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RehabMeasures Instrument

Roll Test

Last Updated

Purpose

Determines the presence of horizontal canalilithiasis or cupulolithiasis.

Acronym ?

Assessment Type

Observer

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Vestibular Disorders

Key Descriptions

  • Roll Test (Herdman, 2007):
    1) Patient lies supine with neck flexed 20?
    2) Head is quickly rolled 90? to one side for up to one minute, observe presence & direction of nystagmus, and then return slowly to midline; maintaining the neck flexion, the procedure is repeated to the other side. Note patient report of vertigo.
  • Canalithiasis – nystagmus is geotropic (toward the earth) when the head is rolled to the right and left, and lasts a short duration (approximately < 60 seconds).
  • Cupulolithiasis – nystagmus is apogeotropic (away from the earth) when the head is rolled right and left, and is persistent (> 60 seconds).

Number of Items

2

Equipment Required

  • Electronystamography
  • Videonystagmography
  • Video recorder
  • Video goggles or Frenzel goggles to view nystagmeu

Time to Administer

Less than 5 minutes

Required Training

Training Course

Age Ranges

Child

6 - 12

years

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Linda B. Horn, PT, DScPT, MHS, NCS, Karen H. Lambert, PT, MPT, NCS, and the Vestibular EDGE Task Force of the Neurology Section of the APTA (2013).

Body Part

Head

ICF Domain

Body Structure
Body Function

Measurement Domain

General Health
Sensory

Professional Association Recommendation

 

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

 

For detailed information about how recommendations were made, please visit:  

 

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

VEDGE

LS

LS

LS

 

Recommendations based on vestibular diagnosis

 

Peripheral

Central

Benign Paroxysmal Positional Vertigo (BPPV)

Other

VEDGE

LS

LS

LS

LS

  

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

VEDGE

Yes

Yes

Yes

Yes

Considerations

Variations to test procedure: 

  • 30? neck flexion (Fife, 1998) 
  • Patient supine, amount of neck flexion omitted (Baloh, 1993; Fife, 1998) 
  • 180-degree supine roll test (Lim, 2013) 
    • Starting from the end position of the Roll Test, the head is rotated 180? to the opposite side 
    • Electronystagmography and a video eye movement recorder were used to measure SPV (slow phase velocity) and determine which was the affected side
    • No statistically significant difference was noted between the Roll Test and the 180-degree Supine Roll Test in the rate of positive findings. 
    • Success rate for determining the affected side when using the Roll Test, 180-degree Supine Roll Test and the Bow and Lean Test was 84.4% (91% for geotropic and 76.3% for apogeotropic)

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Bibliography

Baloh, R. W., Jacobson, K., et al. (1993). "Horizontal semicircular canal variant of benign positional vertigo." Neurology 43(12): 2542-2549. 

Fife, T. D. (1998). "Recognition and management of horizontal canal benign positional vertigo." Am J Otol 19(3): 345-351. 

Herdman, S. J. (1990). "Treatment of benign paroxysmal positional vertigo." Phys Ther 70(6): 381-388.   

Lim, H. J., Park, K., et al. (2013). "The significance of 180-degree head rotation in supine roll test for horizontal canal benign paroxysmal positional vertigo." Otol Neurotol 34(4): 736-742.