Measurement Characteristics and Clinical Utility of the Clinical Test of Sensory Interaction on Balance (CTSIB) and Modified CTSIB in Individuals With Vestibular Dysfunction

      Vestibular dysfunction resulting from peripheral vestibular disorders, head trauma, and other central nervous system disorders can lead to imbalance and falls.1-3 Balance impairment can have a significant impact on an individual's ability to perform activities of daily living or participate in work and leisure activities. A thorough assessment of balance includes examination of the sensory systems that contribute to postural control. The Clinical Test of Sensory Interaction on Balance (CTSIB) was developed to assess the contribution of the visual, somatosensory, and vestibular systems to postural control.4 The original test evaluates static postural stability in 6 distinct standing conditions with eyes open, with eyes closed, and with the use of a dome to alter visual input on both firm and foam surfaces. This test has been modified to include eyes open and eyes closed on both firm and foam surfaces, given the finding that altered visual inputs from the dome were not different from those in the eyes closed condition.5 This test can be administered in less than 15 minutes with minimal equipment (stopwatch and foam pad). The CTSIB and modified CTSIB have excellent reliability and validity in adults with vestibular disorders and can be easily administered in all clinical settings.
      This Rehabilitation Measures Database summary provides a review of the psychometric properties of the CTSIB and modified CTSIB in adults with vestibular dysfunction. A full review of the CTSIB and modified CTSIB as well as reviews of more than 100 other instruments can be found at
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      • 1.
        Pothula VB, Chew F, Lesser TH, Sharma AK. Falls and vestibular impairment. Clin Otolaryngol Allied Sci 2004;29:179-182.
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        Franke LM, Walker WC, Cifu DX, Ochs AL, Lew HL. Sensor integrative dysfunction underlying vestibular disorders after traumatic brain injury: a review. J Rehabil Res Dev 2012;49:985-994.
      • 3.
        Liston MB, Bamiou DE, Martin F, et al. Peripheral vestibular dysfunction in older adults experiencing multiple non-syncopal falls versus age-matched non-fallers: a pilot study. Age Ageing 2014;43:38-43.
      • 4.
        Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction on balance: suggestion from the field. Phys Ther 1986;66:1548-1550.
      • 5.
        Cohen H, Blatchly CA, Gombash LL. A study of the clinical test of sensory interaction and balance. Phys Ther 1993;73:346-351.
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        El-Kashlan HK, Shepard NT, Asher AM, Smith-Wheelock M, Telian SA. Evaluation of clinical measures of equilibrium. Laryngyscope 1998;108:311-319.
      • 7.
        Whitney SL, Wrisley DM. The influence of footwear on timed balance scores of the modified clinical test of sensory interaction and balance. Arch Phys Med Rehabil 2004;85:439-443.
      • 8.
        Wrisley DM, Whitney SL. The effect of foot position on the modified clinical test of sensory interaction and balance. Arch Phys Med Rehabil 2004;85:335-338.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary's publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors' employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, the United States Department of Education or the Retirement Research Foundation. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (H133B090024) and the Retirement Research Foundation (2011-027).