Test-Retest reliability and preliminary reliable change estimates for Sway Balance tests administered remotely in community-dwelling adults

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Authors
Caccese, Jaclyn B.
Teel, Elizabeth
Van Patten, Ryan
Muzeau, Mélissa A.
Iverson, Grant L.
VanRavenhorst-Bell, Heidi A.
Advisors
Issue Date
2022-11-02
Type
Article
Keywords
Postural stability , Balance error scoring system (BESS) , Balance , Concussion , Psychometrics (MeSH)
Research Projects
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Citation
Caccese JB, Teel E, Van Patten R, Muzeau MA, Iverson GL and VanRavenhorst-Bell HA (2022) Test-Retest reliability and preliminary reliable change estimates for Sway Balance tests administered remotely in community-dwelling adults. Front. Digit. Health 4:999250. doi: 10.3389/fdgth.2022.999250
Abstract

Objective: Impaired balance and postural stability can occur with advanced age, following traumatic brain injury, in association with neurological disorders and diseases, and as the result of acute or chronic orthopedic problems. The remote assessment of balance and postural stability could be of value in clinical practice and research. We examined the test-retest reliability and reliable change estimates for Sway Balance Mobile Application tests (Sway Medical, Tulsa OK, USA) administered remotely from the participant's home.

Method: Primarily young, healthy community-dwelling adults completed Sway Balance Mobile Application tests remotely on their personal mobile devices once per week for three consecutive weeks while being supervised with a video-based virtual connection. Sway Balance tests include five stances (i.e., feet together, tandem right foot forward, tandem left foot forward, single leg right foot, single leg left foot), which are averaged to compute a Sway Balance composite score from 0 to 100, with higher scores indicating better postural stability. We examined test-retest reliability (measured with intraclass correlation coefficients, ICCs) and preliminary reliable change estimates for 70%, 80%, and 90% confidence intervals.

Results: Participants included 55 healthy adults (ages?=?26.7?±?9.9 years, interquartile range?=?20–30, range?=?18–58; 38 [69%] women). Test-retest reliability for the Sway Balance composite score across three weeks was.88. Test-retest reliability for individual stances ranged from 62 to 83 (all ps?<?0.001). At the 80% confidence interval, preliminary reliable changes estimates were 9 points for the Sway Balance composite score.

Conclusions: For a remote administration, test–retest reliability was moderate-to-good for all Sway Balance stances, as well as for the Sway Balance composite score. Reliable change estimates may allow clinicians to determine whether an improvement or decline in performance is greater than the expected improvement or decline due to measurement error in young adults.

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Publisher
Frontiers Media S.A.
Journal
Book Title
Series
Frontiers in Digital Health
Volume 4
PubMed ID
DOI
ISSN
2673-253X
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