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Test-retest reliability of motion capture technology for assessing balance in children with autism spectrum disorder
Tingting Ma1,2, Lingyun Jia2, Amei Feng1,2
1Department of Physical Therapy for Children, China Rehabilitation Research Center, Beijing Boai Hospital, Beijing, China.
Background:
Children with autism spectrum disorder (ASD) often show balance impairments that may affect motor development. Portable motion capture may provide quantitative balance indices, but its test-retest reliability in pediatric ASD remains unclear.
Research Question:
This study evaluated seven-day test-retest reliability of a portable marker-based motion capture system for head-sway-derived balance indices in children with ASD and described exploratory unadjusted differences from typically developing (TD) children.
Methods:
Twenty-two children (11 ASD, 11 TD) completed long-sitting, eyes-open standing, and eyes-closed standing balance tests using head-mounted reflective markers. Outcomes were mediolateral sway amplitude (Dx), anteroposterior sway amplitude (Dy), and 95% confidence ellipse area (Area). Reliability was assessed using intraclass correlation coefficients, standard error of measurement, and Bland-Altman plots. Between-group analyses were exploratory because the groups were not matched by age or sex.
Results:
In children with ASD, Dy showed good reliability (ICC = 0.77-0.87; SEM = 1.98-3.19), with the highest reliability in long sitting (ICC = 0.87). Dx showed poor to moderate reliability (ICC = 0.45-0.69), and Area showed moderate to good reliability (ICC = 0.65-0.77). Exploratory comparisons showed larger sway values in the ASD group, but these results may reflect baseline age and sex differences.
Significance:
The system reproducibly measured anteroposterior head-sway in children with ASD, particularly in long sitting. Further validation against reference balance measures and larger age- and sex-matched studies is needed before diagnostic or discriminative use.
