Abstract
Background Recent protocols for posturographic assessment of postural control and balance have included head shake test conditions to challenge the vestibular contributions of postural control in an effort to increase the diagnostic accuracy of identifying individuals with impaired balance. However, evidence is limited regarding the test-retest reliability of such assessment protocols. Purpose The purpose of this study was twofold: to determine the test-retest reliability of postural control assessment on the Biodex Biosway™, an accessible and field expedient tool for posturographic assessment, and to determine the test-retest reliability of the Head Shake Sensory Interaction and Balance Test (HS-SIB), an adaptation of the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) which adds two head shake conditions to challenge the vestibular contributions to postural control. Study Design. This was a correlational time series cohort study completed in a biomechanics laboratory. Methods The sample consisted of nineteen healthy adults (10 females, 9 males). Sway Index, Equilibrium Score, and the area of the ellipse enclosing 95% of the anterior-posterior (AP) and medial-lateral (ML) center of gravity (COG) displacement (AREA95) are the 3 summary variables. Standard Error of Measurement (SEM) and Minimum Detectable Change (MDC) are also reported. Results Test-retest reliability was generally poor with limited exceptions. Moderate to good reliability was observed for the more challenging stance conditions (ICC range 0.58-0.81), including those with head shake. Conclusions Field-expedient systems, such as the Biodex BioSway™, may offer reliable posturographic testing where gold-standard methods are not available. Clinicians should be aware that less demanding test conditions have limited reliability; however, test-retest reliability of this assessment tool is improved with more challenged stance conditions and the inclusion of a head shake task.
Highlights
Computerized dynamic posturography (CDP) represents the gold standard for assessment of balance and postural control
To provide a more complete picture of the Biodex BioswayTM system’s measurement properties, we report Standard Error of Measurement (SEM) and Minimum Detectable Change (MDC)
For the Sway Index (SI) output metric from the Biodex BioswayTM, moderate reliability was observed for C4, C5, and C6
Summary
Computerized dynamic posturography (CDP) represents the gold standard for assessment of balance and postural control. Some reports suggest that inclusion of a head shake test condition may help to increase the diagnostic utility of posturographic assessment of postural control by identifying those with more subtle impairments which may be clinically important but more difficult to detect with standard clinical assessment [2–4]. Portable technologies, such as the Biodex BioswayTM, have allowed the clinician to extend some of the functionality of gold-standard testing methods into fieldbased settings. Clinicians should be aware that less demanding test conditions have limited reliability; test-retest reliability of this assessment tool is improved with more challenged stance conditions and the inclusion of a head shake task
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