Instrumented Static and Reactive Balance in Collegiate Athletes: Normative Values and Minimal Detectable Change

Tessa L Petersell; David L Quammen; Regan Crofts; Amanda J Morris; Nora Fino; Cameron B Jensen; Adam Hollien; Ryan Pelo; Brody J Roemmich; Leland E Dibble; Peter C Fino

doi:10.4085/1062-6050-0403.23

Instrumented Static and Reactive Balance in Collegiate Athletes: Normative Values and Minimal Detectable Change

J Athl Train. 2023 Nov 28. doi: 10.4085/1062-6050-0403.23. Online ahead of print.

Authors

Affiliations

¹ University of Utah, Department of Health & Kinesiology, Salt Lake City, UT.
² University of Utah, Department of Physical Therapy and Athletic Training, Salt Lake City, UT.
³ California State University Sacramento, Department of Kinesiology, Sacramento, CA.
⁴ University of Utah, Division of Epidemiology, Department of Internal Medicine, Salt Lake City, UT.

PMID: 38014789
DOI: 10.4085/1062-6050-0403.23

Abstract

Context: Wearable sensors are increasingly popular in concussion research because of their objective quantification of subtle balance deficits. However, normative data and minimum detectable change values are necessary to serve as a references for diagnostic use and tracking longitudinal recovery.

Objective: Identify normative values and minimal detectable change values for instrumented static and reactive balance tests, an instrumented static Mediolateral Root Mean Square (ML RMS) sway standing balance assessment, and the instrumented, modified Push & Release (I-mP&R), respectively.

Design: Cross-Sectional Study.

Setting: Clinical Setting.

Patients or other participants: Normative static ML RMS sway and I-mP&R data were collected on 377 (n=184 females) healthy National Collegiate Athletic Association Division I athletes at the beginning of their competitive seasons. Test-retest data were collected in 36 healthy control athletes based on standard recovery timelines after concussion.

Results: Descriptive statistics, intraclass correlation coefficients (ICC), and minimal detectable change (MDC) values were calculated for primary outcomes of mediolateral (ML) root-mean-square (RMS) sway in a static double limb-stance standing on firm ground and a foam block, and time to stability and latency from the I-mP&R in single- and dual-task conditions.

Results: Normative outcomes across static ML RMS sway and I-mP&R were sensitive to sex and type of footwear. ML RMS sway demonstrated moderate reliability in the firm condition (ICC=0.73; MDC=2.7cm/s2), but poor reliability in the foam condition (ICC=0.43; MDC=11.1cm/s2). Single- and dual-task time to stability from the I-mP&R exhibited good reliability (ICC=0.84 and 0.80, respectfully; MDC=0.25s, 0.59s, respectfully). Latency from the I-mP&R had poor to moderate reliability (ICC=0.38, 0.55; MDC=107ms, 105ms).

Conclusions: Sex-matched references should be used for instrumented static and reactive balance assessments. Footwear may explain variability in static ML RMS sway and time to stability of the I-mP&R. Moderate-to-good reliability suggest time to stability from the I-mP&R and ML RMS static sway on firm ground can be used for longitudinal assessments.

Keywords: Reactive balance; normative data; test-retest reliability.