Comparison of the SWAY balance mobile application to the BESS balance assessment in older adults

Abstract

Balance assessment has commonly been subjective; however, advances in handheld mobile devices have provided objective balance measurement tools. Recently, the SWAY Balance Mobile Application, which utilizes tri-axial accelerometers to determine balance variations, was significantly correlated with the Balance Error Scoring System (BESS) for young adults. Older adults have not been assessed.

The assessment of balance has commonly been a subjective task; however, technological advances in handheld mobile devices have provided an objective way to measure balance via the use of tri-axial accelerometers. Recent literature has demonstrated that the SWAY Balance Mobile Application (SWAY), which utilizes tri-axial accelerometers to determine variations in balance, was significantly correlated with the Balance Error Scoring System (BESS). Such literature demonstrates that SWAY can provide an objective balance score for young adults; however, special populations such as older adults need to be assessed.PURPOSE: To compare the objective SWAY Balance Mobile Application to the subjective BESS balance assessment of older adults.METHODS: Forty-three older adults (19 male, 24 female; aged 60.14 ± 6.72 years) completed the SWAY and the BESS balance assessments concurrently. A modified version of the BESS was used for testing, whereas the participant completed the balance stances on solid ground and did not repeat the stances on a foam mat. Participants simultaneously completed the SWAY, by holding a common mobile consumer electronic device mid-sternum and completing 5 different balance stances. The balance stances included a double leg stance, single leg stance (tested for dominant and non-dominant leg separately), and tandem stance (heel-to toe; tested with dominant foot behind the non-dominant and again with non-dominant foot behind the dominant). A Certified Athletic Trainer determined the BESS scores for each participant using only the double leg stance and the non-dominant variations of the remaining stances; however, all 5 stances were used to determine the SWAY score. A lower score on the BESS indicates better balance, whereas, a higher score on the SWAY indicates better balance. Correlation analyses were used to determine the relationship between the SWAY and the BESS balance assessment techniques.RESULTS: The mean SWAY score was 64.54 (± 16.25) and the mean BESS score was 11.00 (± 3.96). There was a significant negative correlation between the SWAY scores and the BESS balance assessment scores (r = -0.640, p < .01).CONCLUSION: The SWAY Balance Mobile Application may provide an objective way for professionals and non-professionals alike to assess balance of special populations, such as older adults.