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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2013; 23(03): 135-146
DOI: 10.1055/s-0033-1337977
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Metric Characteristics of the Tests for Dynamic Balance Evaluation

Metrische Eigenschaften von Tests für die Beurteilung der dynamischen Gleichgewichtsfähigkeit
N. Sarabon
1   Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
2   Science and Research Center, Institute for Kinesiology Research, University of Primorska, Koper, Slovenia
3   S2P Ltd., Laboratory for Motor Control and Motor Behaviour, Ljubljana, Slovenia
,
T. Zacirkovnik
2   Science and Research Center, Institute for Kinesiology Research, University of Primorska, Koper, Slovenia
,
J. Rosker
2   Science and Research Center, Institute for Kinesiology Research, University of Primorska, Koper, Slovenia
3   S2P Ltd., Laboratory for Motor Control and Motor Behaviour, Ljubljana, Slovenia
,
S. Loefler
1   Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
› Author Affiliations
Further Information

Publication History

received 07 October 2012

accepted 21 February 2013

Publication Date:
13 June 2013 (online)

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Metric Characteristics of the Tests for Dynamic Balance EvaluationPhysikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2013; 23(04): 246-246
DOI: 10.1055/s-0033-1351293

Abstract

Different dynamic balance tests help to identify specific balance deficits in elderly and various population groups. In addition, dynamic balance tests have proved useful in identifying potential locomotor-system injury risk factors. These tests differ in the quality of their metric characteristics which could influence their applicability to measure balance in different clinical groups. Reliability, validity, sensitivity and objectivity define metric characteristics of an individual test. This paper provides an overview of the available scientific literature regarding measurement characteristics of the most commonly used dynamic balance tests. Reliability (intra-session, inter-session, inter-tester and intra-tester), sensitivity, validity and ability to predict possible balance impairing trauma and disease are presented. Clinical balance tests (balance assessed by analogue scales), functional reach, star excursion tests and out step tests were most frequently studied for their metric characteristics. In general intra-session reliability proved to be slightly higher than inter-session reliability. On the contrary there is a lack of reports on inter-tester and intra-tester reliability, especially for star excursion tests and for the tests performed on an unstable surface. Tests differ in the validity; possibly resulting from use of different reference standards. In addition factors such as age, fatigue, learning, and anthropometric characteristics have been shown to affect dynamic balance. Majority of tests were successfully implemented in the process of identifying fall prone individuals. However the reports on potential of dynamic balance tests to help predict other lower extremity injury or sports performance are sparse. In general dynamic balance measuring tests (not all parameters) proved to have sufficient metric characteristics for their practical application. However individual parameters and goals of balance assessment should be considered, when choosing the most appropriate test.

Zusammenfassung

Die Verwendung dynamischer Balance Tests ermöglicht die Identifikation spezieller Gleichgewichtsdefizite bei älteren Personen und verschiedenen Bevölkerungsgruppen. Zusätzlich haben dynamische Balance Tests ihre Fähigkeit potenzielle Verletzungsrisiken des Bewegungs­apparates zu erkennen unter Beweis gestellt. Jedoch gibt es Unterschiede in der Qualität der metrischen Eigenschaften und Anwendbarkeit von Gleichgewichtsmessungen in verschiedenen Altersgruppen. Reliabilität, Validität, Sensitivi­tät und Objektivität definieren die metrischen Eigenschaften von individuellen Tests. Diese Arbeit gibt einen Überblick über die vorhandene Literatur bezüglich der Messeigenschaften der meistverwendeten dynamischen Balance Tests. Reliabilität (Intrasession, Test-Retest, Interrater, Intrarater), Sensitivität, Validität und die Fähigkeit mögliche gleichgewichtsbeeinträchtigende Traumata oder Krankheiten prognostizieren zu können werden vorgestellt. Klinische Gleichgewichtstests (bewertet mit analogen Skalen), „Functional Reach“-Tests, Star-Excursion Tests und Schritt auslösende Tests wurden wegen ihrer metrischen Eigenschaften am häufigsten untersucht. Im Allgemeinen zeigt sich eine leicht höhere Intra- als Intersession Reliabilität. Jedoch fehlen Berichte über die Interrater und Intrarater Reliabilität speziell für Star-Excursion Tests und Tests auf labilen Untergründen. Die Validität der Tests unterscheidet sich. Möglicherweise lässt sich dies durch die Verwendung unterschiedlicher Referenzstandards erklären. Zusätzlich hat sich gezeigt, dass Alter, Ermüdung, Lerneffekte und anthropometrische Eigenschaften die dynamische Balance beeinflussen. Die Mehrheit der Tests konnte mögliche Stürze prognostizieren. Allerdings gibt es wenig Berichte über mögliche andere Prognosen (Verletzungen der unteren Extremitäten, sportliche Leistungen). Generell haben Tests für die Beurteilung der dynamischen Gleichgewichtsfähigkeit (wenn auch nicht alle Para­meter) be­wiesen, dass sie ausreichende metrische Eigenschaften be­sitzen. Es sollten jedoch individuelle Parameter und Ziele der angestrebten Balancemessung bei der Wahl eines geeigneten Tests berücksichtigt werden.

Key words

dynamic balance - metric characteristics - testing - reliability - validity - sensitivity

Schlüsselwörter

metrische Eigenschaften - Reliabilität - Validität - Sensitivität
 

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