Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of falling

Abstract

Background Impairments in dynamic balance have a detrimental effect in older adults at risk of falls (OARF). Gait initiation (GI) is a challenging transitional movement. Centre of pressure (COP) excursions using force plates have been used to measure GI performance. The Nintendo Wii Balance Board (WBB) offers an alternative to a standard force plate for the measurement of CoP excursion. Aims To determine the reliability of COP excursions using the WBB, and its feasibility within a 4-week strength and balance intervention (SBI) treating OARF. Methods Ten OARF subjects attending SBI and ten young healthy adults, each performed three GI trials after 10 s of quiet stance from a standardised foot position (shoulder width) before walking forward 3 m to pick up an object. Averaged COP mediolateral (ML) and anteroposterior (AP) excursions (distance) and path-length time (GI-onset to first toe-off) were analysed. Results WBB ML (0.866) and AP COP excursion (0.895) reliability (ICC 3,1 ) was excellent, and COP path-length reliability was fair (0.517). Compared to OARF, healthy subjects presented with larger COP excursion in both directions and shorter COP path length. OARF subjects meaningfully improved their timed-up-and-go and ML COP excursion between weeks 1-4, while AP COP excursions, path length, and confidence-in-balance remained stable. Discussion COP path length and excursion directions probably measure different GI postural control attributes. Limitations in WBB accuracy and precision in transition tasks needs to be established before it can be used clinically to measure postural aspects of GI viably. Conclusions The WBB could provide valuable clinical evaluation of balance function in OARF.

Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study

“…Gait initiation is a functional task that is classically used in the literature as an experimental paradigm to investigate how the central nervous system (CNS) controls balance in dynamical conditions in both healthy adults [e.g., (31)(32)(33)(34)(35) for recent articles] and pathological patients [e.g., (36)(37)(38)(39)(40) for recent articles]. Gait initiation appears to be the major biomechanical model, complementary to the classical clinical test, in order to predict postural disorders in elderly fallers and non-fallers (41)(42)(43)(44). Therefore, it seems highly appropriate for an investigation on the effects of WBV on dynamic balance.…”

Reliability and Usability Analysis of an Embedded System Capable of Evaluating Balance in Elderly Populations Based on a Modified Wii Balance Board

“…On the other hand, inter-rater reliability points to the consistency of measurements carried out by different examiners. Previous evidence [ 18 ] has indicated that the WBB is a reliable, safe, and feasible tool to assess static balance in highly functional individuals [ 51 ], older adults at risk of falls [ 52 ], and adults with stroke [ 53 ]. The primary reported drawback of using the WBB for medical assessment is the inconsistent sampling frequency [ 19 ].…”

Quantitative assessment of postural balance in patients with chronic anterior cruciate ligament injury- A controlled study

“…2,3,5e7 The postural balance in stance could be evaluated more precisely on a force plate and researchers prefer the Center of Pressure (COP) excursions as the key measure. 5 It has also been observed that the absence of mechanoreceptors in an ACLD knee could activate other mechanoreceptors and thereby create a compensatory muscle activation, 6e8 to stabilize the knee joint. 3 This function can be enhanced by using proprioceptive and neuromuscular exercise protocols after ACL injury.…”