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Our Advanced Technology

Nationally recognized as a pioneer in identifying and treating vestibular disorders, balance and dizziness expert Jim Buskirk has worked with medical firms and engineers to create devices and harness systems to provide innovative, safe treatment facilities. Working closely with research physicians, Peak & Balance Centers of America continually participates in clinical trials for new devices and research projects.

Peak & Balance has a unique, individualized approach to treating vestibular disorders. While conventional pharmaceutical treatment relieves symptoms for some sufferers, there are people for whom this course of treatment is ineffective. Many people who suffer from disorders of the vestibular system can effectively and quickly regain vestibular health after:

  • A complete diagnostic evaluation
  • Assessment of the results of the evaluation
  • Prescription of a customized series of therapies based on recommendations from the assessment
  • Rehabilitation exercises with a team of highly experienced physical therapists who specialize in vestibular health
  • Ongoing follow-up care

Vestibular rehabilitation has been proven to effectively treat patients with dizziness and balance problems. Studies show that 85% of patients achieve full recovery within just six weeks of vestibular rehabilitation.

Equipment Used

Peak & Balance Centers offers the latest in testing technology for balance and vestibular disorders, resulting in a prompt, accurate diagnosis.

Computerized Dynamic Posturography (CDP)

There are three key components that contribute to a person’s balance. If any of the three are not functioning properly, it can have an impact on their ability to conduct normal daily activity. The three components are as follows:

  • Visual
  • Muscle & Joint
  • Vestibular (Inner Ear)

Posturography allows the therapist to assess each one of the three components independently. The information gathered during testing on the CDP allows the therapist to identify fall risk factors, work-related dysequilibrium, and malingering. Posturography also helps the therapist assess whether the patient’s balance disorder is due to misinformation or misinterpretation of sensory and motor inputs and her ability to suppress information that is inaccurate.

Dynamic Visual Acuity Test (DVAT)

The Dynamic Visual Acuity Test (DVAT) assesses impairments in a patient’s ability to perceive objects accurately while actively moving the head. In normal individuals, losses in visual acuity are minimized during head movements by the vestibular ocular reflex (VOR) system that maintains the direction of gaze on an external target by driving the eyes in the opposite direction of the head movement.

When the VOR system is impaired, visual acuity degrades during head movements. To quantify losses in visual acuity during head movement, the first step is to determine the patient’s head fixed (static) visual acuity. This is accomplished by seating the patient a prescribed distance before the computer monitor and displaying sequences of the optotype “E” of predetermined size and in one of four possible random orientations.

When the patient correctly identifies the orientation of at least 3 of 5 successive “E” presentations of a given size, the optotype size is reduced and the process repeated until the orientation of the optotype can no longer be reliably determined. Static visual acuity is then based on the smallest “E” that can be identified accurately.


This diagnostic tool is capable of directly observing and recording eye movements during specific conditions. It does this with the use of two infrared video cameras mounted in a pair of goggles and worn by the patient during the testing. How eyes move under different conditions of a patient’s position and gaze can provide important information concerning a patient’s ability to coordinate eye and head movement and maintain a stable image when moving through space.

The patient’s ability to track objects and maintain a stable image as he is walking or running is an important factor in the ability to balance himself under different environmental conditions. Abnormal eye movements under these varying conditions also suggest various pathological conditions that may be present and helps in making a more accurate diagnosis.

Vestibular Evoked Myogenic Potential (VEMP)

Peak & Balance Centers of America now offers VEMP testing. This is a relatively new test that can help identify the specific site of injury to the inner ear and/or balance nerve.

During the examination, small recording electrodes are taped to the neck and shoulders. Sounds are presented to one ear while the patient’s head is held in a certain orientation. The VEMP is a short-latency EMG (eletromyographic) response evoked at high-level acoustic stimulation and recorded from surface electrodes over the contracted sternocleidomastoid (SCM) muscle.

Electronystagmography and rotational tests only assess the horizontal semicircular canals of the vestibular system. The VEMP assesses the saccule and inferior vestibular nerve, which other tests do not assess. By conducting the test, if a VEMP amplitude is reduced on one side compared to the other, you are assured that the response reduction is due to a vestibular abnormality and not due to a lack of tonic SCM muscle contraction caused by improper patient position or fatigue.


The VORTEQ high frequency VOR test system provides information about the vestibulo-ocular reflex in subjects who present with dizziness. As a complement to ENG or VNG and rotational chairs, the VORTEQ offers a simple method to further evaluate VOR gain, phase, and symmetry in the frequency range 0.5 to 8Hz.

During testing, a standard configuration of ENG electrodes and an EOG amplifier records eye movement while, simultaneously, an accelerometer records head velocity. The subject shakes their head in a “Yes” or “No” direction to the beat of an electronic metronome over a frequency range specified for the test. Software algorithms quickly and automatically analyze eye and head velocities over the 15 second test period to determine VOR gain, phase, and symmetry. Results are graphed and printed in both summary and composite reports.

When you have a patient who you think would benefit from vestibular therapy, give us a call at (312) 646-1001 and we’ll be happy to answer your questions about the treatments we offer and our plan of care. Learn more about the referral process.

Peak & Balance Centers of America