Tests limited to research settings

By Marcello Cherchi, MD PhD

Introduction

The diagnostic tests that have made their way into clinical use generally meet several criteria:

  • They are helpful in diagnosing multiple diseases, including some which are common.
  • They are affordable by a clinical practice.
  • They physically fit into a clinical practice.

Below we briefly discuss some tools that are relevant for testing vestibular system function, but fail to meet one or more of the criteria listed above.

Human centrifuge

Human centrifuges are a mechanism for using the centrifugal component of rotational acceleration to mimic linear acceleration (Brandt 1962; Hallgren et al. 2016; Hallgren et al. 2015; Moore et al. 2003; Schoenmaekers et al. 2022). The linear acceleration can be used to study otolith function.

The Figure below, from Hallgren and colleagues (Hallgren et al. 2015), illustrates an experimental human centrifuge setup.

Figure: Experimental human centrifuge setup. From Hallgren et al. (2015).
Figure: Experimental human centrifuge setup. From Hallgren et al. (2015).

The Figure below, from Schoenmaekers and colleagues (Schoenmaekers et al. 2022), illustrates a setup used for utricular stimulation.

Figure: Human centrifuge setup to elicit utricular stimulation. From Schoenmaekers et al. (2022).
Figure: Human centrifuge setup to elicit utricular stimulation. From Schoenmaekers et al. (2022).

The arrangements shown in the figures above can be achieved with a modified rotatory chair. More elaborate human centrifuges with swinging gondolas have also been used, as shown in the Figure below, from Tribukait and Eiken (Tribukait and Eiken 2005).

Figure: Human centrifuge with swinging gondola. From Tribukait and Eiken (2005).
Figure: Human centrifuge with swinging gondola. From Tribukait and Eiken (2005).

Customized rotatory chair setups are expensive. Human centrifuges with swinging gondolas are expensive and take up a great deal of space.

Moog platform

William Moog (1915 – 1997) invented the electrohydraulic servo valve, which was one of the crucial components in developing the Moog platform. This device is helpful in studying vestibular responses to static and dynamic tilt.

The Figures below, from Mardirossian and colleagues (Mardirossian et al. 2014), and from Strupp and colleagues (Strupp et al. 2023), show Moog platforms.

Figure: Moog platform. From Mardirossian et al. (2014).
Figure: Moog platform. From Mardirossian et al. (2014).
Figure: Moog platform. From Strupp et al. (2023).
Figure: Moog platform. From Strupp et al. (2023).

Moog platforms are expensive pieces of machinery that require considerable space, and consequently are largely restricted to research settings, so there is relatively little literature drawing on data from them (Beylergil et al. 2019; Chaudhuri et al. 2013; La Scaleia et al. 2023; Mardirossian et al. 2014).

Parallel swing

Parallel swing testing is a method for testing otolith responses to linear acceleration.

The Figures below, from Gresty and Bronstein (Gresty and Bronstein 1992) and Walsh (Walsh 1961), show a schematics of the arrangement of a parallel swing.

Figure: Parallel swing for testing otolith function. From Gresty and Bronstein (1992).
Figure: Parallel swing for testing otolith function. From Gresty and Bronstein (1992).
Figure: Parallel swing for testing otolith function. From Walsh (1961).
Figure: Parallel swing for testing otolith function. From Walsh (1961).

In practice, parallel swings are quite large, as shown in the Figures below, from Oosterveld (Oosterveld 1970) and Greven and colleagues (Greven et al. 1974).

Figure: Photograph of an actual parallel swing. From Oosterveld (1970).
Figure: Photograph of an actual parallel swing. From Oosterveld (1970).
Figure: Photograph of an actual parallel swing. From Green et al. (1974).
Figure: Photograph of an actual parallel swing. From Green et al. (1974).

Parallel swings require considerable space for operation.

Linear accelerator (“sled”)

Sleds (also called linear accelerators) have been used to generate linear acceleration for testing otolith function.

The Figure below, from Gresty and Bronstein (Gresty and Bronstein 1992), shows the setup of a sled for this purpose.

Figure: Linear accelerator ("sled") used for testing otolith function. From Gresty and Bronstein (1992).
Figure: Linear accelerator (“sled”) used for testing otolith function. From Gresty and Bronstein (1992).

These types of devices are generally constructed in research laboratories.

Gait analysis

Gait analysis involves tracking in two or three dimensions the movement of individual joints during locomotion. This is generally done in a gait lab, which requires a complex setup for capturing and analyzing data.

The Figures below, from Pamies-Vila and colleagues (Pàmies-Vilà et al. 2015), show examples of fiducial marking of joints, and the cameras that track their movements.

Figure: Fiducial markers on joints. From Pamies-Vila et al. (2015).
Figure: Fiducial markers on joints. From Pamies-Vila et al. (2015).
Figure: Gait lab camera setup for capturing motion of joint fiducials. From Pamies-Vila et al. (2015).
Figure: Gait lab camera setup for capturing motion of joint fiducial markers. From Pamies-Vila et al. (2015).

Gait laboratories are expensive operations that require considerable computing power for data collection and analysis.

Wearable inertial sensors

The miniaturization of technology for sensors (accelerometers) and transmitters (WiFi, Bluetooth) has advanced application of wearable inertial sensors for clinical research. Much of this remains restricted to investigational protocols, but it is likely that this will gradually penetrate medical practice in fields such as ataxia (Shah et al. 2021; Velazquez-Perez et al. 2021; Zhou et al. 2022) and movement disorders (Carpinella et al. 2017; Hubble et al. 2015; Lu et al. 2020; Monje et al. 2019; Ossig et al. 2016; Pardoel et al. 2019; Sanchez-Ferro and Maetzler 2016). This technology is just beginning to be applied to vestibular disorders (AlSharif et al. 2023; Gawronska et al. 2023; Gawronska et al. 2022; Meldrum et al. 2022; Zhang et al. 2021).

References

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Page first published on May 6, 2023. Page last updated on November 8, 2025

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