Inter- and Intra-Tester Reliability of Postural Stability Tests in Patients With Whiplash-Associated Disorder

Area of Science:

• Neurology
• Physical Therapy
• Biomechanics

Background:

• Whiplash-associated disorder (WAD) often impairs postural balance.
• Reliable assessment of balance is crucial for WAD rehabilitation.
• Existing balance tests need validation for WAD populations.

Purpose of the Study:

• To evaluate the inter- and intra-tester reliability of various postural balance tests.
• To assess the clinical meaningfulness of these balance tests in WAD patients.
• To determine the reliability of comparing different balance test conditions.

Main Methods:

• Fifteen chronic WAD patients performed 7 postural balance tests on a force platform.
• Tests included neutral, gaze-rotated, head-rotated, and neck-torsioned positions.
• Reliability was assessed using intraclass correlation, t-tests, and variance coefficients for sway velocity and velocity moment.

Main Results:

• Individual balance tests demonstrated strong inter- and intra-tester reliability (correlation ≥0.70).
• Results were clinically meaningful with minimal variability between testers and sessions.
• Correlations for differences between test variations were negligible to moderate, indicating clinical insignificance.

Conclusions:

• Individual postural balance tests are clinically reliable for WAD patients.
• Caution is advised when interpreting differences between balance test variations.
• Further research is needed to confirm test utility in distinguishing study groups and assessing sensory systems.