Reliability of measures of dynamic stability for the assessment of balance recovery after a forward loss of balance

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Publication date: June 2019

Source: Gait & Posture, Volume 71

Author(s): Steffen Ringhof, Andrea Arensmann, Thorsten Stein

Abstract

Background

Falls are common and serious events, which mostly occur during locomotion, that are associated with deficient dynamic balance. An experimental approach that simulates falling forward has become increasing popular to investigate dynamic balance. However, research has not been conducted to examine the test-retest reliability of this experimental approach.

Research question

What is the reliability of dynamic stability measures that are used for the assessment of balance recovery after forward loss of balance?

Methods

Nineteen healthy young adults (24.3 ± 2.8 yrs; nine females) volunteered for this study. They reported twice to the laboratory to perform two tests: (i) a stepping task, in which they were instructed to recover balance by taking a step after being suddenly released from an inclined forward position; and (ii) a standing task, in which we aimed to identify the maximum forward leaning angle they were able to compensate for without taking a step. Intra-class correlation coefficients (ICC) were calculated for the margin of stability (MoS) and spatiotemporal parameters for both tests.

Results

The reliability of the stepping task variables ranged from poor to excellent, with ICCs tending to increase with the number of trials included in the analysis. Intra-session analysis (one-way rm ANOVA) revealed a significant trial effect for the MoS, indicating that stepping responses changed across repeated trials. With respect to the standing task, test-retest reliability was only fair for the maximal initial leaning angle.

Significance

In essence, these results indicate that the inter-session reliability of the stepping task is acceptable, depending on the measures used and the number of trials conducted. However, one must be aware that behavioral adaptations arise with repeated exposure to simulated forward falls. Finally, this study’s results suggest that the reproducibility of the standing task is limited.