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Validity of an Automated Balance Error Scoring System.
Stephen M Glass1, Alessandro Napoli2, Elizabeth D Thompson1
11 Department of Physical Therapy, Temple University College of Public Health, Philadelphia, PA.
Journal of Applied Biomechanics
|August 7, 2018
Summary
The Automated Assessment of Postural Stability (AAPS) system offers automated scoring for the Balance Error Scoring System (BESS) test. While showing promise for concussion assessment, AAPS scores are not yet interchangeable with human BESS scores.
Area of Science:
- Neuroscience
- Sports Medicine
- Biomechanical Engineering
Background:
- The Balance Error Scoring System (BESS) is a standard, human-scored clinical test for assessing balance, particularly in suspected concussions.
- Existing instrumented balance tests often yield abstract results, limiting their clinical applicability.
- The Automated Assessment of Postural Stability (AAPS) system aims to provide objective, BESS-aligned error scoring.
Purpose of the Study:
- To compare the scoring agreement between the Automated Assessment of Postural Stability (AAPS) and traditional human-based Balance Error Scoring System (BESS) scoring.
- To evaluate the reliability and potential utility of AAPS as an automated alternative for balance assessment in concussion evaluation.
Main Methods:
- Twenty-five healthy adults completed a modified Balance Error Scoring System (BESS) test.
- Each test was scored independently by three human raters and the Automated Assessment of Postural Stability (AAPS) computerized system.
- Interrater (human-human) and inter-method (AAPS-human) reliability were assessed using Intraclass Correlation Coefficients (ICC) and Bland-Altman limits of agreement (LOA).
Main Results:
- Human raters demonstrated good to excellent interrater agreement (ICC > 0.7).
- Inter-method agreement between AAPS and human raters varied from poor to excellent (ICC values not specified).
- Bland-Altman analysis indicated wider limits of agreement for AAPS versus the human average compared to human-human agreement, suggesting systematic differences.
Conclusions:
- The Automated Assessment of Postural Stability (AAPS) provides consistent, automated scoring for the BESS test.
- While AAPS shows potential for automating balance testing, its scores are not directly interchangeable with human BESS scores due to observed discrepancies.
- Further research is needed to refine AAPS and establish its clinical interchangeability with traditional human scoring for concussion management.
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