What is the Hamid vestibular stress test for dizziness, vertigo, and imbalance?

Updated: Mar 13, 2017
  • Author: Hesham M Samy, MD, PhD; Chief Editor: Robert A Egan, MD  more...
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Answer

The Hamid vestibular stress test is composed of a sensory and a motor component and is performed by using a high-compliance foam pad (HCFP). The examination is simple, easy to administer, and applicable to most patients with dizziness and disequilibrium.

In the sensory component, the patient stands on the HCFP with eyes open and arms stretched out while the examiner observes the degree of sway in the primary position and at the limits of stability. The patient then tilts the head back and moves it right and left, first with eyes open and then with eyes closed. The examiner must be prepared to catch the patient if he or she falls. Experience with this examination has shown that patients cannot stand on the HCFP with eyes closed and head tilted back unless they have an intact vestibular and balance system.

The motor component is more challenging than the sensory component and is referred to as the body-impulse test. The physician places his or her hands against the patient’s shoulders and asks the patient to push forward against the hands for a count of 10. The physician then releases his or her hands, watches the patient’s response, and catches the patient if necessary. Most patients can correct for the sudden perturbation by performing 3 corrective responses:

  • Forward bending (hip-sway strategy)

  • Stepping forward

  • Stepping back to the original position


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