Technology-based balance performance assessment can eliminate floor and ceiling effects

Area of Science:

• Rehabilitation Engineering
• Biomedical Engineering
• Clinical Biomechanics

Background:

• Clinical balance assessments often suffer from ceiling and floor effects, limiting their sensitivity.
• Technology-based assessments, particularly using virtual reality, offer potential for objective and quantitative balance measures.
• The Computer-Assisted Rehabilitation Environment (CAREN) provides a platform for developing advanced balance assessment tools.

Purpose of the Study:

• To develop a Performance Assessment Tool (PAT) for the CAREN system.
• To evaluate the reliability and validity of the PAT scores.
• To compare balance performance between individuals with and without mobility impairments.

Main Methods:

• Three virtual reality games were developed and implemented on the CAREN system.
• The PAT was tested on 49 participants (36 able-bodied, 13 with impaired mobility).
• Measures were transformed into scores to minimize ceiling and floor effects, and validated against clinical balance tests.

Main Results:

• The PAT demonstrated an association between scores and age.
• Scores showed overlap between high-performing individuals with impairments and low-performing able-bodied individuals.
• PAT scores correlated significantly with established clinical balance measures.

Conclusions:

• The developed PAT effectively overcomes ceiling and floor effects present in traditional clinical tools.
• The PAT provides objective, reliable, and scalable balance assessment.
• This tool holds promise for monitoring rehabilitation progress and training effects in individuals with balance impairments.