Research Article

A preliminary study of sinusoidal harmonic acceleration test results in 7-12 years old normal children


Background and Aim: Sinusoidal harmonic acceleration (SHA) test is one of the most effective and best-tolerated methods to assess vestibular system function, especially horizontal semicircular canal in children. A prerequisite for using this test in children, is the availability of normative data. Despite of the numerous studies related to the SHA in adults, few researches have been documented in children. The aim of this study was to obtain normal values for SHA responses in normal children.
Methods: In this cross-sectional study, 38 children (20 boys and 18 girls) between 7 to 12 years old (mean age=9.55, SD=1.71) with normal hearing and no history of vestibular dysfunction were enrolled. SHA test was performed in five frequencies (0.01, 0.02, 0.08, 0.16 and 0.32 Hz) and fixation suppression test was performed in two frequencies (0.16 and 0.32 Hz). Parameters of gain, phase and symmetry in SHA test and fixation index (FI) in visual fixation suppression test in each frequency were recorded and compared tow genders.
Results: SHA responses and visual fixation suppression results were recorded in all children. Effect of frequency in each parameters of gain and phase were shown to have statistical significant differences, that is with increasing of frequency, gain increases and phase decreases (p≤0/001).
Conclusion: In this study normative values for SHA test and visual fixation suppression responses were proposed. These normative data can be used in the assessment of balance disorders and dizziness in school age children.

1. Casselbrant ML, Mandel EM, Sparto PJ, Perera S, Redfern MS, Fall PA, et al. Longitudinal posturography and rotational testing in children three to nine years of age: normative data. Otolaryngol Head Neck Surg. 2010;142(5):708-14.
2. Brey RH, Mcpherson JH, Lynch RM. Background and introduction to whole body rotational testing. In: Jacobson GP, Shepard NT, editors. Balance function assessment and management. 1st ed. San Diego: Plural Publishing Inc; 2008. p. 270.
3. Li CW, Hooper RE, Cousins VC. Sinusoidal harmonic acceleration testing in normal humans. Laryngoscope. 1991;101(2):192-6.
4. Ahmed MF, Goebel JA, Sinks BC. Caloric test versus rotational sinusoidal harmonic acceleration and step-velocity tests in patients with and without suspected peripheral vestibulopathy. Otol Neurotol. 2009;30(6):800-5.
5. Rubin W. Sinusoidal harmonic acceleration test in clinical practice. Ann Otol Rhinol Laryngol Suppl. 1981;90(4 Pt 3):18-25.
6. Arriaga MA, Chen DA, Cenci KA. Rotational chair (ROTO) instead of electronystagmography (ENG) as the primary vestibular test. Otolaryngol Head Neck Surg. 2005;133(3):329-33.
7. Teramoto K. A visual suppression test using post-rotatory nystagmus. Auris Nasus Larynx. 1992;19(2):83-94.
8. Maes L, De Kegel A, Van Waelvelde H, Dhooge I. Rotatory and collic vestibular evoked myogenic potential testing in normal-hearing and hearing-impaired children. Ear hear. 2014;35(2):e21-32.
9. Wang WQ, Chi FL, Wu LW, Lu HZ. Normative data and clinical practice of sinusoidal harmonic acceleration test. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010;45(1):14-8. Chinese.
10. Maes L, Dhooge I, De Vel E, D'haenens W, Bockstael A, Keppler H, et al. Normative data and test-retest reliability of the sinusoidal harmonic acceleration test, pseudorandom rotation test and velocity step test. J Vestib Res. 2008;18(4):197-208.
11. Valente M. Maturational effects of the vestibular system: a study of rotary chair, computerized dynamic posturography, and vestibular evoked myogenic potentials with children. J Am Acad Audiol. 2007;18(6):461-81.
12. Aust G. The effect of age on inhibition of visual fixation of the rotatory-induced nystagmus reaction. Laryngorhinootologie. 1993;72(1):9-14. German.
13. Golz A, Westerman ST, Gilbert LM, Joachims HZ, Netzer A. Effect of middle ear effusion on the vestibular labyrinth. J Laryngol Otol. 1991;105(12):987-9.
14. Casselbrant M, Furman J, Rubenstein E, Mandel E. Effect of otitis media on the vestibular system in children. Ann Otol Rhinol Laryngol. 1995;104(8):620-4.
15. Cyr DG, Brookhouser PE, Valente M, Grossman A.Vestibular evaluation of infants and preschool children. Otolaryngol Head Neck Surg. 1985;93(4):463-8.
16. Rine MR. Management of the pediatric patient with vestibular hypofunction. In: Herdman SJ, editor. Vestibular rehabilitation. 3rd ed. Philaddlphia: Margaret M. Biblis; 2007. p. 363.
IssueVol 24 No 2 (2015) QRcode
SectionResearch Article(s)
Sinusoidal harmonic acceleration suppression of the visual system horizontal semicircular canal 7-12-year normal children

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How to Cite
Badfar F, Sharifian Alborzi M, Rezazadeh N, Akbarzade Baghban A, Zarrinkoob H, Pourfahimi A. A preliminary study of sinusoidal harmonic acceleration test results in 7-12 years old normal children. Aud Vestib Res. 24(2):64-70.