LAUSR

In Reply Narozny et al raise an interesting observation about our article,1 which highlights the need for research in sensory impairments. Balance disorder is a major public health concern in the US and significantly contributes to the onset of falls and hip fractures.BalancetestingwasincorporatedintheNationalHealthand Nutrition Examination Survey (NHANES) from 1999 to 2004 to estimate the prevalence of balance problems in the US general population using the modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces (the modified Romberg test). Based on this national surveillance, Agrawal and colleagues2 reported an estimated 35.4% of US adults aged 40 years or older (69 million Americans) experienced vestibular dysfunction as determined by the modified Romberg test. Currentclinicalpracticescommonlyadaptcrudebalancetesting (eg, 1-leg standing test) as a part of physical performance assessments made in adults to screen for balance problems that require targeted interventions for fall prevention.3 However, crude balance testing provides limited information on sensory impairments, which may impede the effectiveness of interventions to improve balance function. We acknowledge the limitations in the modified Romberg test as a screening measure for vestibular diseasesandvisual/proprioceptivedisorders; itremainsasimpletool thatprovidesadditional informationonbalanceproblemsrelated to multiple sensory impairments that is better than crude balance testing. Sensory impairments contribute to a wealth of unfavorable health outcomes. Emerging epidemiologic data suggest that deficits in the sensory system were associated with an increased risk ofmortalityandotherdiseases.1,4,5 Becausetheprevalenceofsensory impairments is increasing, accompanied by population agingandcertaindiseases(eg,coronavirusdisease2019),6 enhanced diagnostic assessments of the sensory system should be considered in clinical and research settings. Such assessments will facilitate investigations into the effects of sensory deficits and loss on long-term health outcomes at the population level and facilitate referrals of patients to specialists for targeted interventions.