Estimating Postural Control With the Balance Rehabilitation Unit: Measurement Consistency, Accuracy, Validity, and Comparison With Dynamic Posturography

Abstract

OBJECTIVE To examine the psychometric properties (test-retest reliability, concurrent validity, construct validity) of the Balance Rehabilitation Unit (BRU) during testing of sensory integration processes in healthy adults and individuals with vestibular disorders. DESIGN Experimental cross-sectional design. SETTING Vestibular disorders clinic. PARTICIPANTS Participants (N= 90); 30 subjects with vestibular disorders (18 to 85 years); 30 young healthy adults (18 to 50 years); and 30 older healthy adults (60 to 85 years). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES: Participants were tested twice with the BRU and once with the Smart Equitest Sensory Organization Test (SOT) The Center of Pressure (COP) was recorded in the anteroposterior (COPap) and mediolateral (COPml) directions. The COPap and COPml time series were used to estimate the COP area andvelocity. RESULTS The intra-class correlation coefficient (ICC) of the BRU COP area and velocity measures for all subjects were at least 0.76 in all sensory organization conditions (p<.001). Significant correlations were found between the BRU and SOT, ranging from 0.64 to 0.81 for COP area and from 0.44 to 0.76 for COP velocity. The older control group had significantly greater COP area and velocity compared with the younger controls for BRU and SOT. COP (area, velocity) was significantly higher for the younger vestibular group compared with the younger controls. CONCLUSIONS The reliability and validity of COP measurements obtained during testing of sensory integration processes were demonstrated using the BRU. Future work should examine the responsiveness of these measures when individuals with balance disorders participate in rehabilitation.

Normative Data for the NeuroCom Sensory Organization Test in US Military Special Operations Forces

“…The resulting scores provide information about the assimilation of the visual, proprioceptive, and vestibular components of balance. 15 Previous investigators looked at the SOT as a way to assess and track rehabilitation progress in participants with vestibular deficits 20,24 and central nervous system disorders 25 and in an aging population. 26,27 The use of the SOT in a healthy population is a relatively new concept.…”

Changes in postural control in patients with Parkinson's disease: a posturographic study

“…COP displacements were used to estimate COP sway area. The following standard formula was used to calculate the area, where F is the Fischer distribution at 95%; σ 2 ap and σ 2 ml are the variances of the COP data in the anteroposterior and mediolateral directions, respectively; and σ 2 ap, ml is the covariance of COP data in both directions [16,22]: P<0.025). The COP sway area, LOS sway area and BFR of a representative healthy subject and patient with PD are illustrated in Fig.…”

“…The equivalent daily dose of L-dopa was calculated using a published formula for conversion [21]. The parameters analysed were LOS, 95% confidence intervals (CI) of COP and balance functional reserve (BFR) during 10 different conditions that assessed sensory integration abilities [16,22]. The LOS test evaluates the ability to displace one's COP in anteroposterior and lateral planes without risk of falling.…”

“…All patients were evaluated by a single neurologist and physiotherapist with experience in PD using multiple assessment instruments: Unified Parkinson's Disease Rating Scale (UPDRS) motor scores (Part III) [18], modified HY staging [18], modified Schwab and England Capacity for Daily Living Scale (S&E ADL) [18], Dynamic Gait Index (DGI scores ≤19 indicate major risk of falls, scores >19 indicate minor risk of falls) [19,20] and computerised posturography [15,16]. The equivalent daily dose of L-dopa was calculated using a published formula for conversion [21].…”

“…Moreover, a limited number of studies have addressed LOS in patients with PD [12][13][14]. The posturography module of the Balance Rehabilitation Unit (BRU) [15,16] is an integrated virtual reality system equipped with virtual reality goggles, a static force platform and software that measures postural control in 10 different sensory conditions. The aim of this study was to quantify the LOS and to analyse the influence of visual, somatosensory and visual-vestibular inputs on the postural control of patients with PD and healthy subjects.…”