Ageberg Eva, Roberts David, Holmström Eva, Fridén Thomas
Department of Rehabilitation, University Hospital, Lund, Sweden.
BMC Musculoskelet Disord. 2003 Jun 27;4:14. doi: 10.1186/1471-2474-4-14.
To assess balance in single-limb stance, center of pressure movements can be registered by stabilometry with force platforms. This can be used for evaluation of injuries to the lower extremities. It is important to ensure that the assessment tools we use in the clinical setting and in research have minimal measurement error. Previous studies have shown that the ability to maintain standing balance is decreased by fatiguing exercise. There is, however, a need for further studies regarding possible effects of general exercise on balance in single-limb stance. The aims of this study were: 1) to assess the test-retest reliability of balance variables measured in single-limb stance on a force platform, and 2) to study the effect of exercise on balance in single-limb stance, in healthy subjects.
Forty-two individuals were examined for test-retest reliability, and 24 individuals were tested before (pre-exercise) and after (post-exercise) short-duration, sub-maximal cycling. Amplitude and average speed of center of pressure movements were registered in the frontal and sagittal planes. Mean difference between test and retest with 95% confidence interval, the intraclass correlation coefficient, and the Bland and Altman graphs with limits of agreement, were used as statistical methods for assessing test-retest reliability. The paired t-test was used for comparisons between pre- and post-exercise measurements.
No difference was found between test and retest. The intraclass correlation coefficients ranged from 0.79 to 0.95 in all stabilometric variables except one. The limits of agreement revealed that small changes in an individual's performance cannot be detected. Higher values were found after cycling in three of the eight stabilometric variables.
The absence of systematic variation and the high ICC values, indicate that the test is reliable for distinguishing among groups of subjects. However, relatively large differences in an individual's balance performance would be required to confidently state that a change is real. The higher values found after cycling, indicate compensatory mechanisms intended to maintain balance, or a decreased ability to maintain balance. It is recommended that average speed and DEV 10; the variables showing the best reliability and effects of exercise, be used in future studies.
为了评估单腿站立时的平衡能力，可通过使用测力平台的稳定测量法记录压力中心的移动情况。这可用于评估下肢损伤。确保我们在临床环境和研究中使用的评估工具具有最小的测量误差非常重要。先前的研究表明，疲劳运动会降低维持站立平衡的能力。然而，关于一般运动对单腿站立平衡可能产生的影响，仍需要进一步研究。本研究的目的是：1）评估在测力平台上测量的单腿站立平衡变量的重测信度，以及2）研究运动对健康受试者单腿站立平衡的影响。
对42名个体进行重测信度检查，对24名个体在短时间、次最大强度骑行前（运动前）和后（运动后）进行测试。在额面和矢状面记录压力中心移动的幅度和平均速度。采用测试与重测之间的平均差异及95%置信区间、组内相关系数以及带有一致性界限的布兰德-奥特曼图作为评估重测信度的统计方法。配对t检验用于运动前和运动后测量结果的比较。
测试与重测之间未发现差异。除一个变量外，所有稳定测量变量的组内相关系数在0.79至0.95之间。一致性界限表明无法检测到个体表现的微小变化。在八个稳定测量变量中的三个变量中，骑行后发现了更高的值。
缺乏系统变化以及较高的组内相关系数值表明该测试对于区分不同受试者组是可靠的。然而，要确定变化是真实的，个体平衡表现需要有相对较大的差异。骑行后发现的较高值表明存在旨在维持平衡的代偿机制，或者维持平衡的能力下降。建议在未来的研究中使用平均速度和DEV 10；这两个变量显示出最佳的信度和运动效果。
