The Fukuda Test for Vestibular Function

Test Your Balance and Vestibular Function

Photo of a girl balancing on a log.
The Fukuda Test is used to test your balance and vestibular function.. Don Mason/Getty Images

If you are feeling dizzy, have vertigo or are having problems maintaining your balance, then you may be suffering from a vestibular system problem. Your doctor may refer you to a physical therapist to assess your problem and to provide strategies to help manage your dizziness.

When your physical therapist is assessing your balance and vestibular system, he or she will likely perform several tests to determine the cause of your disequilibrium.

Tests of your eye motion, head and neck motion, and balance tests may be performed. Special tests, like the Dix-Hallpike maneuver, may be performed to rule in or rule out benign paroxysmal positional vertigo (BPPV).

The Fukuda Stepping test is one balance and vestibular test that may also be performed during a vestibular and balance exam. The test is used to determine if there is vestibular system weakness on one side of your body.

Performing the Fukuda Stepping Test

To perform the Fukuda Stepping Test, you should first make sure you have plenty of space around you. It is also a good idea to have a friend or family member nearby to assist you in performing the test.

To start the test, stand in the middle of a room. Place a small piece of tape on the floor in front of your toes to mark your starting position.

Close both eyes and hold your arms out stretched directly in front of you. Now, start stepping in place.

Your pace should be comfortable as if you were taking a brisk walk. Make sure someone is watching you so you do not bump into anything the room.

Remain walking in place for 50 to 100 steps. After stepping, open your eyes and determine how much your body rotated to one side or the other.

Assessing the Results of the Fukuda Test

After performing the Fukuda Stepping Test, place a small piece of tape on the floor along the front of your toes, and compare the angle of this line with your original line.

If you have taken only 50 steps, then an angle of 30 degrees or more may indicate vestibular weakness to the side your body deviated.

If you performed the Fukuda Test for 100 steps, an angle greater than 45 degrees indicates single sided vestibular weakness on the side to which your body turned while doing the test.

Is the Fukuda Stepping Test Reliable?

There is some question amongst healthcare providers as to whether the Fukuda Test is a reliable measure of vestibular function. One study examined patients with confirmed vestibular dysfunction on one side and compared them to patients with no vestibular function impairments. The results indicated that it didn't matter if you had a vestibular problem or not; some people rotated to one side, others did not.

Another study found that in patients with confirmed vestibular dysfunction, about 50% turned toward the affected side, 25% turned towards the unaffected side, and 25% remained relatively stable with a turn of fewer than 45 degrees from the starting position.

This indicates that the Fukuda Stepping Test may not be able to be used to indicate which side of your vestibular system is affected.

Still, the Fukuda Stepping Test may be used by your physical therapist as an initial outcome measure to determine your vestibular, or kinesthetic awareness, function. Plus, it is a fun, simple test to do.

If you have dizziness or vertigo, then specific testing may be necessary to determine the cause of your problem. The Fukuda Stepping Test is a simple test to perform to monitor your current dizziness and to help your physical therapist find the right treatment for your dizziness.

Sources: Bonanni M, Newton R. Test-retest reliability of the Fukuda Stepping Test. Physiother Res Int. 1998;3(1):58-68.
Honaker, Julie A. and Shepard, Neil T., "Fukuda Stepping Test: Sensitivity and Specificity" (2009). Special Education and Communication Disorders Faculty Publications. Paper 20.
Zhang YB, Wang WQ. Reliability of the Fukuda stepping test to determine the side of vestibular dysfunction. J Int Med Res. 2011;39(4):1432-7.

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