Test-retest reliability of stability outcome measures during treadmill walking in patients with balance problems and healthy controls |
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| Institution: | 1. Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands;2. Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands;1. University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands;2. University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands;3. Wilhelmina Children’s Hospital, University Medical Center Utrecht, Department of Rehabilitation Medicine, Utrecht, The Netherlands;1. BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany;2. Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstr. 175, 79117 Freiburg, Germany;1. Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom;2. Centre of Sport and Regenerative Medicine, LANS Medicum, Hamburg, Germany;3. Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany;1. Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail stop 1005, Kansas City, KS 66160, United States;2. Bioengineering Graduate Program, University of Kansas, 3135A Learned Hall, 1530 W 15th St, Lawrence, KS 66045, United States;3. Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail stop 1005, Kansas City, KS 66160, United States;1. Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada;2. Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada;3. State Key Laboratory of Mechanical Systems and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China;4. Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada;1. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada;2. Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada;3. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada;4. Evauative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada |
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| Abstract: | BackgroundImprovement of balance control is an important rehabilitation goal for patients with motor and sensory impairments. To quantify balance control during walking, various stability outcome measures have described differences between healthy controls and patient groups with balance problems. To be useful for the evaluation of interventions or monitoring of individual patients, stability outcome measures need to be reliable.Research questionWhat is the test-retest reliability of six stability outcome measures during gait?MethodsPatients with balance problems (n = 45) and healthy controls (n = 20) performed two times a two-minute walk test (2MWT). The intraclass correlation coefficient (ICC) and Bland-Altman analysis (coefficient of repeatability; CR) were used to evaluate the test-retest reliability of six stability outcome measures: dynamic stability margin (DSM), margin of stability (MoS), distance between the extrapolated centre of mass (XCoM) and centre of pressure (CoP) in anterior-posterior (XCoM-CoPAP) and medial-lateral (XCoM-CoPML) direction, and inclination angle between centre of mass (CoM) and CoP in anterior-posterior (CoM-CoPAP-angle) and medial-lateral (CoM-CoPML-angle) direction. A two way mixed ANOVA was performed to reveal measurement- and group-effects.ResultsThe ICCs of all stability outcome measures ranged between 0.51 and 0.97. Significant differences between the measurements were found for the DSM (p = 0.017), XCoM-CoPAP (p = 0.008) and CoM-CoPAP-angle (p = 0.001). Significant differences between controls and patients were found for all stability outcome measures (p < 0.01) except for the MoS (p = 0.32). For the XCoM-CoP distances and CoM-CoP angles, the CRs were smaller than the difference between patients and controls.SignificanceBased on the ICCs, the reliability of all stability outcome measures was moderate to excellent. Since the XCoM-CoPML and CoM-CoPML-angle showed no differences between the measurements and smaller CRs than the differences between patients and controls, the XCoM-CoPML and CoM-CoPML-angle seem the most promising stability outcome measures to evaluate interventions and monitor individual patients. |
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| Keywords: | Gait Balance control Stability Reliability Spinal cord injury Stroke |
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