Software Application for Balance Assessment
Top Contributors - Shrouk Ashraf Rekaby, Kim Jackson, Shahd Mohammed Abdelhafeez Hamed, Adham Abdelhady, Mohamed A Hassanin, Mariam Eldaly, Aya Alhindi and Esraa Elsaeed Mohamed
Introduction[edit | edit source]
Balance is the ability to evenly distribute body weight in static positions e.g. standing or during movement so person doesn’t fall or can recover from any external disturbances to this state and it is closely related to the position of body’s center of gravity. Due to its dependence on neuromusculoskeletal system, Balance deficits can occur due to many disorders or diseases in your body. Imbalance symptoms like dizziness and vertigo are common in world-wide community (dizziness 17 - 30%, and for vertigo 3 - 10%)[1]. That’s why Physiotherapists and other health care professions pay special attention to balance deficits among patients they deal with.
The three-level nervous system deficits model based on the level of neuronal processing involved[2]:
Level 1: Low level deficits depict gait disorders due to peripheral sensory (peripheral neuropathy, vestibular, hearing[3] or visual dysfunction) or peripheral motor impairment (myopathy, focal muscle weakness e.g. peroneus paresis). Low level impairments can be compensated, if central nervous functions are intact.
Level 2: Intermediate level deficits are caused by dysfunction of postural or motor responses, and sensory and motor modulation as in spastic hemiplegia, spastic paraplegia, extrapyramidal (e.g. Parkinsonian) gait disorders, and cerebellar movement disorders.
Level 3: Higher level disorders are characterized by cognition deficits in planning, intention, and executive functions, as well as gait apraxia. As in dementia and depression.
Patients with diseases of other body systems can complain from imbalance like patients with chronic obstructive pulmonary disease[4], Obesity[5], Hip arthroplasties (Surgical and post-operative risk factors)[6]and knee osteoarthritis[7].
Types of Balance[edit | edit source]
- Static balance: can be defined as the maintenance of a steady position on a fixed ,firm stable support base [8]. Static balance can be also defined as the ability to maintain support with minimum movement of one or both legs.
2.Dynamic balance : it is the ability to perform activities while maintaining a stable position.[9]
Traditional Assessment[edit | edit source]
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Software Application Assessment[edit | edit source]
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Reliability[edit | edit source]
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Validity[edit | edit source]
Functional reach test:
functional reach test has been proven to be a valid method for balance assessment[10][11][12][13], but clinicians should consider other factors that can affect the results, such as decreased trunk mobility, decreased calf muscle flexibility, trunk rotation, and center of pressure displacement. So, it is recommended that clinicians use multiple assessment tools for balance assessment, as no one test can measure all factors affecting balance[14].
Berg balance scale:
Fullerton Advanced Balance Scale (FAB):
Balance Evaluation Systems Test (BESTest):
The Four Stage Balance Test:
The Functional Gait Assessment (FGA) :
Biodex Balance system (BBS):
Dawson et al., examined the validity of commonly used assessment tools to measure balance (i.e., four‐square step test, timed‐up‐and‐go test, and Biodex balance system) and found that all these tools have poor construct validity, and each of them is focused on a particular aspect of balance factors[15].
Microsoft Kinect™:
Several studies assessed the validity of using Microsoft Kinect™ for standing balance assessment using positional variability of center of mass (COM) and revealed that it is a valid method for this assessment[16][17].
MyAnkle software application:
Abdo et al., tested the validity of MyAnkle smartphone application using BBS as a gold standard and supported usage of MyAnkle for balance assessment while closing eyes but the validity of the application to evaluate balance with eyes open is unsupported by any evidence, irrespective of the participant's grouping or limb side. Also, the application failed to discriminate between patients and healthy people so clinicians should be cautious while using this application in follow-up[18].
Resources[edit | edit source]
References[edit | edit source]
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- ↑ Murdin L, Schilder AGM. Epidemiology of Balance Symptoms and Disorders in the Community. Otology & Neurotology. 2015 Mar;36(3):387–92.
- ↑ Axer H, Axer M, Sauer H, Witte OW, Hagemann G. Falls and gait disorders in geriatric neurology. Clinical Neurology and Neurosurgery. 2010 May;112(4):265–74.
- ↑ Carpenter MG, Campos JL. The Effects of Hearing Loss on Balance: A Critical Review. Ear & Hearing [Internet]. 2020 Oct 26;41(Supplement 1):107S119S. Available from: https://journals.lww.com/ear-hearing/fulltext/2020/11001/the_effects_of_hearing_loss_on_balance__a_critical.12.aspx
- ↑ beauchamp MK, Hill K, Goldstein RS. Impairments in balance discriminate fallers from non-fallers in COPD [Internet]. Respiratory Medicine ; 2009 [cited 2024 Feb 16]. Available from: https://www.resmedjournal.com/article/S0954-6111(09)00209-1/fulltext
- ↑ Alice A, Yadav M, Verma R, Kumari M, Arora S. Effect of obesity on balance. International journal of health sciences. 2022 Jun 17;3261–79.
- ↑ Di Laura Frattura G, Bordoni V, Feltri P, Fusco A, Candrian C, Filardo G. Balance Remains Impaired after Hip Arthroplasty: A Systematic Review and Best Evidence Synthesis. Diagnostics. 2022 Mar 11;12(3):684.
- ↑ Arden NK, Crozier S, Smith H, Anderson F, Edwards C, Raphael H, et al. Knee pain, knee osteoarthritis, and the risk of fracture. Arthritis & Rheumatism. 2006;55(4):610–5.
- ↑ Gonçalves C, Vila-Chã C, Bezerra P, Clemente F, Leão C, Brandão A, et al. The connection between dynamic and static balance in young people who are active. 2022;23(2):65–75; Human Movement. Reference: 10.5114/hm.2021.106165.
- ↑ 1. Mahmoudi F, Rahnama N, Daneshjoo A, Behm DG. Comparison of dynamic and static balance among professional male soccer players by position. Journal of Bodywork and Movement Therapies [Internet]. 2023 Oct 1 [cited 2023 Oct 6];36:307–12. Available from: https://www.sciencedirect.com/science/article/pii/S1360859223001705
- ↑ Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. Journal of gerontology. 1990 Nov 1;45(6):M192-7.
- ↑ Duncan PW, Studenski S, Chandler J, Prescott B. Functional reach: predictive validity in a sample of elderly male veterans. J Gerontol 1992; 47: M93–M98.
- ↑ Weiner DK, Bongiorni DR, Studenski SA, Duncan PW, Kochers berger GG. Does functional reach improve with rehabilitation? Arch Phys Med Rehabil 1993; 74: 796–800.
- ↑ Weiner DK, Duncan PW, Chandler J, Studenski SA. Functional reach: a marker of physical frailty. J Am Geriatr Soc 1992; 40: 203 207.
- ↑ Jonsson E, Henriksson M, Hirschfeld H. Does the functional reach test reflect stability limits in elderly people?. Journal of rehabilitation medicine. 2003 Jan 1;35(1):26-30.
- ↑ Dawson N, Dzurino D, Karleskint M, Tucker J. Examining the reliability, correlation, and validity of commonly used assessment tools to measure balance. Health science reports. 2018 Dec;1(12):e98.
- ↑ Clark RA, Pua YH, Fortin K, Ritchie C, Webster KE, Denehy L, Bryant AL. Validity of the Microsoft Kinect for assessment of postural control. Gait & posture. 2012 Jul 1;36(3):372-7.
- ↑ Yang Y, Pu F, Li Y, Li S, Fan Y, Li D. Reliability and validity of Kinect RGB-D sensor for assessing standing balance. IEEE Sensors Journal. 2014 Jan 2;14(5):1633-8.
- ↑ Abdo N, ALSaadawy B, Embaby E, Youssef AR. Validity and reliability of smartphone use in assessing balance in patients with chronic ankle instability and healthy volunteers: A cross-sectional study. Gait & Posture. 2020 Oct 1;82:26-32.
