Reliability of the measures of weight-bearing distribution obtained during quiet stance by digital scales in subjects with and without hemiparesis

Best Quantitative Tools for Assessing Static and Dynamic Standing Balance after Stroke: A Systematic Review

Purpose: Our objective was to examine the psychometric qualities (reliability and validity) and clinical utility of quantitative tools in measuring the static and dynamic standing balance of individuals after stroke. Method: We searched four databases (PubMed/MEDLINE, PEDro, Embase, and CINAHL) for studies published from January 2018 through September 2019 and included those that assessed the psychometric properties of standing balance tests with an adult stroke population. We evaluated the quality of the studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and assessed each test on a utility assessment scale. Results: A total of 22 studies met the inclusion criteria, and 18 quantitative tools for assessing static or dynamic standing balance of individuals with stroke were analyzed. Findings support good or excellent reliability for all tests, whereas correlations for validity ranged from weak to strong. Study quality was variable. Dynamic balance tests had better clinical utility scores than static ones. Five tests had complete psychometric analyses: quiet standing on a force platform, five-step test, sideways step, step length, and turn tests.

Reliability of upright weight-bearing distribution measures obtained by computed baropodometry for participants with and without post-stroke hemiparesis

Background/Aims

Measurements from force platforms and digital scales have been applied to classify weight-bearing distribution in post-stroke hemiparesis. However, an intermediate tool – computed baropodometry – is breaking new ground in this field of diagnosis, with a need to report its reliability. Intra-test and test/retest reliabilities of the percentage of total body weight borne by the predominantly used hemibody calculated from computed baropodometry in participants with and without chronic hemiparesis was investigated in this study.

Methods

A total of 40 participants were evaluated and combined for age and sex in two different groups. Repeated measures were taken to analyse differences among records obtained from averages during 5, 10 or 20 seconds (intra-test reliability) and between the test and 1-week retest (test/retest reliability) for both groups. The analysis of variance, intra-class correlation coefficient and data plotted by Bland-Altman method were administrated.

Results

The intra-test analysis did not show differences among records obtained from different time durations (5, 10 and 20 seconds). Excellent to moderate intra-class correlation coefficient values (0.794 to 0.644) between test and retest were observed in the hemiparesis group from the records obtained by short to the longer lasting time durations, while for control groups, intra-class correlation coefficient values (0.661 to 0.748) were classified as moderate.

Conclusions

Acceptable reliability was found for all participants. Moreover, improved repeatability was reported when the measures were obtained by shorter time periods for both groups.

Force Plate Assessment of Quiet Standing Balance Control: Perspectives on Clinical Application within Stroke Rehabilitation

Assessment of balance control is essential to guide physical rehabilitation poststroke. However, current observational assessment tools available to physiotherapists provide limited information about underlying dyscontrol. This paper describes a force plate-based assessment of quiet standing balance control that we have implemented for individuals attending inpatient stroke rehabilitation. The assessment uses two force plates to measure location of ground reaction forces to maintain stability in quiet standing in five conditions (eyes open, eyes closed, standing symmetrically, and maximal loading on the less-affected and more-affected limbs). Measures of interest are variability of the centers of pressure under each foot and both feet combined, weight-bearing asymmetry, and correlation of center of pressure fluctuations between limbs. We present representative values for the above-mentioned measures and case examples to illustrate how the assessment can reveal patient-specific balance control problems and direct treatment. We identify limitations to our current assessment and recommendations for future research.