Advertisement

Short-term repeatability of body sway during quiet standing in people with hemiparesis and in frail older adults1

      Abstract

      Helbostad JL, Askim T, Moe-Nilssen R. Short-term repeatability of body sway during quiet standing in people with hemiparesis and in frail older adults. Arch Phys Med Rehabil 2004;85:993–9.

      Objective

      To investigate short-term repeatability of a posturographic quiet standing test protocol in people with hemiparesis and in frail older adults.

      Design

      Test-retest design, using 5 different quiet standing task conditions in which size and compliance of the support surface, visual influence, and cognitive demands were manipulated. Retest was performed after 15 minutes.

      Setting

      Rehabilitation units and day care center.

      Participants

      Twenty-three people with stroke (mean age, 74.4y) and 16 frail older adults (mean age, 82.1y).

      Interventions

      Not applicable.

      Main outcome measures

      Repeatability of trunk acceleration root mean square by within-subject standard deviation, coefficient of variation, and intraclass correlation coefficients (ICCs).

      Results

      The ICC1,2 ranged from .13 to .75 for people with hemiparesis and from .73 to .92 for frail older adults when tested with their eyes open. The least demanding task condition gave the best repeatability. Standing with eyes closed resulted in very low ICC1,2 in people with hemiparesis (.16) and in frail older adults (−.18). Interpretation of the results was similar for the other 2 reliability measures.

      Conclusions

      A mean of 2 repeated measures gave adequate repeatability for frail older adults but not for people with stroke when they were tested with their eyes open. This study showed the importance of establishing short-term repeatability relative to each clinical population in which such tests are used.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Domholdt E
        Physical therapy research principles and applications. WB Saunders, Philadelphia1993
        • Badke M.B
        • Duncan P.W
        Patterns of motor responses during postural adjustments when standing in healthy subjects and hemiparetic patients.
        Phys Ther. 1983; 63: 13-20
        • Camicioli R
        • Panzer V.P
        • Kaye J
        Balance in the healthy elderly.
        Arch Neurol. 1997; 54: 976-981
        • Shumway-Cook A
        • Horak F.B
        Assessing the influence of sensory interaction of balance. Suggestion from the field.
        Phys Ther. 1986; 66: 1548-1550
        • Winter D.A
        A.B.C. (anatomy, biomechanics, control) of balance during standing and walking. Waterloo Biomechanics, Waterloo (ON)1995
        • Wolfson L
        • Whipple R
        • Derby C.A
        • et al.
        A dynamic posturography study of balance in healthy elderly.
        Neurology. 1992; 42: 2069-2075
        • El Kahky A.M
        • Kingma H
        • Dolmans M
        • de Jong I
        Balance control near the limit of stability in various sensory conditions in healthy subjects and patients suffering from vertigo or balance disorders.
        Acta Otolaryngol. 2000; 120: 508-516
        • Benvenuti F
        • Mecacci R
        • Gineprari I
        • et al.
        Kinematic characteristics of standing disequilibrium.
        Arch Phys Med Rehabil. 1999; 80: 278-287
        • Geurts A.C
        • Nienhuis B
        • Mulder T.W
        Intrasubject variability of selected force-platform parameters in the quantification of postural control.
        Arch Phys Med Rehabil. 1993; 74: 1144-1150
        • Hill K.D
        • Carroll S.G
        • Kalogeropoulos A
        • Schwarz J.A
        Retest reliability of center of pressure measures of standing balance in healthy older women.
        Aust J Ageing. 1995; 14: 76-80
        • Brouwer B
        • Culham E.G
        • Liston R.A
        • Grant T
        Normal variability of postural measures.
        Scand J Rehabil Med. 1998; 30: 131-137
        • Geursen J.B
        • Altena D
        • Massen C.H
        • Verduin M
        A model of the standing man for the description of his dynamic behaviour.
        Agressologie. 1976; 17: 63-69
        • Murray M.P
        • Seireg A
        • Scholz R.C
        Center of gravity, center of pressure, and supportive forces during human activities.
        J Appl Physiol. 1967; 23: 831-838
        • Morris J.R
        Accelerometry—a technique for the measurement of human body movements.
        J Biomech. 1973; 6: 729-736
        • Winter D.A
        • Patla A.E
        Signal processing and linear systems for the movement sciences. Waterloo Biomechanics, Waterloo (ON)1977
        • Moe-Nilssen R
        A new method for evaluating motor control in gait under real-life environmental conditions. Part 2: Gait analysis.
        Clin Biomech (Bristol, Avon). 1998; 13: 328-335
        • Moe-Nilssen R
        A method for evaluating motor control in gait under real-life environmental conditions. Part 1: The instrument.
        Clin Biomech (Bristol, Avon). 1998; 13: 320-327
        • Nigg B.M
        Acceleration.
        in: Nigg B.M Herzog W Biomechanics of the musculo-skeletal system. John Wiley & Sons, Chicester2001: 237-253
        • Yack H.J
        • Berger R.C
        Dynamic stability in the elderly.
        J Gerontol. 1993; 48: M225-M230
        • Moe-Nilssen R
        Test-retest reliability of trunk accelerometry during standing and walking.
        Arch Phys Med Rehabil. 1998; 79: 1377-1385
        • Moe-Nilssen R
        • Helbostad J.L
        Trunk accelerometry as a measure of balance control during quiet standing.
        Gait Posture. 2002; 16: 60-68
        • Lord S.R
        • Sherrington C
        • Menz H.B
        Falls in older people. Cambridge Univ Pr, Cambridge2001
        • Nyberg L
        • Gustafson Y
        • Berggren D
        • Brannstrom B
        • Bucht G
        Falls leading to femoral neck fractures in lucid older people.
        J Am Geriatr Soc. 1996; 44: 156-160
        • Woollacott M.H
        Systems contributing to balance disorders in older adults.
        J Gerontol A Biol Sci Med Sci. 2000; 55: M424-M428
        • Altman D.G
        Practical statistics for medical research. Chapman & Hall/CRC, London1991
        • Geurts A.C
        • Mulder T.W
        • Rijken R.A
        • Nienhuis B
        From the analysis of movements to the analysis of skills. Bridging the gap between laboratory and clinic.
        J Rehabil Sci. 1991; 4: 9-12
        • Panzer V.P
        • Bandinelli S
        • Hallett M
        Biomechanical assessment of quiet standing and changes associated with aging.
        Arch Phys Med Rehabil. 1995; 76: 151-157
        • Bland J.M
        • Altman D.G
        Measurement error.
        BMJ. 1996; 313: 744
        • Bland J.M
        An introduction to medical statistics. 2nd ed. Oxford Univ Pr, Oxford1995
        • Keating J
        • Matyas T
        Unreliable inferences from reliable measurements.
        Aust J Physiother. 1998; 44: 5-10
        • Shrout P.E
        • Fleiss J.L
        Intraclass correlations.
        Psychol Bull. 1979; 86: 420-428
        • Gill J
        • Allum J.H
        • Carpenter M.G
        • et al.
        Trunk sway measures of postural stability during clinical balance tests.
        J Gerontol A Biol Sci Med Sci. 2001; 56: M438-M447
        • Hageman P.A
        • Leibowitz J.M
        • Blanke D
        Age and gender effects on postural control measures.
        Arch Phys Med Rehabil. 1995; 76: 961-965
        • Shumway-Cook A
        • Anson D
        • Haller S
        Postural sway biofeedback.
        Arch Phys Med Rehabil. 1988; 69: 395-400
        • Shumway-Cook A
        • Woollacott M.H
        Motor control. Williams & Wilkins, Baltimore1995
        • McCollum G
        • Leen T.K
        Form and exploration of mechanical stability limits in erect stance.
        J Mot Behav. 1989; 21: 225-244