Increasing the usefulness of tandem walking evaluation

J Otolaryngol Head Neck Surg. 2008 Dec;37(6):860-4.


Objective: Tandem walking testing is a "standard" clinical technique for assessing balance and gait, but it is not a standardized test. We wished to develop a protocol by which we could measure sway during tandem walking at a patient's preferred cadence and at an altered cadence, which might be more challenging.

Design: Fifteen patients with vestibular complaints were evaluated with standard tandem walking testing while wearing the Swaystar belt-mounted accelerometer and were also assessed in the same way with tandem walking at two altered cadences.

Methods: We measured tandem walking sway amplitude and sway velocity with eyes open in both pitch and roll planes at a patient's preferred cadence, at 75% of their preferred cadence, and at 125% of their preferred cadence.

Main outcome measures: We measured total sway amplitude and sway velocity in pitch and roll planes during tandem walking with eyes open while wearing Swaystar to see if there was any increase in sway at nonpreferred cadences.

Results: There was no correlation between preferred cadence and the age of the patient. However, there was a significant increase in both sway amplitude and sway velocity at both of the nonpreferred cadences.

Conclusion: Disruption of a patient's preferred cadence may present an unnatural task, and this challenge to a patient's innate gait may help detect subtle vestibular disease.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Age Factors
  • Exercise Test / methods*
  • Female
  • Gait / physiology*
  • Humans
  • Male
  • Middle Aged
  • Postural Balance / physiology*
  • Predictive Value of Tests
  • Sensation Disorders / diagnosis*
  • Sensation Disorders / etiology
  • Sensation Disorders / physiopathology
  • Task Performance and Analysis
  • Vestibular Diseases / complications*
  • Vestibular Diseases / diagnosis
  • Vestibular Diseases / physiopathology*