Closing the gap while standing still: clinimetric properties of a low-cost balance platform and a user-friendly app for posturography

Background The Wii Balance Board (WBB) is used as a rehabilitation tool for balance or strength interventions and posturography in balance tasks. Nonetheless, implementation of posturography using the WBB in a clinical setting is hampered by required technical skills for signal processing to obtain...

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Main Authors: Tom Vredeveld, John F. Stins, Annelies J. van Vliet, Vincent C.M. Tuinder, Stephan P.J. Ramaekers, Michel W. Coppieters, Annelies L. Pool-Goudzwaard
Format: Article
Language:English
Published: PeerJ Inc. 2025-02-01
Series:PeerJ
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Online Access:https://peerj.com/articles/18299.pdf
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author Tom Vredeveld
John F. Stins
Annelies J. van Vliet
Vincent C.M. Tuinder
Stephan P.J. Ramaekers
Michel W. Coppieters
Annelies L. Pool-Goudzwaard
author_facet Tom Vredeveld
John F. Stins
Annelies J. van Vliet
Vincent C.M. Tuinder
Stephan P.J. Ramaekers
Michel W. Coppieters
Annelies L. Pool-Goudzwaard
author_sort Tom Vredeveld
collection DOAJ
description Background The Wii Balance Board (WBB) is used as a rehabilitation tool for balance or strength interventions and posturography in balance tasks. Nonetheless, implementation of posturography using the WBB in a clinical setting is hampered by required technical skills for signal processing to obtain meaningful balance measures. Therefore, this study aims to evaluate the concurrent validity and test–retest reliability of a WBB to measure center of pressure (COP) parameters and to provide an easy-to-use web application to improve implementation of posturography in clinical practice. Methods A cross-sectional study was carried out including 30 healthy adults who performed repeated balance tasks including single and double leg standing still with eyes open or eyes closed. A WBB on top of a laboratory-grade force plate synchronously measured COP. Parameters based on COP displacement were calculated, including standard deviation of displacement, velocity, pathlength and 95% predicted ellipse area. Results The concurrent validity of the WBB to measure COP in quiet standing still tasks was excellent for all parameters (Intraclass Correlation Coefficient (ICC) > 0.900, p < 0.001), apart from medio-lateral velocity (ICC = 0.571, p = 0.090 to ICC = 0.711, p = 0.057). For the single leg balance tasks, across the two measurements, all WBB COP derived parameters showed excellent correlations with COP parameters derived from a laboratory-grade force plate (ICC > 0.95, p < 0.001). Test–retest reliability of the WBB was poor (ICC below 0.5) to occasionally good (ICC between 0.75 to 0.90) for the COP parameters from quiet standing balance tasks. Comparable reliability was found for the repeated measurements of single leg standing still. Power spectra analysis of both force plates revealed larger measurement error by the WBB in medio-lateral direction in tasks requiring minimal postural adjustments. Conclusion The WBB revealed excellent concurrent validity with a laboratory-grade force plate for balance tasks on a single leg or two legs for most COP parameters. The reliability was poor to moderate for most tasks, however comparable to the findings from the laboratory grade force plate. An open-source web application, employing R Shiny, was created to provide a tool to analyse COP parameters. Hereby, it was demonstrated that open-source scientific tools may help researchers to bridge the gap between scientific findings and clinical use of posturography.
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spelling doaj-art-d6e77d073ea34dc7a1cb133297a90b722025-02-06T15:05:12ZengPeerJ Inc.PeerJ2167-83592025-02-0113e1829910.7717/peerj.18299Closing the gap while standing still: clinimetric properties of a low-cost balance platform and a user-friendly app for posturographyTom Vredeveld0John F. Stins1Annelies J. van Vliet2Vincent C.M. Tuinder3Stephan P.J. Ramaekers4Michel W. Coppieters5Annelies L. Pool-Goudzwaard6Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam University of Applied Sciences, Amsterdam, NetherlandsDepartment of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsDepartment of Biomedical Technology, Faculty of Technology, Amsterdam University of Applied Sciences, Amsterdam, NetherlandsDepartment of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsCentre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam University of Applied Sciences, Amsterdam, NetherlandsDepartment of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsDepartment of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsBackground The Wii Balance Board (WBB) is used as a rehabilitation tool for balance or strength interventions and posturography in balance tasks. Nonetheless, implementation of posturography using the WBB in a clinical setting is hampered by required technical skills for signal processing to obtain meaningful balance measures. Therefore, this study aims to evaluate the concurrent validity and test–retest reliability of a WBB to measure center of pressure (COP) parameters and to provide an easy-to-use web application to improve implementation of posturography in clinical practice. Methods A cross-sectional study was carried out including 30 healthy adults who performed repeated balance tasks including single and double leg standing still with eyes open or eyes closed. A WBB on top of a laboratory-grade force plate synchronously measured COP. Parameters based on COP displacement were calculated, including standard deviation of displacement, velocity, pathlength and 95% predicted ellipse area. Results The concurrent validity of the WBB to measure COP in quiet standing still tasks was excellent for all parameters (Intraclass Correlation Coefficient (ICC) > 0.900, p < 0.001), apart from medio-lateral velocity (ICC = 0.571, p = 0.090 to ICC = 0.711, p = 0.057). For the single leg balance tasks, across the two measurements, all WBB COP derived parameters showed excellent correlations with COP parameters derived from a laboratory-grade force plate (ICC > 0.95, p < 0.001). Test–retest reliability of the WBB was poor (ICC below 0.5) to occasionally good (ICC between 0.75 to 0.90) for the COP parameters from quiet standing balance tasks. Comparable reliability was found for the repeated measurements of single leg standing still. Power spectra analysis of both force plates revealed larger measurement error by the WBB in medio-lateral direction in tasks requiring minimal postural adjustments. Conclusion The WBB revealed excellent concurrent validity with a laboratory-grade force plate for balance tasks on a single leg or two legs for most COP parameters. The reliability was poor to moderate for most tasks, however comparable to the findings from the laboratory grade force plate. An open-source web application, employing R Shiny, was created to provide a tool to analyse COP parameters. Hereby, it was demonstrated that open-source scientific tools may help researchers to bridge the gap between scientific findings and clinical use of posturography.https://peerj.com/articles/18299.pdfReproducibility of resultsPosturographyCenter of pressurePostural controlBalanceForce platform
spellingShingle Tom Vredeveld
John F. Stins
Annelies J. van Vliet
Vincent C.M. Tuinder
Stephan P.J. Ramaekers
Michel W. Coppieters
Annelies L. Pool-Goudzwaard
Closing the gap while standing still: clinimetric properties of a low-cost balance platform and a user-friendly app for posturography
PeerJ
Reproducibility of results
Posturography
Center of pressure
Postural control
Balance
Force platform
title Closing the gap while standing still: clinimetric properties of a low-cost balance platform and a user-friendly app for posturography
title_full Closing the gap while standing still: clinimetric properties of a low-cost balance platform and a user-friendly app for posturography
title_fullStr Closing the gap while standing still: clinimetric properties of a low-cost balance platform and a user-friendly app for posturography
title_full_unstemmed Closing the gap while standing still: clinimetric properties of a low-cost balance platform and a user-friendly app for posturography
title_short Closing the gap while standing still: clinimetric properties of a low-cost balance platform and a user-friendly app for posturography
title_sort closing the gap while standing still clinimetric properties of a low cost balance platform and a user friendly app for posturography
topic Reproducibility of results
Posturography
Center of pressure
Postural control
Balance
Force platform
url https://peerj.com/articles/18299.pdf
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