Abstract
The high prevalence of postural instability in individuals with intellectual disability (ID) warrants the need for reliable and practical postural control assessments. Stabilometry is a postural control assessment that has been widely used for clinical populations. However, the scant systematic knowledge about the reliability of stabilometric protocols for adults with ID renders results questionable and limits its value for clinicians and researchers. The study's purpose was to develop a stabilometric protocol for adults with and without ID based on optimal combinations of shortest necessary trial durations and the least number of trial repetitions that guarantee sufficient reliability. Participants performed six trials of bipedal standing in 2 vision (eyes open vs eyes closed) x 2 surface (solid vs compliant) conditions on a force platform. Several parameters were calculated from the first 10-, 20-, and 30-s interval of every center-of-pressure (COP) trial data. For different trial durations, we identified the number of trials that yielded acceptable relative (intraclass correlation coefficient ≥ 0.70) and absolute (standard error of measurement < 20%) reliability using the Spearman-Brown prophecy formula. To determine the optimal combination of trial duration and number of repetition for each COP parameter, we implemented a two-step process: 1) identify the largest number of repetition for each of the three trial durations and then 2) select the trial duration with the lowest number of repetition. For both ID- and non-ID groups, we observed a trend whereby shorter trial durations required more repetitions and vice versa. The phase plane and ellipse area were the most and least reliable center-of-pressure parameter, respectively. To achieve acceptable reliability, four 30-s trials of each experimental condition appeared to be optimal for testing participants with and without ID alike. The results of this research can inform stabilometric test protocols of future postural control studies of adults with ID.
Highlights
Postural control is the ability to achieve, maintain and restore one’s center of mass (COM) within their base of support [1] and, as such, provides foundation for the successful and safe execution of sensorimotor tasks
For mean center of pressure (COP) amplitude in the AP and ML directions to be reliable in all conditions, 30-s trials had to be repeated six times
Three 15-s trials were sufficient for the COP amplitude in the AP and ML directions to obtain the same reliability criteria that we set for this pilot study
Summary
Postural control is the ability to achieve, maintain and restore one’s center of mass (COM) within their base of support [1] and, as such, provides foundation for the successful and safe execution of sensorimotor tasks. This ability is the product of concerted activities of multiple body systems. In response to postural instability, the central nervous system regulates the necessary voluntary and automatic adjustments in motor output to stabilize the body [2]. The maintenance of postural control is contingent on intact neuromusculoskeletal functions and any disruption of the multiple systems that regulate and maintain postural control results in increased postural instability. Adults with ID have a substantially higher incidence of falls and consequent hospitalization than the general population [7,8,9]
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