Posture Evoked Response or the PER test is often used to test a patient’s postural response and determine the severity of balance loss as a means of narrowing down the root of symptoms. The patient is placed on a moving or rotating surface and then postural response to said movements are measured via surface electromyography (EMG).

Claremont Graduate University

Approximately 60% of individuals experiencing symptoms associated with vestibular disorders are correctly diagnosed by medical professionals. Diagnoses are typically performed by enacting the following examination methods: general examination, assessment of eye movement, a fistula test, employment of the Dix-Hallpike maneuver, a head thrust/ head shaking test, cerebral testing, and more. Some vestibular disorders, such as mal de debarquement, have less successful diagnoses than others.

Diagnosis of Vestibular Disorders

Babu, Seilesh, Christopher A Schutt, and Dennis I Bojrab, eds. 2019. Diagnosis and Treatment of Vestibular Disorders. Cham, Switzerland: Springer. https://doi.org/10.1007/978-3-319-97858-1.

 Diagnosis and Treatment of Vestibular Disorders

Often times if diagnosis via symptomatic explanation alone is not possible, then often times rotary chair testing will be employed in an attempt to determine the given disorder or cause. Testing is conducted using a rotational chair kept in a lightproof enclosure/ space. Rotational testing is usually comprised of a set of oscillations and a series of abrupt, jarring accelerations.

Rotary Chair Testing to Diagnose Vestibular Disorders


Dynamic Posturography/ Postural Response to Diagnose Vestibular Disorders


The ADP/ Adaptive Protocol Testing is similar to PER, except that the movements are done at a much slower rate. The slower velocities enable the autonomic nervous system to react in smaller, more delicate increments/ muscle responses that cannot be observed during PER testing. This test may be performed alongside PER testing or else after PER testing to help narrow down scope.

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