Key Points about a Balance Assessment Test

  • A balance assessment test is a series of tests to help diagnose balance disorders.
  • Your doctor may order a balance assessment test to diagnose a variety of balance disorders such as benign paroxysmal positional vertigo, Meniere’s disease, vestibular neuritis, migraines, or head injury.
  • There are few risks associated with a balance assessment test.
  • During a balance assessment, your doctor will perform a variety of tests to diagnose your balance disorder.
  • Tests may include electronystagmography (ENG) and videonystagmography (VNG) tests, rotary chair test, posturography, vestibular evoked myogenic potentials (VEMP) test or Dix-Hallpike maneuver.
  • Your treatment plan will depend on which balance disorder you have. Treatment can range from medicines to vestibular rehab. In the most severe cases, you may need surgery.


A balance assessment test, also known as vestibular balance testing or vestibular testing, is a series of tests to evaluate for balance disorders.

A balance disorder is a condition where you may feel dizzy or unsteady on your feet. Balance disorders can range from mild to severe. In severe cases, you may have trouble walking, climbing stairs, or performing day-to-day activities.

Balance disorders are most common in older people. This is a primary reason older adults are more prone to falls than younger people.

Candidates for a balance test

Your doctor may perform a balance test to determine if you have a balance disorder. Causes of balance disorders include:

  • Benign paroxysmal positional vertigo (BPPV)
  • Meniere’s disease
  • Vestibular neuritis
  • Migraines
  • Head injury
  • Side effects from medication usage

Symptoms that may indicate you have one of these disorders include:

  • Feeling dizzy or like you are spinning while standing still.
  • Losing your balance or staggering as you walk.
  • Tinnitus (ringing in the ears).
  • Feeling lightheaded or as if you are floating.
  • Feeling confused or having blurry vision.

Once your doctor can diagnose your condition, he or she can develop a treatment plan to help you return to normal as quickly as possible.

Risks associated with a balance assessment test

Balance Assessment tests are generally safe. While you may feel dizzy or nauseous on some tests, these feelings typically go away quickly.

Preparing for a balance assessment test

Your provider will outline what you need to do to prepare for your balance assessment tests. You may be given any of the following guidelines include:

  • Wear loose, comfortable clothes.
  • Make specific changes to your diet.
  • Stop taking medications a day or more before tests.

Expectations during a balance assessment test

A balance assessment test is typically performed by your primary care provider, audiologist, or ENT specialist. Generally, your provider will need to complete a series of tests to diagnose your balance disorder. Tests may include:

Electronystagmograpy (ENG) and videonystagmography (VNG) tests

An ENG or VNG test records and measures your eye movements to evaluate your balance. During testing, you will be asked to:

  • Sit in a dark room.
  • Follow patterns of light on a screen.
  • Move into various positions as you follow the light pattern.
  • Put warm or cold water into your ear to cause your eyes to move in specific directions. This test could reveal you have nerve damage in the inner ear.

Rotary chair test

A rotary chair test will evaluate your eye movements. During the test, you will sit in a motorized chair and put on special goggles that will record your eye movements as the chair moves in different directions.

Posturography test

Posturography tests measure your ability to stay balanced while standing. During the test, you will stand on a platform without shoes on. The platform will move around at various angles to evaluate your ability to stand on a moving surface. You will wear a safety harness during this test.

Vestibular-evoked myogenic potentials (VEMP) test

A VEMP test will measure how your muscles react to sound to evaluate problems with your inner ear. During the test, you will recline in a chair with earphones on. Sensor pads will be attached to your neck, forehead, and under your eyes, recording your muscle movements in these areas. You will be asked to lift your head or eyes while different sound patterns are sent to the earphones.

Dix-Hallpike maneuver

A Dix-Hallpike maneuver measures how your eyes react to quick, abrupt movements. During this test, your provider will quickly move you into various positions and evaluate your eye movements to see if you feel like you are moving or spinning.

Your doctor may also perform a video head impulse test, which is a newer version of the Dix-Hallpike maneuver. During this test, you will wear goggles to record your eye movements while your doctor gently turns your head.

Recovery from a balance assessment test

If your results were abnormal, your doctor may develop a treatment plan or order more tests. Depending on your diagnosis, treatment may include:

  • Medicines to control symptoms
  • Positioning exercises - if you have BPPV, you may need an Epley maneuver to reposition crystals in the inner ear, which are causing your symptoms.
  • Lifestyle modifications or changes - for certain balance disorders such as Meniere's disease, lifestyle modifications such as quitting smoking or changing your diet can help relieve your symptoms.
  • Vestibular rehab - exercises to help you improve your balance and prevent falls.
  • Surgery - if all other conservative treatments have failed, surgery may help correct your inner ear issues. The type of surgery you need will depend on the cause of your disorder.

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