ReviewThe test–retest reliability of centre of pressure measures in bipedal static task conditions – A systematic review of the literature
Section snippets
Background
Postural stability is an important component in maintaining an upright position and in maintaining balance during normal daily movements and activities. Postural stability is also an important factor in the elderly where balance disability may increase the risk of falls and subsequent injury. In sport, problems with balance may lead to serious injuries [1]. Thus, postural stability has important implications in sports and rehabilitation. Many different methods exist today for assessing postural
Aims
The aims of this systematic literature review are (1) to describe and assess the methodological procedures of studies of the most commonly used COP measurements and methods, (2) to determine the reliability of commonly used centre of pressure measures in bipedal static task conditions, and (3) to provide recommendations regarding standardized COP methods for future use in study designs.
Search strategy
A comprehensive search strategy was developed by identifying all potentially relevant search terms, categorizing these terms into specific search phases and subsequently combining them by using Boolean terms. This search strategy was designed to be used in six different electronic databases. These were PubMed, MEDLINE, EMBASE, Web of Science, ScienceDirect, Digital Dissertations and the Cochrane library. The search strategy is available upon contacting the corresponding author.
Electronic searches
All databases
Literature search results
Initially, the online search strategy identified 215 study abstracts which were screened individually by the reviewers. The application of inclusion/exclusion criteria by the reviewers on the titles and abstracts eliminated a further 162 papers. The most common reason for exclusion was not meeting the selection criteria like static or bipedal tasks. From the titles and abstracts of papers selected (n = 53), full articles were reviewed and the same two reviewers (AR and TB) applied the inclusion
The statistics
As with the general experimental setups, an equally heterogeneous selection of statistics for describing the reliability was used, including the coefficient of variation (CV), generalizability coefficient (GC) as well as Pearson's correlation coefficient (PCC). The most commonly applied statistic however, were the different forms of the intraclass correlation coefficient (ICC). While most used models described originally by Shrout and Fleiss [13], others again employed modified versions [14].
Relationships between methods and reliability
While various studies have investigated the same COP parameters such as mean velocity or area of sway, an inter-study comparison of each parameter's individual reliability is often problematic because of differences in study designs. Only a few studies offer similar experimental procedures that allow for comparing the effect of various factors on the reliability of COP measures (Table 3a, Table 3b, Table 3c).
General considerations
Due to the heterogeneous study designs and statistical models used there remains little common ground for combining the reliability of all data presented. Only a few papers allowed for direct inter-study comparison of results and most of the conclusions had to be drawn from those studies. No quantitative pooling of results from the studies was possible, but we were nevertheless able to extract enough information to make recommendations regarding reliable experimental setups for COP measurements.
Conclusion
The overall results indicate that the reliability of traditional COP parameters is acceptable if our recommendations are followed in the study design. The test–retest reliability depends primarily on factors such as the number of trial recordings and duration rather than the selection of particular COP parameters. Care should be taken to thoroughly assess the subject's physical status and anthropometric properties prior to the measurements. The primary finding of this systematic review is there
Acknowledgements
The author(s) like to thank Tino Bos DC (TB) for his valuable contribution during the first phase of the literature search and Alexander Steinbrenner DC (AS) for volunteering as a third reviewer.
Conflict of interest statement: The authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) this work.
References (52)
- et al.
The dynamics of standing balance
Trends Cogn Sci
(2002) Human balance and posture control during standing and walking
Gait Posture
(1995)- et al.
Comparison of kinematic and kinetic methods for computing the vertical motion of the body center of mass during walking
Hum Mov Sci
(2004) - et al.
Comparison of three methods to estimate the center of mass during balance assessment
J Biomech
(2004) - et al.
Age and gender effects on postural control measures
Arch Phys Med Rehabil
(1995) - et al.
Intrasession reliability of force platform parameters in community-dwelling older adults
Arch Phys Med Rehabil
(2008) - et al.
Kinematic characteristics of standing disequilibrium: reliability and validity of a posturographic protocol
Arch Phys Med Rehabil
(1999) - et al.
Reliability of traditional and fractal dimension measures of quiet stance center of pressure in young, healthy people
Arch Phys Med Rehabil
(2005) - et al.
Reliability of COP-based postural sway measures and age-related differences
Gait Posture
(2008) - et al.
Sampling duration effects on centre of pressure summary measures
Gait Posture
(2001)
Generalizability of Stabilogram diffusion analysis of center of pressure measures
Gait Posture
Reliability of centre of pressure summary measures of postural steadiness in healthy young adults
Gait Posture
Standing steadiness measurements: empirical selection of testing protocol and outcome measures
Neurotoxicol Teratol
Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people
Arch Phys Med Rehabil
Stabilometric parameters are affected by anthropometry and foot placement
Clin Biomech (Bristol, Avon)
Test–retest reliability of center of pressure measures of postural stability during quiet standing in a group with musculoskeletal disorders consisting of low back pain, anterior cruciate ligament injury and functional ankle instability
Gait Posture
Body weight is a strong predictor of postural stability
Gait Posture
Normalization of temporal-distance parameters in pediatric gait
J Biomech
Test–retest reliability of centre of foot pressure measures to assess postural control during unperturbed stance
Med Eng Phys
The assessment of body sway and the choice of the stability parameter(s)
Gait Posture
Should the instructions issued to the subject in traditional static posturography be standardised?
Med Eng Phys
The sensitivity of posturographic parameters to acquisition settings
Med Eng Phys
An improved technique for the extraction of stochastic parameters from stabilograms
Gait Posture
Generalizability of center of pressure measures of quiet standing
Gait Posture
Postural control measured as the center of pressure excursion in young female gymnasts with low back pain or lower extremity injury
Gait Posture
Effect of ageing and vision on limb load asymmetry during quiet stance
J Biomech
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