OBJECTIVE Recent research on head shake posturography has demonstrated a modest increase in sensitivity to identifying peripheral vestibular system asymmetry when horizontal head movements were added to portions of the standard Sensory Organization Test (SOT) battery. However, limitations with respect to the head shake protocol were outlined, and usable data for assessing performance could not be established. The purpose of this study was to test a change in protocol for use of head shake SOT to address the noted limitations. METHODS Forty participants ranging in age from 20 to 79 years with no history of dizziness completed Conditions 2 and 5 of the SOT portion of computerized dynamic posturography on EquiTest equipment, while maintaining head still as well as 4 horizontal head movement velocity tasks. RESULTS Slope of a linear regression fit to 6 performance points was used to characterize each participant. Spearman's ranked correlation (r) indicated a significant relationship between the slope of the line representing a decline in performance with age (r = -.52, p = .0006). CONCLUSIONS The head shake modification showed a trend in increasing the separation of normal individuals across age and eliminated the limitations addressed in earlier research. Future research will investigate the head shake modification for identifying vestibular peripheral system asymmetries.