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Kyung-Min Kim, Joo-Sung Kim, Jeonghoon Oh, and Dustin R. Grooms

Sensory dependence is the preferential contribution of visual, vestibular, and somatosensory feedback for completing a motor task or maintaining stability and can be modified by pathologies, task conditions, or training. 1 , 2 The sensory organization test (SOT) is the gold standard for

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Shirley S.M. Fong, Joanne W.Y. Chung, Shamay S.M. Ng, Ada W.W. Ma, Lina P.Y. Chow, and William W.N. Tsang

This study compared the sensory organization and standing balance of adolescent tennis players, taekwondo (TKD) practitioners, and healthy control participants. Sixty participants including 12 tennis players, 21 TKD practitioners, and 27 healthy control participants were tested. All of the participants underwent the Sensory Organization Test (SOT) and the Unilateral Stance Test (UST) on a Smart Equitest system. Results revealed that tennis players had higher SOT visual ratios than the control participants (p = .005), and TKD practitioners swayed more slowly in the UST than the control participants (p = .039). No differences (p > .05) were found in the composite score, somatosensory ratio, or vestibular ratio between the groups. Tennis players swayed less when they relied more on visual input to maintain balance, whereas TKD practitioners were more stable when standing on one leg. Parents may consider these sports as recreational activities for their children to develop specific balance abilities.

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D. Clark Dickin and Jacqueline E. Heath

Whole body vibration (WBV) has been shown to improve force and power output as well as flexibility and speed, with improvements suggested to result from reduced electromechanical delays, improved rate of force development, and sensitivity of muscle spindles. Fixed frequency studies on postural control have been somewhat equivocal; however, individualized frequency protocols have shown promising results in other motor tasks. To assess this, 18 healthy young adults experienced three 4-minute WBV sessions with postural control assessed before vibration, after multiple exposures, and during recovery, with altered levels of sensory information available to the participants. Sway velocity, sway path length, and sway area were assessed in each environment. Study findings revealed that stability was impacted following WBV, with more challenging environments eliciting improvements persisting for 20 minutes. When the environment was less challenging, postural stability was impaired; however, the effects dissipated quickly (10-20 min). It was determined that exposure to individualized frequency WBV served to impair postural control when the challenge was low, but resulted in heightened stability when the overall challenge was high and vestibular information was needed for stability.

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Kyung-Min Kim, Joo-Sung Kim, and Dustin R. Grooms

Context: Patients with somatosensory deficits have been found to rely more on visual feedback for postural control. However, current balance tests may be limited in identifying increased visual dependence (sensory reweighting to the visual system), as options are typically limited to eyes open or closed conditions with no progressions between. Objective: To assess the capability of stroboscopic glasses to induce sensory reweighting of visual input during single-leg balance. Design:Descriptive Setting: Laboratory Participants: 18 healthy subjects without vision or balance disorders or lower extremity injury history (9 females; age = 22.1 ± 2.1 y; height = 169.8 ± 8.5 cm; mass = 66.5 ± 10.6 kg) participated. Interventions: Subjects performed 3 trials of unipedal stance for 10 s with eyes open (EO) and closed (EC), and with stroboscopic vision (SV) that was completed with specialized eyewear that intermittently cycled between opaque and transparent for 100 ms at a time. Balance tasks were performed on firm and foam surfaces, with the order randomized. Main Outcome Measures: Ten center-of-pressure parameters were computed. Results: Separate ANOVAs with repeated measures found significant differences between the 3 visual conditions on both firm (P-values =< .001) and foam (P-values =< .001 to .005) surfaces for all measures. For trials on firm surface, almost all measures showed that balance with SV was significantly impaired relative to EO, but less impaired than EC. On the foam surface, almost all postural stability measures demonstrated significant impairments with SV compared with EO, but the impairment with SV was similar to EC. Conclusions:SV impairment of single-leg balance was large on the firm surface, but not to the same degree as EC. However, the foam surface disruption to somatosensory processing and sensory reweighting to vision lead to greater disruptive effects of SV to the same level as EC. This indicates that when the somatosensory system is perturbed even a moderate decrease in visual feedback (SV) may induce an EC level impairment to postural control during single-leg stance.

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Ian McGinnis, Justin Cobb, Ryan Tierney, and Anne Russ

pursuits, saccadic eye movements, near-point convergence testing, vestibulo-ocular reflex testing, visual motion sensitivity testing, the Balance Error Scoring System (BESS) test, and the Sensory Organization Test (SOT). 7 Most individuals who experience a sport-related concussion will clinically recover

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Daniel G. Miner, Brent A. Harper, and Stephen M. Glass

Posturography is the gold standard for the assessment of sensory and motor contributions to postural control. 1 Assessments such as the Sensory Organization Test (SOT) and Head Shake SOT (HS-SOT) represent reliable testing protocols that may be sensitive to subtle, persistent deficits in postural

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Lilly H. VanDeMark, Christina B. Vander Vegt, Cassie B. Ford, Jason P. Mihalik, and Erik A. Wikstrom

Postural control is a continuous task maintained by the integration of visual, vestibular, and somatosensory system feedback and efferent responses. 1 The contribution of each sensory modality (ie, the sensory organization strategy) is internally modulated, spontaneously, depending on the

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J.D. DeFreese, Michael J. Baum, Julianne D. Schmidt, Benjamin M. Goerger, Nikki Barczak, Kevin M. Guskiewicz, and Jason P. Mihalik

9 10 6  Diving 0 2 0  Football a 5 8 9  Gymnastics 1 0 1  Lacrosse 8 9 0  Soccer 7 2 5  Softball 1 3 1  Track and Field 0 2 2  Wrestling 5 4 3 a No association between sex and distress group, χ 2 2  = 2.47; P  = .29. Design All study variables (ie, neurocognition, sensory organization, symptoms

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John R. Biggan, Forest Melton, Michael A. Horvat, Mark Ricard, David Keller, and Christopher T. Ray

The understanding of prefrail and nonfrail older adults’ postural control with and without increased environmental and cognitive stress is imperative to the development of targeted interventions to decrease fall risk within these populations. Thirty-eight individuals participated in this study. Postural control testing included the Sensory Organization Test (SOT) on a NeuroCom EquiTest. Cognitive and environmental load testing was performed during Condition 6 of the SOT. Though there were no group differences on composite equilibrium score (p = .06), the cognitive task (Stroop task) impaired equilibrium scores more than the auditory or visual distracter tasks (p < .05 and p < .01) for both groups. These results suggest that both prefrail and nonfrail older adults’ postural control is reduced in demanding environments. Given these findings, the need for multimodal exercise interventions to target both physical and cognitive factors is apparent.

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Luke M. Ross, Johna K. Register-Mihalik, Jason P. Mihalik, Karen L. McCulloch, William E. Prentice, Edgar W. Shields, and Kevin M. Guskiewicz


Recent evidence has revealed deficiencies in the ability to divide attention after concussion.


To examine the effects of a single vs a dual task on cognition and balance in healthy subjects and to examine reliability of 2 dual-task paradigms while examining the overall feasibility of the tasks.


Pretest–posttest experimental design.


Sports medicine research laboratory.


30 healthy, recreationally active college students.


Subjects performed balance and cognitive tasks under the single- and dual-task conditions during 2 test sessions 14 d apart.

Main Outcome Measures:

The procedural reaction-time (PRT) test of the Automated Neuropsychological Assessment Metrics (eyes-closed tasks) and an adapted Procedural Auditory Task (PAT; eyes-open tasks) were used to assess cognition. The NeuroCom Sensory Organization Test (SOT) and the Balance Error Scoring System (BESS) were used to assess balance performance. Five 2-way, within-subject ANOVAs and a paired-samples t test were used to analyze the data. ICCs were used to assess reliability across 2 test sessions.


On the SOT, performance significantly improved between test sessions (F 1,29 = 35.695, P < .001) and from the single to the dual task (F 1,29 = 9.604, P = .004). On the PRT, performance significantly improved between test sessions (F 1,29 = 57.252, P < .001) and from the single to the dual task (F 1,29 = 7.673, P = .010). No differences were seen on the BESS and the PAT. Reliability across test sessions ranged from moderate to poor for outcome measure.


The BESS appears to be a more reliable and functional tool in dual-task conditions as a result of its increased reliability and clinical applicability. In addition, the BESS is more readily available to clinicians than the SOT.