MCTSIB (Modified Clinical Test of Sensory Interaction in Balance)

Assesses performance of inputs in balance when sensory systems are compromised.

Refer to the text below the calculator for more information about the MCTSIB.


The MCTSIB is the simplified, modified version of the Clinical Test of Sensory Interaction in Balance by Shumway-Cook and Horak, where only 4 of the original 6 conditions are retained (visual conflict conditions with the use of visual dome are removed).

The MCTSIB provides insight into whether each of the three sensory systems available for balance are used effectively by the patient suffering from a series of conditions from vestibular or neurological disorders, stroke or brain injury.


Instructions:

  • Patient performance in maintaining balance during each of the 4 conditions is timed for 30 seconds.
  • If during the first attempt the patient is unable to maintain the position for 30 seconds, they are provided with 2 additional attempts and an average time of the 3 trials is calculated.
  • A trial is terminated when the patient’s arms or feet change position.

Starting Position: Patient stands with feet shoulder width apart and arms crossed over chest.

1Condition 1: Eyes open, Firm surface

Trial 1 (time in seconds out of 30 sec)
Trial 2 (time in seconds out of 30 sec)
Trial 3 (time in seconds out of 30 sec)

2Condition 2: Eyes closed, Firm surface

Trial 1 (time in seconds out of 30 sec)
Trial 2 (time in seconds out of 30 sec)
Trial 3 (time in seconds out of 30 sec)

3Condition 3: Eyes open, Foam surface

Trial 1 (time in seconds out of 30 sec)
Trial 2 (time in seconds out of 30 sec)
Trial 3 (time in seconds out of 30 sec)

4Condition 4: Eyes closed, Foam surface

Trial 1 (time in seconds out of 30 sec)
Trial 2 (time in seconds out of 30 sec)
Trial 3 (time in seconds out of 30 sec)
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About the MCTSIB

The MCTSIB evaluates balance performance, specifically how sensory inputs are being used when one, two or all sensory systems are removed.

In condition 1, all sensory systems are available and the patient should have no difficulty in maintaining their balance (with feet shoulder width apart and arms crossed over chest) on the firm surface, with eyes open, for 30 seconds.

In condition 2, the vision sensory system is removed (as patients is asked to keep eyes closed) whilst maintaining their position for 30 seconds. The patient can rely on the other two systems to maintain balance.

In condition 3, the somatosensory system is removed (patient standing on foam, unsteady surface). The patient can rely on vision and vestibular inputs for balance.

In condition 4, both the somatosensory and vision systems are removed (patient stands on foam surface with eyes closed). Patient can rely only on inputs from the vestibular system for balance.

Failure to maintain balance:

  • Failure in condition 2 indicates reliance on visual input to maintain balance;
  • Failure in condition 3 & 4 indicates that the patient relies on the somatosensory input to maintain their balance and that the visual and/or the vestibular system is not being used and likely compromised.

The modified CTSIB is an easily administered test evaluating the ability of the patient to stand upright under several sensory conditions, shortened from the original 6 condition CTSIB following a study by Cohen et al. on three groups of neurologically asymptomatic adults (young, middle-aged and older) and a fourth group of subjects with vestibular disorders.

 

References

Original reference

Cohen H, Blatchly CA, Gombash LL. A study of the clinical test of sensory interaction and balance. Phys Ther. 1993; 73(6):346-51; discussion 351-4.

Other references

Wrisley DM, Whitney SL. The effect of foot position on the modified clinical test of sensory interaction and balance. Arch Phys Med Rehabil. 2004;85(2):335-8.

Motor Control: Translating Research into Clinical Practice. Anne Shumway-Cook, Marjorie H. 3rd Edition. Lippincott Williams and Wilkins. 2007. Chapter 11.


Specialty: Neurology

System: Nervous

Objective: Evaluation

No. Of Items: 4

Year Of Study: 1993

Abbreviation: MCTSIB

Article By: Denise Nedea

Published On: May 6, 2020

Last Checked: May 6, 2020

Next Review: May 6, 2025