Patient guide · Vestibular assessment
Posturography, computerised balance-force-plate assessment for falls risk and vestibular rehab.
Computerised dynamic posturography (CDP) uses a force plate and moving visual surround to quantify balance strategy — for falls risk assessment, vestibular rehabilitation planning and monitoring recovery.
Key facts
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Definition
Computerised force-plate balance assessment quantifying postural strategy.
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Foundation of vestibular rehabilitation
The objective baseline that structures a personalised rehab programme.
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Quantifies three sensory contributions
Separates vestibular, visual and somatosensory inputs into balance.
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SOT (Sensory Organisation Test) protocol
Six standardised conditions with fixed and sway-referenced surround.
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Complements caloric, vHIT and DVA
Sits alongside the other vestibular tests, not in place of them.
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Reported by vestibular clinician
Reviewed by a vestibular physiotherapist or audiologist.
How the assessment works
From consultation to personalised rehab plan.
A standardised protocol so results can be compared between sessions and between clinicians.
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Vertigo / vestibular consultation
A structured clinical history and bedside exam frames the request.
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Stand on the force plate
Bare feet on a pressure-sensing platform, harness for safety.
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Complete 6 SOT conditions
Eyes open / closed, fixed / sway-referenced surround and platform.
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Balance strategy analysed
Software calculates ankle vs. hip strategy and equilibrium score.
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Repeat conditions for reliability
Each condition is run three times to establish a stable mean.
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Structured report
A written report with sensory ratios, composite score and falls risk.
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Personalised rehab plan
Findings drive a targeted vestibular rehabilitation programme.
What it shows
The patterns CDP is designed to detect.
Posturography answers a specific clinical question — which sensory system is under-performing, and how that translates into falls risk.
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Vestibular hypofunction
Reduced equilibrium in conditions that isolate the vestibular system.
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Somatosensory dependency
Over-reliance on foot / ankle proprioception for balance.
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Visual dependency
Over-reliance on the visual surround — destabilised by moving scenes.
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Balance strategy pattern
Ankle vs. hip strategy — hip dominance suggests deconditioning or risk.
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Falls risk score
Composite equilibrium score benchmarked against age-matched norms.
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Post-vestibular neuritis recovery
Objectively tracks central compensation after acute vestibular loss.
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Post-BPPV residual imbalance
Explains lingering unsteadiness after successful Epley manoeuvres.
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Red flag: severe bilateral vestibulopathy — urgent audiology / neurology
Marked bilateral loss needs urgent onward referral.
Treatment options
What CDP results translate into.
The report is only useful if it changes the plan. These are the interventions CDP typically drives.
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Vestibular rehabilitation programme
Structured gaze stabilisation, habituation and balance exercises.
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Balance retraining
Progressive challenge to somatosensory, visual and vestibular systems.
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Falls prevention (Otago, Tai Chi)
Evidence-based group and home programmes for older adults.
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Home exercise plan
A daily routine matched to the SOT profile, reviewed at follow-up.
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Anti-migraine therapy
Lifestyle, diet and preventative medication where vestibular migraine is driving symptoms.
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ENT / neuro-otology referral
Onward specialist review where the pattern suggests central pathology.
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Structured follow-up
Repeat CDP after 8–12 weeks to quantify progress objectively.
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Multi-disciplinary team review
Physiotherapy, audiology and ENT coordinated around a single plan.
Red flags
When posturography needs urgent onward pathways.
Some patterns need audiology, neurology or ENT review — not just rehab. The clinician flags these on the report.
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Bilateral vestibulopathy
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Cerebellar disease
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Post-stroke imbalance
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Peripheral neuropathy with falls
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Persistent postural-perceptual dizziness (PPPD)
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Post-concussion syndrome
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Post-COVID vestibular dysfunction
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Vestibular schwannoma
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Sarcopenia with falls
Frequently asked
Everything patients ask about posturography.
What CDP measures, when it’s useful, and how it shapes rehabilitation.
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What is computerised dynamic posturography?
CDP is a computerised balance test. You stand on a force-sensing platform inside a visual surround; both can stay fixed or move in response to your sway. Software then quantifies how much you rely on vestibular, visual and somatosensory input to stay upright.
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Is posturography painful?
No. You stand quietly on a platform wearing a safety harness. Each condition lasts around 20 seconds and the whole assessment takes 30–45 minutes.
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What does the SOT actually measure?
The Sensory Organisation Test runs six conditions that isolate each sensory system in turn. The equilibrium score, sensory analysis ratios and strategy score together describe how you balance and where the weakness sits.
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When should I be referred for posturography?
It is most useful after a suspected vestibular event, for unexplained falls, to plan vestibular rehabilitation, and to objectively monitor recovery. It complements — not replaces — caloric, vHIT and DVA.
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How does this help my rehabilitation?
The profile identifies which sensory system to challenge and which to protect. Your vestibular physiotherapist uses that to build a targeted programme rather than a generic set of exercises.
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Can posturography be repeated to track progress?
Yes — repeat testing at 8–12 weeks gives an objective measure of whether the rehab programme is working, and where to adjust it.
Sources
The guidance this page is built on.
Reviewed 2026-07-30. Next scheduled review 2027-07-30.
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In practice, in London
The honest picture around posturography in London
With posturography, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Public provision for posturography is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
A typical private booking for posturography in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For posturography specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
There are a lot of consultants in London who can technically handle posturography. Fewer who do it week in, week out for the exact question you’re bringing. We spend most of our time working out which is which — and being straight when a different test or a different specialist would serve you better. Everything runs to CQC, GMC and Royal College standards; the choice is about fit, not floor.
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