Performance of Fukuda Stepping Test as a function of the severity of caloric weakness in chronic dizzy patients

Julie A. Honaker, Neil T. Shepard

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: The purpose of the Fukuda Stepping Test (FST) is to measure asymmetrical vestibulospinal reflex tone resulting from labyrinthine dysfunction. The FST is a low cost evaluation for dizzy patients; however, when compared with gold standard caloric irrigation unilateral weakness (UW) value ≥25%, the FST has not been shown to be a sensitive tool for identifying unilateral vestibular hypofunction. Purpose: The purpose of this technical report is to further evaluate the clinical utility of FST with and without headshake as a function of increased caloric asymmetry for individuals with unilateral peripheral vestibular pathology. Research Design: Retrospective review of FST results with and without head shaking component as compared to gold standard, caloric irrigation UW outcome values at four severity levels: 0-24% UW (normal caloric value); 25-50% UW (mild caloric UW); 51-75% UW (moderate caloric UW); 76-100% UW (severe caloric UW). Study Sample: 736 chronic (≥8 wk symptom complaints) dizzy patients. Results: Standard FST and FST following a head shake task are insensitive to detecting mild to moderate peripheral vestibular paresis. Increased test performance was observed for patients with severe canal paresis (>76% UW); however, continued inconsistencies were found in turn direction toward the severe unilateral vestibular dysfunction. Conclusions: Overall, the FST provides little benefit to clinicians when used in the vestibular bedside examination.

Original languageEnglish (US)
Pages (from-to)616-622
Number of pages7
JournalJournal of the American Academy of Audiology
Issue number8
StatePublished - Sep 2012


  • Caloric irrigations
  • Fukuda stepping test
  • Head shake
  • Unilateral weakness

ASJC Scopus subject areas

  • Speech and Hearing


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