Institute of Regional Health Services Research, University of Southern Denmark, Winsloewparken 193, Odense C 5000, Denmark.
BMC Pediatr. 2014 Jun 10;14:144. doi: 10.1186/1471-2431-14-144.
Because body proportions in childhood are different to those in adulthood, children have a relatively higher centre of mass location. This biomechanical difference and the fact that children's movements have not yet fully matured result in different sway performances in children and adults. When assessing static balance, it is essential to use objective, sensitive tools, and these types of measurement have previously been performed in laboratory settings. However, the emergence of technologies like the Nintendo Wii Board (NWB) might allow balance assessment in field settings. As the NWB has only been validated and tested for reproducibility in adults, the purpose of this study was to examine reproducibility and validity of the NWB in a field setting, in a population of children.
Fifty-four 10-14 year-olds from the CHAMPS-Study DK performed four different balance tests: bilateral stance with eyes open (1), unilateral stance on dominant (2) and non-dominant leg (3) with eyes open, and bilateral stance with eyes closed (4). Three rounds of the four tests were completed with the NWB and with a force platform (AMTI). To assess reproducibility, an intra-day test-retest design was applied with a two-hour break between sessions.
Bland-Altman plots supplemented by Minimum Detectable Change (MDC) and concordance correlation coefficient (CCC) demonstrated satisfactory reproducibility for the NWB and the AMTI (MDC: 26.3-28.2%, CCC: 0.76-0.86) using Centre Of Pressure path Length as measurement parameter. Bland-Altman plots demonstrated satisfactory concurrent validity between the NWB and the AMTI, supplemented by satisfactory CCC in all tests (CCC: 0.74-0.87). The ranges of the limits of agreement in the validity study were comparable to the limits of agreement of the reproducibility study.
Both NWB and AMTI have satisfactory reproducibility for testing static balance in a population of children. Concurrent validity of NWB compared with AMTI was satisfactory. Furthermore, the results from the concurrent validity study were comparable to the reproducibility results of the NWB and the AMTI. Thus, NWB has the potential to replace the AMTI in field settings in studies including children. Future studies are needed to examine intra-subject variability and to test the predictive validity of NWB.
由于儿童在童年时期的身体比例与成年后不同，因此他们的重心位置相对较高。这种生物力学差异以及儿童的运动尚未完全成熟，导致儿童和成人的摆动表现不同。在评估静态平衡时，使用客观、敏感的工具至关重要，以前已经在实验室环境中进行过此类测量。然而，任天堂 Wii 平衡板（NWB）等技术的出现可能允许在现场环境中进行平衡评估。由于 NWB 仅在成年人中进行了可重复性和再现性验证和测试，因此本研究的目的是在儿童人群中，在现场环境中检查 NWB 的可重复性和有效性。
来自 CHAMPS-Study DK 的 54 名 10-14 岁儿童进行了四项不同的平衡测试：睁眼双侧站立（1）、睁眼时用优势腿（2）和非优势腿（3）进行单侧站立，以及闭眼双侧站立（4）。使用 NWB 和力台（AMTI）完成四轮四项测试。为了评估可重复性，采用日内测试-重测设计，两次测试之间间隔两小时。
Bland-Altman 图辅以最小可检测变化量（MDC）和一致性相关系数（CCC）表明，使用压力中心路径长度作为测量参数时，NWB 和 AMTI 的可重复性令人满意（MDC：26.3-28.2%，CCC：0.76-0.86）。Bland-Altman 图表明 NWB 和 AMTI 具有良好的同时有效性，并在所有测试中均具有令人满意的 CCC（CCC：0.74-0.87）。在有效性研究中，限值协议的范围与可重复性研究的限值协议的范围相当。
NWB 和 AMTI 均可用于测试儿童人群的静态平衡，具有良好的可重复性。与 AMTI 相比，NWB 的同时有效性令人满意。此外，同时有效性研究的结果与 NWB 和 AMTI 的可重复性结果相当。因此，NWB 有可能在包括儿童在内的研究中替代 AMTI 在现场环境中使用。需要进一步的研究来检查个体内变异性并测试 NWB 的预测有效性。
