Reliability and Practical Clinical Application of an Accelerometer-Based Dual-Task Gait Balance Control Assessment

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Publication date: Available online 13 May 2019

Source: Gait & Posture

Author(s): Will Pitt, Li-Shan Chou

Abstract

Background

Gait balance control assessment using whole body center of mass (COM) kinematic measures in concussed individuals reveals persistent balance deficits up to two months post-injury. A reliable and clinically practical gait balance control assessment leveraging similar kinematic measures is necessary to improve concussion assessment and management.

Research Question

Can peak accelerations collected during a dual-task (DT) gait assessment from a single low back placed accelerometer be measured reliably on different days, by different raters, in different environments, and be practically applied in a Division One (D1) athletics program?

Methods

A single accelerometer placed on the low back over the L5 vertebra was utilized with a DT gait analysis protocol. Twenty (10 F) healthy participants performed the assessment in a laboratory and non-laboratory environment, on two separate days, and with two different raters. Eight gait event specific peak accelerations along three orthogonal axes were collected. In addition, data were collected from a cohort of 14 D1 female soccer players during a single assessment to explore the practical clinical application.

Results

Cronbach’s α values for the eight metrics ranged from .881 to .980 and ICC values from .868 to .987. Average assessment time for the 14 D1 female athletes was 8.50 ± 0.58 minutes, and significant differences between walking conditions were identified for Vert Accel 1 (p < .01), Vert Accel 2 (p = .01), and A-P Accel (p < .01).

Significance

High Cronbach’s α and ICC values coupled with a short assessment time and sensitivity to differences in gait balance control indicate our testing apparatus and protocol are both reliable and clinically practical. Additionally, gait event specific peak accelerations from a single accelerometer can detect subtle changes in gait balance control and may facilitate improvements in sport-related concussion diagnosis and return to activity decision making.