MCQ-Balance: a method to monitor patients with balance disorders and improve clinical interpretation of posturography

PeerJ. 2021 Feb 23:9:e10916. doi: 10.7717/peerj.10916. eCollection 2021.

Abstract

Background: An estimated 20% to 30% of the global population has suffered a vertiginous episode. Among them, 20% do not receive a clear diagnosis. Improved methods, indicators and metrics are necessary to assess the sensory systems related to balance, especially when patients are undergoing treatment for vertiginous episodes. Patients with balance disorders should be monitored for changes at the individual level to gather objective information. In this study, we evaluate the use of the MCQ-Balance (Measure, Classify and Qualify) assessment for examining a patient's balance progression using tests to measure static balance control and dynamic postural balance with a stabilometric platform.

Materials and methods: The MCQ-Balance assessment comprises three stages: (i) measuring the progression of each variable between two separate and consecutive days (called sessions) using the Magnitude-Based Decision analysis; (ii) classifying the progression of the patient's balance with a score; and (iii) qualifying the progression of the patient's balance from the resulting scores using a set of rules. This method was applied to 42 patients with balance disorders of peripheral or central origin characterised by vertigo as the cardinal symptom. Balance progression was measured using the MCQ-Balance assessment over the course of three months, and these results were compared with the assessment of a clinical expert.

Results: The MCQ-Balance assessment showed an accuracy of 83.4% and a Cohen's Kappa coefficient of 0.752 compared to the assessment of a clinical expert.

Conclusion: The MCQ-Balance assessment facilitates the monitoring of patient balance and provides objective information that has the potential to improve medical decision making and the adjustment of individual treatment.

Keywords: Balance sensory systems; Methodology; Monitoring; Objective information; Patient-level analysis; Personalized medicine; Stabilometric platform; Vertigo.

Grants and funding

The project was co-financed by the Government of Aragon, the European Regional Development Fund, and the University of Zaragoza (Spain). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.