Reliability of IMU-Based Balance Assessment in Clinical Stroke Rehabilitation

 You do realize survivors don't give a flying fuck about assessments? They want EXACT RECOVERY PROTOCOLS! GET THERE! In my opinion all assessment research is completely wasted.

Reliability of IMU-Based Balance Assessment in Clinical Stroke Rehabilitation

Author links open overlay panelR.A.W.Felius^a

M.Geerars^cS.M.Bruijn^bN.C.Wouda^dJ.H.Van Diee¨n^bM.Punt^a

https://doi.org/10.1016/j.gaitpost.2022.08.005Get rights and content

Abstract

Background

Balance is often affected after stroke, severely impacting activities of daily life. Conventional testing methods to assess balance provide limited information, as they are subjected to floor and ceiling effects. Instrumented tests, for instance using inertial measurement units, offer a feasible and promising alternative.

Research question

We examined whether postural sway can reliably be measured in sitting and standing balance in people after stroke in clinical rehabilitation using a single inertial measurement unit. Additionally, we assessed to what extent averaging two measurements would improve test-retest reliability compared to a single measurement, and if sway features can potentially be used to monitor progression.

Method

Forty participants performed two assessments with a test-retest interval of 24 hours. Each assessment consisted of one sitting and four standing balance conditions (eyes open, feet together, eyes closed and foam). The standing balance conditions were performed twice during both assessments. In total, 35 sway features were calculated for each condition. For the standing balance conditions, these were calculated for both single test-retest measurement and the average of the two test and retest measurements. We determined the reliability using the intraclass correlation coefficient for both single and averaged measurements. Additionally, the minimal detectable change and the relative minimal detectable change were computed.

Results

The single and averaged measurements resulted in 22 sitting, 30 & 32 eyes open, 27 & 22 feet together, 28 & 33 eyes closed and 23 & 13 foam sway features with good-excellent reliability. Overall, the difference between intraclass correlation coefficient values of the single and averaged measurements was small and inconsistent. The relative minimal detectable change ranged between 0.5 and 1.5 standard deviation.

Significance

Sitting and standing balance can reliably be assessed in people after stroke in clinical rehabilitation with a single measurement using one inertial measurement unit.

Section snippets

Background

The majority of people after stroke experience muscular weakness or partial paralysis on one side of the body, resulting in problems with balance and gait [1]. Of all possible sensory-motor consequences, balance impairments presumably have the greatest impact on activities of daily life (ADL), hence on the quality of life and ability to live independently [2], [3]. Moreover, impaired balance is related to a higher incidence of falls [4]. The consequences of falls are devastating and often the

Participants

Forty people after stroke were recruited in two rehabilitation-centres in the Netherlands. Prior to participation, participants signed written informed consent. All participants were diagnosed with stroke, defined according to the World Health Organisation definition [27], and hospitalized prior to admission. Eligible participants were above the age of 18 years, in the sub-acute or chronic stage after stroke, able to comprehend and sign the informed consent and capable of understanding and

Descriptives

Participant characteristics and test results are described in Table 2. In total, forty people after stroke participated in the study. In total 38, 33, 23, 25 and 23 test-retest measurements were included in SIT, EO, FT, EC and FO, respectively. The FC was not further analysed, due to an insufficient number of valid measurements (N = 5). The mean and standard deviation of the single and averaged measurements are described in Tables A6 and A7.

Reliability single measurement

The ICC-values for the single test-retest measurements

Discussion

We examined the test-retest reliability of a wide variety of sway features in sitting and standing balance using a single inertial measurement unit in people after stroke in clinical rehabilitation. Additionally, we compared the reliability of a single and averaged measurements for various standing balance conditions and assessed the potential of sway features to monitor progression. In summary, we found that many sway features reflecting sitting and standing balance were reliable for both

Conclusion

We studied the reliability of balance assessment using a single inertial measurement unit in people after stroke in clinical rehabilitation. We found that postural sway can reliably be assessed during sitting and various standing balance conditions with a single measurement. Considering the relatively low minimal detectable change, this method to measure balance is a candidate to monitor progression during clinical rehabilitation.