Reliable change of the sensory organization test

Objective: To establish the sensitivity and specificity of the NeuroCom Sensory Organization Test (SOT) and provide practitioners with cut-scores for clinical decision making using estimates of reliable change. Design: Retrospective cohort study. Setting: Research laboratory. Patients: Healthy (n = 66) and concussed (n = 63) young adult participants. Interventions: Postural control assessments on the NeuroCom SOT were completed twice (baseline and follow-up) for both groups. Postconcussion assessments were administered within 24 hours of injury diagnosis. Main Outcome Measurements: The reliable change technique was used to calculated cut-scores for each SOT variable (composite balance; somatosensory visual, and vestibular ratios) at the 95%, 90%, 85%, 80%, 75%, and 70% confidence interval levels. Results: When cut-scores were applied to the post-concussion evaluations, sensitivity and specificity varied with SOT variable and confidence interval. An evaluation for change on one or more SOT variable resulted in the highest combined sensitivity (57%) and specificity (80%) at the 75% confidence interval. Conclusions: Use of reliable change scores to detect significant changes in performance on the SOT resulted in decreased sensitivity and improved specificity compared to a previous report. These findings indicate that some concussed athletes may not show large changes in postconcussion postural control and this postural control evaluation should not be used in exclusion of other assessment techniques. The postural control assessment should be combined with other evaluative measures to gain the highest sensitivity to concussive injuries.