Gans Sensory Organization Performance Test

Original Editor - Alyssa Brooks-Wells
Top Contributors - Alyssa Brooks-Wells and Kim Jackson

Purpose[edit | edit source]

The Gans Sensory Organization Performance (SOP) Test is a simple bedside assessment of postural stability. It merges elements from the Romberg test, Modified Clinical Test of Sensory Integration of Balance (mCTSIB), and Fukuda Stepping Test. The individual is positioned in seven distinct conditions, altering factors such as the base of support, surface type, and visual input. The test evaluates the individual's capacity to sustain balance across these varied conditions, assessing their postural control ability. The Gans SOP is simple and cost-effective for clinicians to utilize.[1]

Technique[edit | edit source]

Before beginning the test, ensure the patient's safety by performing near external support such as a wall or corner. A gait belt may also be useful with some patients. The patient must be able to stand and ambulate independently for the test to be reliable and a valuable indicator of vestibular function.[2]

The Gans SOP Test has seven conditions. The test is performed without shoes, arms by their sides, in a quiet and controlled environment. Continue to monitor and guard the patient throughout holding the position for up to the full 20 seconds. The tester rates each condition the patient performs as: Normal, Sway, or Fall, and also indicates the direction of sway or fall to the left or right. A sway can be normal or abnormal depending on severity. The condition is rated as a fall if the patient comes out of the test position or cannot maintain the test position.[2]

Gans SOP Conditions (held for 20 seconds each)[2]
# Body Position Surface Eyes Origin Test
1 Feet shoulder-width apart Firm Open Romberg
2 Feet shoulder-width apart Firm Closed Romberg
3 Modified tandem (feet apart) Firm Open Romberg
4 Modified tandem (feet apart) Firm Closed Romberg
5 Feet shoulder-width apart Foam Open mCTSIB
6 Feet shoulder-width apart Foam Closed mCTSIB
7 March in place at a comfortable step height and pace, and then close eyes and continue to march Firm Closed Fukuda

For conditions 3 and 4, the patient can choose the foot placement and which foot is in front and behind.

Evidence and Application[edit | edit source]

Conditions 1-4 are not sensitive to vestibular dysfunction, but they are used as a baseline for overall balance and stability. If they are unable to perform these baseline conditions, they are unable to safely continue the test.

Condition 6 is the most sensitive test (75% sensitivity) for uncompensated vestibulopathy.

Condition 7 is positive if there is a drift or turn >30 degrees from the starting position. This test is 50% sensitive for uncompensated vestibulopathy, and most often the patient will turn toward the weaker side (impaired ear).

If the patient presents with both a positive "fall" in condition 6 and drifts >30 degrees in condition 7, there is 95% sensitivity to identify uncompensated vestibulopathy and correlation with caloric testing.[2]

Resources[edit | edit source]

The specific foam pad utilized during research for this test can be found on the American Institute of Balance's website.

References[edit | edit source]

  1. Sakumura J, Gans R. Fall Risk Management in Audiology and ENT Practice: The Role of Cognitive, Vestibular, and Auditory Function. Journal of Audiology and Otolaryngology. 2022.
  2. 2.0 2.1 2.2 2.3 Vestibular First. Gans Sensory Organization Performance (SOP) Test Available from: (accessed 20/March/2024)