biodex BioSway Operation Manual page 19

CONTENTS
Figure 4.4. The Limits of Stability Test is a good indicator of control within a normalized sway envelope.
clInIcal teSt of SenSory InteGratIon and balance – ctSIb or mctSIb
(modIfIed ctSIb)
The Clinical Test of Sensory Interaction and Balance CTSIB is an accepted test protocol for
Balance assessment on a static surface. The CTSIB test protocol was selected for Fall Risk assess-
ment as it is well documented in the literature as an effective test in identifying individuals with
mild to severe balance problems. The CTSIB consists of six conditions. This test provides a gen-
eralized assessment of how well a patient can integrate various senses with respect to balance
and compensate when one or more of those senses are compromised.
• Condition 1 – Eyes open firm surface: Baseline: Incorporates visual, vestibular and
somatosensory inputs
• Condition 2 – Eyes closed firm surface: Eliminate visual input to evaluate vestibular and
somatosensory inputs.
• Condition 3 – Visual conflict on firm surface: Some vision present but information conflicts
with vestibular information. This condition brings in more vestibular and somatosensory
inputs.
• Condition 4 – Eyes open on a dynamic surface used to evaluate somatosensory interaction
with visually input.
• Condition 5 – Eyes closed on dynamic surface: used to evaluate somatosensory interaction
with vestibular input
• Condition 6 – Visual conflict on dynamic surface: Used to evaluate the mediation of visual
with and vestibular and somatosensory inputs.
Another version of this test called the modified CTSIB is often used. The m-CTSIB eliminates
conditions 3 and 6. The BioSway uses the M-CTSIB format of 4 conditions as the default with
the ability to include the other 2 if desired.
The CTSIB was selected as the primary test for Fall Screening for these reasons:
1. The breadth of the existing studies supporting and accepting the CTSIB as a valid clinical
assessment of balance
2. Well documented definitive correlations for fall risk assessment
3. Clinician familiarity with the test
CLINICAL CONSIDERATIONS — 4-4 —