Execution
- 1Position the patient sitting and ask the patient to fixate on a target moving with the head, such as the patient's thumb held at arm's length.
- 2Instruct the patient to keep the eyes on the target while moving the head and trunk together.
- 3Rotate the patient's trunk and head together slowly side to side.
- 4Observe whether the eyes remain smoothly on the target or show saccadic intrusions.
- 5Compare symptom provocation and ocular control in both directions.
Positive outcome
The test is positive when the patient cannot suppress the VOR and shows corrective saccades, gaze instability, or marked symptom provocation while the target moves with the head. Abnormal cancellation is more concerning for central cerebellar or brainstem involvement than simple unilateral peripheral hypofunction. Medication, alertness, and visual fixation ability can affect the result.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Leigh & Zee (2015) | oculomotor reference text, no diagnostic accuracy | NA | NA | NA | NA |
CommentVOR cancellation is a screening observation of central ocular motor control, not a validated stand-alone diagnostic test in most physiotherapy settings. Abnormal results should prompt broader neurological and vestibular assessment. It is low value as an isolated diagnostic test but important as part of a safety screen.
Low Clinical Value