with vestibular loss.
A difference over 4.5 seconds suggested gait disorientation and may prompt further dizziness evaluation, with guarding.
Key findings
01A GDT difference time over 4.5 seconds best separated healthy adults from adults with chronic vestibular hypofunction at site 1, and the paper reported 0.910 for this separation.
02In the independent site 2 dataset, the paper reported 0.894 for the GDT, and sensitivity and specificity did not differ significantly from site 1.
03When either the eyes-closed walking time or the GDT difference time exceeded its threshold, sensitivity was 0.98 and specificity was 0.81.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used selected adults: all could walk unaided, had normal lower-limb strength and sensation, and had no neurologic, musculoskeletal, vision, or pain conditions, so it may not apply to many patients with dizziness. Site 1 had 20 healthy adults and 20 adults with chronic vestibular hypofunction, and site 2 had 16 healthy adults and 13 adults with surgically induced vestibular loss, so the samples were small and not age-matched. The two groups were not the same: site 1 had chronic unilateral or bilateral vestibular hypofunction, while site 2 had subacute unilateral loss after schwannoma surgery. The site 1 assessor knew group assignment and criterion test results, which may have influenced administration or interpretation. The test needs a 10-m pathway and guarding for eyes-closed walking, and one healthy participant withdrew after a soleus tear while bicycling home. Eyes-closed walking can be affected by visual, somatosensory, auditory, or cognitive-perceptual problems, and the paper did not test people with those conditions. The analyses were done after data collection rather than pre-specified.
Declared interests
Research support is listed as N.I.H., Extramural and Non-U.S. Gov't. The provided text does not state author conflicts of interest.
The easy way to misread this
Do not use the 4.5-second result to diagnose vestibular loss in all adults with dizziness. The study enrolled only people who could walk unaided and had no neurologic, musculoskeletal, vision, or pain conditions, and eyes-closed walking can be affected by other problems.