Development of Valid and Reliable Measures of Postural Stability

Abstract

Background/Objective: The development of simple postural stability tests that relate to performance of activities of daily living (ADL) and can be quickly performed in a clinical setting may assist clinicians in determining appropriate wheelchair configurations and postural supports in an efficient manner. The study's purpose was to validate 3 clinical measures of reach-functional reach (FR), reach area (RA), and bilateral reach (BR)-against the performance of ADL tasks.Methods: Two groups of 20 subjects differing by time since spinal cord injury were tested. Three measures of reach-FR, RA, and BR-were recorded with and without permitting compensatory strategies. Subjects also attempted a series of ADL tasks. Group 2 subjects participated in test-retest reliability of the reach measures and to measure reach while using compensatory strategies. Correlation, ANOVA, and linear regression were used for analysis.Results: Regression analysis showed that injury level was a significant predictor of success in performing ADL tasks (%ADL). Significant but not strong correlations were found between %ADL and all uncompensated reach measures. Within Group 2 subjects, compensated FR (r ¼ 0.663) and RA (r ¼ 0.647) were more related to the %ADL score than the uncompensated FR (r ¼ 0.348) and RA (r ¼ 0.305) measurements. BR had the strongest relationship with %ADL scores (P ¼ 0.031) and was the only significant uncompensated reach measurement within the regression analyses.Discussion and Conclusion: While working with clients on seated stability and functional movement, clinicians should be encouraged to incorporate BR tasks because it has the strongest relationship to ADL performance. Researchers interested in studying postural control and stability during functional tasks should consider using uncompensated reach measures.

Proposal and validation of a clinical trunk control test in individuals with spinal cord injury

“…In effect, the results of the test-retest vary from 0.51 to 0.94 depending on the test and the patient's neurological level. [13][14][15][16] The high correlations found in this study are probably due to the way the scale has been designed, with simplified and detailed elaboration of the items, which renders it understandable and easy to apply and interpret for the evaluator as well as for the patient. These results suggest that other clinicians in other places could use this test in their daily practice and research.…”

“…It has been demonstrated that maintenance of posture in individuals with SCI is associated with neurological level and SCI type, as well as with time of evolution. 18 Some clinical tests for balance in the sitting posture [13][14][15] show different results according to the neurologic level and elapsed time since the injury. Lynch et al 13 state that the functional reach varies according to the neurologic level.…”

“…[12][13][14][15][16] The ones that are mostly used only evaluate posture in the sitting position. However, trunk balance is defined as the capacity to maintain the postural control of the trunk, including moving and shifting body weight from side to side to release one limb for a particular function, such as reaching or grasping.…”

Trunk strength and function using the multidirectional reach distance in individuals with non-traumatic spinal cord injury

“…Upright trunk stability is a necessary component in engaging in functional activities including feeding, dressing, and transferring. 5,6 Proprioceptive input in addition to adequate synergistic recruitment and forcegenerating capabilities of the trunk, hip, and lower extremity muscles is necessary to maintain adequate trunk stability. 7 Furthermore, prior to the initiation of upper extremity activities in the sitting position, anticipatory activity of the erector spinae and abdominal muscles is required to stabilize the trunk.…”

Development and initial validation of the Seated Posture Scale

“…Upright positioning in wheelchairs that influences posture affects key health outcomes such as breathing, eating, and pressure ulcer development [1][2][3][4][5][6][7][8]. Posture and outcomes will be poor if the wheelchair is inadequate.…”