Ja. Goebel et al., POSTUROGRAPHIC EVIDENCE OF NONORGANIC SWAY PATTERNS IN NORMAL SUBJECTS, PATIENTS, AND SUSPECTED MALINGERERS, Otolaryngology and head and neck surgery, 117(4), 1997, pp. 293-302
During the last 10 years, computerized dynamic posturography has yield
ed various patterns of sway on the sensory organization test and the m
otor control test that have been associated with a variety of organic
balance disorders. Some aspects of performance during computerized dyn
amic posturography, however, are under conscious control. Voluntary mo
vements not indicative of physiologic response to balance system stimu
lation can also affect computerized dynamic posturography results. Qua
ntification of nonorganic or ''aphysiologic'' response patterns in nor
mal subjects, patients, and suspected malingerers is crucial to justif
y use of computerized dynamic posturography for identification of phys
iologically inconsistent results, For this purpose the computerized dy
namic posturography records of 122 normal subjects, 347 patients with
known or suspected balance disorders, and 72 subjects instructed to fe
ign a balance disturbance were critically evaluated by use of seven me
asurement criteria, which were postulated as indicating aphysiologic s
way, Each criterion was scored with a standard calculation of the raw
data in a random, blinded fashion. The results of this multicenter stu
dy show that three of the seven criteria are significantly different i
n the suspected ''malingerer'' group when compared with either the nor
mal or patient group. The relative strength of each criterion in disce
rning organic from nonorganic sway provides the examiner with a measur
e of reliability during platform posture testing. This study demonstra
tes that computerized dynamic posturography can accurately identify an
d document nonorganic sway patterns during routine assessment of postu
re control.