Development of a Smartphone-Based Balance Assessment System for Subjects with Stroke

Stroke is a cerebral artery disease that negatively affects activities of daily living (ADLs) and quality of life (QoL). Smartphones have demonstrated strong potential in assessing balance performance. However, such smartphone-based tools have thus far not been applied to stroke survivors. The purpose of this study was to develop a smartphone-based balance assessment system for subjects who have experienced strokes and evaluate the system feasibility. The smartphone-based balance assessment application was developed with Android Studio, and reliability and validity tests were conducted. The smartphone was used to record data using a built-in accelerometer and gyroscope, and increased changes represented greater instability. Six postures were tested for 30 s each. Ten healthy adults were recruited in the reliability test, and the intraclass correlation coefficient (ICC) was used to analyze the within-day and between-day reliabilities. Eight subjects with chronic stroke and eight healthy adults were recruited for the validity test, in which balance performance was compared to represent the application validity. The ICC values of the reliability tests were at least 0.76 (p = 0.00). The acceleration data exhibited no difference between individuals who have experienced stroke and healthy subjects; however, all six postures were found to differ significantly between the two groups in the gyroscope data. The study demonstrates that the smartphone application provides a convenient, reliable, and valid tool for the balance assessments of subjects who have experienced chronic stroke.