Translation to Clinic

The Balance Evaluation Systems Test (BESTest)

This unique clinical balance evaluation tool allows clinicians to separate balance disorders into problems with 6 different balance systems. A copy of the test with clinical examples for how to score each item is now available.

This new test allows clinicians to quantify 4 different types of balance and gait in their patients who wear small inertial sensors during testing. This instrumented test is much more sensitive, reliable and accurate than clinical rating scales or questionnaires for evaluating balance and gait disorders. Currently, we are developing mobility scores for the elderly and for people with Parkinson’s disease, testing its reliability and sensitivity to exercise supported by the Kinetics Foundation.

bestest diagram

Audiobiofeedback for Balance Control

Audiobiofeedback for Balance Control (European Patent)

In collaboration with the U of Bologna Dept of Engineering, we developed a unique biofeedback device to improve balance by providing changes in tones related to postural sway. Our studies have shown significant improvement in quiet stance and in walking in patients who have loss of vestibular function.

Dozza, M., Wall, C., Peterka, R., Chiari L., Horak, F.B. Effects of practicing tandem gait with and without vibrotactile biofeedback in subjects with unilateral vestibular loss. Journal of Vestibular Research 17:195-204, 2007. PMCID: PMC2474458

Dozza, M., Horak, F.B., Chiari, L. Auditory biofeedback substitutes for loss of sensory information in maintaining stance.Exp Brain Res Mar; 178(1): 37-48, 2007.

Dozza M., L. Chiari, and F.B. Horak, Audio-biofeedback improves balance in patients with bilateral vestibular loss, Arch.Phys.Med.Rehabil., 86(7) 1401-1403, 2005.

Agility Exercise Program

Agility Exercise Program to Delay Mobility Disability in Parkinson’s Disease

We are currently testing the effectiveness of a newly designed exercise program specifically focused on improving dynamic balance in people with Parkinson’s disease. This intensive program, directed by physical therapists at OHSU, is unique in providing challenging exercises for each of the constraints on mobility from Parkinson’s disease.

King, L.A., Horak, F.B. Preventing mobility disability in Parkinson’s disease with a sensorimotor agility exercise program., Physical Therapy April, 2009.

Mobility Lab

mobility testing, image depicts Dr Horak and a man with some testing gearWith help of the Balance Disorders Laboratory, APDM Wearable Technologies has developed a novel portable laboratory system called "Mobility Lab" to allow clinicians to measure balance and gait in any environment. 

OHSU works together with APDM to initiate ground-breaking gait and balance research using Mobility Lab. The system provides sensitive, valid, and reliable outcome measures. Using APDM’s advanced wearable sensors (Opals), Mobility Lab makes it easy to collect, analyze, and store data. Opals are attached to a subject, and they are instructed to perform a standardized test. A report is then automatically generated to compare against normative values. This process takes less than five minutes.

Learn more about Mobility Lab at