Normative data for static balance testing in healthy individuals using open source computerized posturography
Computerized posturography is the gold standard for balance assessment. Because of the great cost and dimensions of commercial equipments, low-cost and portable devices have been developed and validated, such as RombergLab, a software in open source term which works connected with a low-cost force platform. The objective of this study was to obtain normative posturography data using this software.
A multicentric prospective and descriptive study, with 350 healthy participants, was designed. Static postural stability (measured using the modified clinical test of sensory interaction on balance) was evaluated using the software connected to the force platform. Using the confidence ellipse area (CEA) in each condition, global equilibrium score (GES) was calculated and adjusted for significant variable factors using cluster analysis.
Mean (SD) GES was 0.72 (0.22). Age (p < 0.01), height (p < 0.01) and recruitment center (p < 0.05) were found as influence factors for GES. Cluster analysis obtained 16 groups stratified by age and height. GES decreases with age and height (p < 0.005). No significant interaction of age nor height was found with GES in these clusters (p > 0.05). After correction for height and age, GES was no longer influenced by the recruitment center (p > 0.05).
With the introduction of the global equilibrium score values of the present study into the software, we consider RombergLab v1.3 a reference posturography tool for healthy individuals. Further studies are needed for validating it as a suitable instrumented test for screening between healthy and pathologic subjects and its reliability over time for the follow-up of patients.
KeywordsPosturography Low-cost posturography Portable posturography Open source software Reference values
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
None of the authors had conflict of interest in relation with the study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 1.Sudarsky L (2001) Gait disorders: prevalence, morbidity, and etiology. Adv Neurol 87:111–117Google Scholar
- 2.Salzman B (2010) Gait and balance disorders in older adults. Am Fam Phys 82:61–69Google Scholar
- 3.Romberg MH (1846) Lehrbuch der Nervenkrankheiten des Menschen. Hirschwald, BerlinGoogle Scholar
- 7.Baloh RW, Angeles L, Furman JMR (1989) Modern vestibular function testing. West J Med 150:58–67Google Scholar
- 10.Marchetti GF, Bellanca J, Whitney SL et al (2013) The development of an accelerometer-based measure of human upright static anterior-posterior postural sway under various sensory conditions: test–retest reliability, scoring and preliminary validity of the balance accelerometry measure (BAM). J Vestib Res Equilib Orientat 23:227–235. https://doi.org/10.3233/VES-130490 Google Scholar
- 21.Turkey John W (1977) Exploratory data analysis. Addison Wesley, Reading, MassachusettsGoogle Scholar
- 25.NeuroCom Balance Manager (2016) Sensory Organitation Test. Natus Medical Incorporated. http://balanceandmobility.com/wp-content/uploads/018528A_NCM_SOT_brochure_EN-US_lo-res.pdf. Accessed 13 Sept 2017
- 28.Carmona S, Zalazar G, D’albora R, Bordabehere G (2017) Portable posturography: validation of variables in people without posture and balance disorders. a pilot study. EC Neurol 6:3:132–136Google Scholar