Tests · Balance
Posturography: how the body keeps its balance standing
Posturography measures how much the body sways while standing on a sensitive platform, under conditions that alter vision and the support surface. It shows which of the balance senses the person relies on most and how steady they can remain. It serves to quantify imbalance and to follow vestibular rehabilitation.
Medically reviewed by Prof. Aline Bittencourt, MD, PhD, CRM-MA 7562 · RQE 1832 Updated on
How the body keeps its balance
Standing without falling seems simple, but it depends on three sources of information working together:
- Vision, which tells you where the ground and the horizon are.
- The vestibular system, in the inner ear, which detects head movement.
- Proprioception, the sensation from the feet, joints and muscles, which reports body position.
The brain combines all three. When one fails, it comes to rely more on the others — and it is that compensation posturography can see.
What the test does
You stand on a sensitive platform that records the small sways of your body. The test presents a sequence of conditions that progressively remove information, one at a time:
| Condition | What it tests |
|---|---|
| Eyes open, firm surface | Balance under favourable conditions |
| Eyes closed, firm surface | How much you rely on vision |
| Unstable surface, eyes open | How much you rely on proprioception from the feet |
| Unstable surface, eyes closed | The vestibular system almost on its own |
By comparing performance across conditions, the test shows which sense is being underused and which is overloaded.
When is it indicated?
- Persistent imbalance when walking, with or without vertigo.
- Before starting vestibular rehabilitation, to guide the programme.
- During rehabilitation, to follow progress with comparable data.
- Assessment of steadiness in people with a history of falls.
- Where the complaint of unsteadiness does not match what the other tests have shown.
What it does not do
Posturography does not localise the lesion. It does not say whether the problem is in the right or left labyrinth, nor which structure is affected. That is the role of the tests that examine each part of the system, described on the page on dizziness and vertigo.
What it measures is the outcome: how steady, in the end, the person is able to remain — and it is that information which guides the training.
Where it is carried out
At Clínica Rhinus, in the Renascença district of São Luís, as part of the neurotologic assessment. The result is interpreted at the consultation, alongside the other balance tests.
This test is carried out on a self-pay basis only. The consultation and the other tests follow the rules of your health plan. Contact our team to arrange booking.
How should I prepare for this test?
- Bring the medical request: it is required.
- Wear comfortable clothing that allows you to move freely.
- Bring flat, closed shoes, or take the test barefoot, as advised.
- If you wear glasses, bring them: part of the test depends on vision.
- Stop medication for dizziness and sedatives as advised by the doctor who requested the test — never on your own initiative.
- Come accompanied if you have significant unsteadiness when walking.
Sources: Brazilian Association of Otorhinolaryngology and Cervico-Facial Surgery (ABORL-CCF) · Flint PW, Francis HW, Haughey BH, et al. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Elsevier; 2020. · Bento RF, Bittencourt AG, Voegels RL. Seminários em Otorrinolaringologia. Fundação Otorrinolaringologia.
Frequently asked questions
Questions about balance
Does posturography tell me the cause of my dizziness?
No. It measures balance performance, not where the problem lies. The tests that point to the side and the structure involved are the others, such as videonystagmography, vHIT and VEMP. Posturography answers a different question: how much that problem actually affects your steadiness.
Is there a risk of falling during the test?
The test is carried out with a safety harness and with the clinician alongside throughout. The platform is low and the conditions are introduced progressively. Feeling some unsteadiness at certain stages is common — that is part of the test and is precisely what is being measured.
What is the result used for?
For two main purposes. Planning vestibular rehabilitation, since the test shows which sense is being underused and needs training. And follow-up: repeating the test during treatment allows numbers to be compared rather than relying only on the perception of improvement.
Do I need other tests as well?
Generally yes. Posturography usually comes after or alongside the tests that investigate the origin of the problem. The usual combination includes audiometry, videonystagmography and, depending on the suspicion, vHIT, cervical VEMP or electrocochleography. Each answers part of the question.