The Development and Validation of a Novel Smartphone Application to Detect Postural Instability

Traditional assessments of balance and postural control often face challenges related to accessibility, cost, subjectivity, and inter-rater reliability. With advancements in technology, smartphones equipped with inertial measurement units (IMUs) are emerging as a promising tool for assessing postural control, measuring both static and dynamic motion. This study aimed to develop and validate a novel smartphone application by comparing it with research-grade posturography instruments, including motion capture and force plate systems to establish construct- and criterion-related validity. Twenty-two participants completed the quiet stance under varying visual (eyes open-EO; eyes closed-EC) and surface (Firm vs. Foam) conditions, with data collected from the smartphone, force plate, and motion capture systems. Intraclass correlation coefficients (ICCs) and Pearson correlation coefficients assessed the reliability and validity for all outcome measures (sway area and sway velocity). The results demonstrated reliability, with strong validity between the devices. A repeated-measures ANOVA found no significant differences between the devices. Postural outcomes revealed the significant main effects of both the visual (EO vs. EC) and surface (Firm vs. Foam) conditions. In conclusion, the study demonstrated the validity, sensitivity, and accuracy of the custom-designed smartphone app, offering the potential for bridging the gap between at-home and clinical balance assessments.