For Healthcare Professionals:
Patients with acute vertigo and dizziness often present with gait instability and postural problems. Whether simple bedside gait and stance tests can help differentiate between peripheral and central causes (e.g., stroke) has remained unclear.
Study design:
Within the EMVERT study (LMU University Hospital, Munich), 200 patients were examined on average 16 hours after symptom onset. They were categorized into three groups:
- Acute vestibular stroke (n = 56)
- Acute unilateral vestibulopathy (AUVP) (n = 52)
- Episodic vestibular disorders (n = 92)
Test procedures:
- Timed Up and Go (TUG)
- Functional Gait Assessment (FGA)
- Gait and Truncal Ataxia Index (GTI)
- Mobile posturography
Key results
- On average, AUVP patients performed worse on TUG, FGA, and GTI compared with stroke or episodic groups.
- Discrimination (ROC) between stroke and AUVP was poor (0.57–0.62), improving only after adjustment for age and sex (0.75–0.82).
- Posturography showed the least body sway in episodic disorders, with similar values in stroke and AUVP.
Conclusion for Practice
Simple gait and stance tests such as TUG, FGA, or GTI are not sufficient on their own in the acute phase to reliably distinguish central from peripheral causes of dizziness.
→ They should always be interpreted in combination with patient history, HINTS examination, imaging, and further clinical findings .
👉 Are you interested in a comprehensive further training in vestibular rehabilitation and differential diagnosis of central vs. peripheral dizziness?
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For Patients – Easy to Understand
Gait and stance tests alone are often not enough to find the cause of dizziness
Researchers wanted to find out whether simple walking and standing tests can help distinguish between a stroke and a balance organ disorder when patients experience sudden or severe dizziness.
What was examined?
200 patients came to the clinic on average 16 hours after their symptoms began. They performed several tests:
- Timed Up and Go (TUG): Measures how quickly and safely you can stand up, walk a short distance, and sit down again.
- Functional Gait Assessment (FGA): Checks how well you keep balance while walking.
- Gait and Truncal Ataxia Index (GTI): Assesses how well your trunk and legs coordinate when walking.
- Mobile posturography: Records how stable you are while standing or walking.
What are the findings?
- Some patients with vestibular nerve inflammation did worse in these tests than stroke patients.
- But the tests alone were not reliable enough to say whether the cause was a stroke or a vestibular nerve problem.
Conclusion
In acute vertigo and dizziness, a thorough and comprehensive examination is always needed. Walking and standing tests are helpful, but not sufficient.
That’s why doctors always look at the results together with: your medical history, special bedside tests developed to distinguish causes of dizziness (the so-called HINTS exam), imaging such as MRI, and other clinical findings.
🎯 Specially trained IVRT® dizziness and vestibular therapistsan professionally assess and treat your balance problems. You canf find them via our IVRT therapist search