Vestlab OS is designed for the diagnosis and therapy of all kinds of balance disorders. It offers a complete arsenal of tests and procedures as well as a rich set of editing and documentation tools.
Vestlab OS is ideally suited for use in a network environment. It enables the user to perform examinations and assessments in different locations and so avoid a lot of ‘running around’.
It offers interfaces that permit access to the user’s existing patient databases. This not only saves time, but also prevents errors. All results and findings can be assembled and printed in freely configurable reports.
A What-You-See-Is-What-You-Get preview allows the user to check the look of the report before printing. Some tests, like the Dizziness Handicap Inventory or the Vertigo Symptom Scale, have been optimized for time saving,
making them easier to use routinely. All tests come with a set of default parameters, which can be changed to the taste of the user. Freely configurable protocols guide the user through a set of routinely performed procedures.
History: Lets the user take a standardized dizziness history. The questions as well as the most common answers can be pre-defined and are available as text modules.
Dizziness Navigator: Standardized questionnaire on the Zenner model. For legal reasons, this test currently does not include an automated analysis module.
Images: Often, in the course of dizziness diagnostics, images are produced – for example photos of the eardrum taken during otoscopic examinations, pictures of the ocular fundus produced by ophthalmoscopes, or X-rays of the petrous part of the temporal bone. These images can be saved in the patient database and can be edited (brush tool, angle measurement, identifiers) and printed out as part of the report.
Clinical findings: This section permits the documentation of clinical findings. The Romberg test can be documented or performed using a balance platform. Standard diagrams for the step tests (Fukuda, Unterberger, star gait) are displayed and documented as well as freely configurable examinations (e.g. finger-nose-test, diadochokinesia, skew deviation, etc.).
Calibration: This test is performed to calibrate the video goggles. It also allows the detection of eye muscle paresis.
Gaze: This test is performed to document gaze-dependent spontaneous nystagmus. The Stoll's gaze diagram is drawn automatically, allowing a quick ALEXANDER classification.
Position test: This test is designed to document position-dependent nystagmus, which frequently appears in patients suffering from atypical BPPV or central system disorders.
Positioning test: This test, also known as Dix-Hallpike test, is performed to diagnose BPPV caused by displaced otoconia in the posterior semicircular canal.
Calorics: This is the classic test of the labyrinth as devised by Barany. Besides the analysis of spontaneous nystagmus, configurable diagrams display the Slow Phase Velocity (SPV). Vestibular Paresis and Directional Preponderance are calculated and displayed in tables.
Optokinetics: Dizziness caused by a malfunctioning of the optokinetic system is indicative of a central system disorder. This test allows an examination of the optokinetic system using a stimulus with a constant or dynamically changing velocity, in a horizontal as well as vertical direction.
Smooth Pursuit: This test assesses the functioning of the brain's pursuit center. A pathological outcome is indicative of degeneration or other central nervous disorder.
Step-Ramp test: Variation of the smooth pursuit test in which the initial saccades are suppressed by a short jump of the visual target.
Gaze holding: This examination is performed to detect gaze-dependent nystagmus. The patient’s gaze follows a visual target that moves incrementally from the center of the screen to the edge. If this triggers early nystagmus in the patient, this is a sign of a central disorder.
Saccades test: This test allows the examiner to assess malfunctions of the saccade system. Besides the classic saccades test, in which the visual target jumps unpredictably, the user can also test for gap saccades, memory saccades or anti-saccades.
Impuls acceleration test: This test, also know as Rotatory Intensity Damping Test (RIDT), is performed to examine the vestibulo-ocular reflex (VOR) using a physiological stimulus. The sitting patient is rotated on the vertical axis for a certain time and then the chair is stopped suddenly. The nystagmus provoked in this way is analysed for gain and time constant.
Constant acceleration test: This test, also know as trapezoidal test, is performed to assess the patient’s vestibulo-ocular reflex (VOR). In the test, the sitting patient is accelerated and rotated on the vertical axis with a constant acceleration value and, after a set period of time, decelerated again.
Sinusodial pendular test: During this test the rotary chair performs sinusoidal pendular movements at a constant frequency. The eye movements provoked by the vestibulo-ocular reflex (VOR) are recorded while a fixation target is turned off or on. This allows the examiner to distinguish central disorders from peripheral disorders and to assess the degree of compensation.
Cervical test: This test is performed to document nystagmus generated by disorders of the cervical spine. In the test, the head of the patient is fixated so there is an absence of visual or labyrinth stimulation. Then the body is turned. If nystagmus occurs, this indicates cervically evoked dizziness.
Unilateral centrifugation (SVV): This test is performed to assess the function of each utricle independently. First, the sitting patient is rotated on the vertical axis until top speed is reached. Then the chair moves a few centimeters to the side, just enough to move one utricle into the center of the rotation. Now the function of the other utricle can be assessed either by performing Subjective Visual Vertical tests (SVV) or by 3D oculography.
Posturography: In this test, the sway of a patient is measured according to freely configurable paradigms. Beside a Fourier frequency analysis, the software calculates all standard parameters.
Balance training: This set of exercises can be done by patients suffering virtually any kind of balance disorder. Standing on the balance platform and using a monitor as a guide, the patient is trained to move his or her center of gravity in a targeted way. This feedback method increases the patient's motivation and speeds compensation of vestibular loss.
Balance screening: This test is performed to assess the patient’s risk of falling. It requires use of a balance platform to measure postural instability.
Limits of Stability: This test is performed to assess the patient's somatosensory competence. During the test, the patient's ability to move his or her center of gravity in a certain direction is measured and analysed. Performing this test is an easy way to assess the progress of rehabilitation.
ABR: Standard ABR as well as Threshold ABR can be performed in an automatic mode if desired. All relevant parameters can be configured. Latency diagrams and tables of latency values and differences are displayed. These values are compared against an age-related database, enabling a quick visual assessment of the results.
VEMP test: Visually evoked muscular potentials (VEMPs) are measured to assess the function of the saccule (cervical VEMP or cVEMP) or utricle (ocular VEMP or oVEMP). When measuring cVEMP, the tension of the muscle is monitored. The P1 and N1 waves are detected and the amplitude asymmetry is calculated automatically.