Normative Data for the NeuroCom Sensory Organization Test in US Military Special Operations Forces

Abstract

Context: Postural stability is the ability to control the center of mass in relation to a person's base of support and can be affected by both musculoskeletal injury and traumatic brain injury. The NeuroCom Sensory Organization Test (SOT) can be used to objectively quantify impairments to postural stability. The ability of postural stability to predict injury and be used as an acute injury-evaluation tool makes it essential to the screening and rehabilitation process. To our knowledge, no published normative data for the SOT from a healthy, highly active population are available for use as a reference for clinical decision making. Objective: To present a normative database of SOT scores from a US Military Special Operations population that can be used for future comparison. Design: Cross-sectional study. Setting: Human performance research laboratory. Patients or Other Participants: A total of 542 active military operators from Naval Special Warfare Combatant-Craft Crewmen (n = 149), Naval Special Warfare Command, Sea, Air, and Land (n = 101), US Army Special Operations Command (n = 171), and Air Force Special Operations Command (n = 121). Main Outcome Measure(s): Participants performed each of the 6 SOT conditions 3 times. Scores for each condition, total equilibrium composite score, and ratio scores for the somatosensory, visual, and vestibular systems were recorded. Results: Differences were present across all groups for SOT conditions 1 (P < .001), 2 (P = .001), 4 (P > .001), 5 (P > .001), and 6 (P = .001) and total equilibrium composite (P = .000), visual (P > .001), vestibular (P = .002), and preference (P > .001) NeuroCom scores. Conclusions: Statistical differences were evident in the distribution of postural stability across US Special Operations Forces personnel. This normative database for postural stability, as assessed by the NeuroCom SOT, can provide context when clinicians assess a Special Operations Forces population or any other groups that maintain a high level of conditioning and training.

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“…The SOT was completed using a Neurocom Smart Balance Master system (Natus Medical Inc., Pleasanton, CA, USA) to quantify the relative role of proprioceptive, visual, and vestibular feedback to standing postural control [ 34 ]. The SOT was tested under six sensory conditions: eyes open on a firm surface (SOT1), eyes closed on a firm surface (SOT2), eyes open with sway referenced visual surround (SOT3), eyes open on sway referenced support surface (SOT4), eyes closed on sway referenced support surface (SOT5), eyes open with sway referenced visual surround, and sway referenced support surface (SOT6).…”

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“…Interpretation of ratio scores of the somatosensory, visual, and vestibular systems conveys how much a participant is able to use those specific sensory cues for balance. The preference ratio defines how well a participant can ignore inaccurate visual clues in a situation of visual conflict [22], ( Table 2).…”

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“…The sensory scores indicate the ability to maintain stability when isolating the visual, vestibular, and somatosensory systems. The preference ratio score indicates participant’s ability to maintain balance in the presence of inaccurate visual cues, [29] relative to a state where all sensory systems remain unchallenged. Scores are represented as an inverse percentage from 0 to 100, with scores closer to 100 indicating greater stability.…”