Abstract
Balance disorders have a high prevalence among elderly people in developed countries, and falls resulting from balance disorders involve high healthcare costs. Therefore, tools and indicators are necessary to assess the response to treatments. Therefore, the aim of this study is to detect relevant changes through minimal detectable change (MDC) values in patients with balance disorders, specifically with vertigo. A test-retest of a static and dynamic balance test was conducted on 34 healthy young volunteer subjects using a portable stabilometric platform. Afterwards, in order to show the MDC applicability, eight patients diagnosed with balance disorders characterized by vertigo of vestibular origin performed the balance test before and after a treatment, contrasting the results with the assessment by a specialist physician. The balance test consisted of four tasks from the Romberg test for static balance control, assessing dynamic postural balance through the limits of stability (LOS). The results obtained in the test-retest show the reproducibility of the system as being similar to or better than those found in the literature. Regarding the static balance variables with the lowest MDC value, we highlight the average velocity of the center of pressure (COP) in all tasks and the root mean square (RMS), the area, and the mediolateral displacement in soft surface, with eyes closed. In LOS, all COP limits and the average speed of the COP and RMS were highlighted. Of the eight patients assessed, an agreement between the specialist physician and the balance test results exists in six of them, and for two of the patients, the specialist physician reported no progression, whereas the balance test showed worsening. Patients showed changes that exceeded the MDC values, and these changes were correlated with the results reported by the specialist physician. We conclude that (at least for these eight patients) certain variables were sufficiently sensitive to detect changes linked to balance progression. This is intended to improve decision making and individualized patient monitoring.
Highlights
Balance disorders have a high prevalence among elderly people in developed countries [1].Connected with the current trend of increasing age of the population [2,3], this has led to a rise in pathologies that affect balance, causing an increased risk of falls in the elderly population
A test-retest study, which consists of repeating the test at two different times with a homogeneous sample of participants under the same conditions, of a static and dynamic balance test was conducted on a sample of 34 healthy young volunteer subjects
We developed a script that applies the Magnitude-Based Decision (MBD) method using as input the measurements taken from the pre- and post-balance tests of one specific patient, and the threshold MDC95% previously calculated in the test-retest study
Summary
Connected with the current trend of increasing age of the population [2,3], this has led to a rise in pathologies that affect balance, causing an increased risk of falls in the elderly population. Of people aged over 65 years, and more than 50% of individuals in health centers or care homes suffer. Stabilometric platforms are useful in assessing balance because they obtain numerous parameters of the centers or pressure (COP) [13,14]. Stabilometric platforms can assess static balance control and dynamic postural balance through different variables and application methods [15,16]. In static balance control methods (such as the Romberg test), subjects must maintain their
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