Trial-to-Trial Reproducibility and Test-Retest Stability of Two Dynamic Balance Tests Among Male Firefighters

Abstract

The aim of this study was to evaluate a dynamic stability test and a functional balance test for trial-to-trial reproducibility and stability over time. In the dynamic stability test a subject stood on the force platform and moved his center of pressure through the targets shown on a computer screen. Functional balance was measured by a test in which the subject had to walk as fast as possible across a wooden plank without falling off. Both tests are repeated six times in two testing periods with an interval of two months. The subjects were 29 male firefighters aged 33 - 56 years. According to intraclass correlation coefficients the functional balance test showed good to excellent (0.78 - 0.96) trial-to-trial reproducibility and stability over time, and the results of the dynamic stability test were moderate (0.16 - 0.81). Individual variation in the repeated tests was considerable. However, the limits of agreement in the functional balance test (± 2 - 3 s) and in the performance time of the dynamic stability test (± 4 - 5 s) would be reasonable for practical use. Furthermore, the test-retest stability improved when the reliability was estimated from the best of at least three repeated trials with the functional balance test and the best of at least five trials with the dynamic stability test.

Postural control - balance testing - functional balance - limits of stability

References

• 1 Aromaa A, Heliövaara M, Impivaara O, Knekt P, Maatela J, Joukamaa M, Klaukka T, Lehtinen V, Melkas T, Mälkiä E, Nyman K, Paunio I, Reunanen A, Sievers K, Kalimo E, Kallio V. Terveys, toimintakyky ja hoidontarve Suomessa (Health, Functional Limitations and Need for Care in Finland. Basic Results From the Mini-Finland Health Survey) (In Finnish).  Helsinki and Turku: Kansaneläkelaitoksen julkaisuja, 1989 AL:32. Publications of the Social Insurance Institution, English Summary
• 2 Atkinson G, Nevill A M. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine.  Sports Med. 1998;  26 217-238
• 3 Baumgartner T A. Norm-referenced measurement: reliability.  In: Safrit MJ, Wood TE (eds). Measurement Concepts in Physical Education and Exercise Science Champaign, IL: Human Kinetics Books 1989: 45-72
• 4 Birmingham T B. Test-retest reliability of lower extremity functional instability measures.  Clin J Sport Med. 2000;  10 264-268
• 5 Bland J M, Altman D G. Statistical methods for assessing agreement between two methods of clinical measurement.  Lancet. 1986;  1 307-310
• 6 Brouwer B, Culham E G, Liston R AL, Grant T. Normal variability of postural measures: implications for the reliability of relative balance performance outcomes.  Scand J Rehabil Med. 1998;  30 131-137
• 7 Chiari L, Cappello A, Lenzi D, Della Croce U. An improved technique for the extraction of stochastic parameters from stabilograms.  Gait Posture. 2000;  12 225-234
• 8 Corriveau H, Hébert R, Prince F, Raîche M. Intrasession reliability of the “center of pressure minus center of mass” variable of postural control in the healthy elderly.  Arch Phys Med Rehabil. 2000;  81 45-48
• 9 Ekdahl C, Jarnlo G B, Andersson S I. Standing balance in healthy subjects: evaluation of a quantitative test battery on a force platform.  Scand J Rehabil Med. 1989;  21 187-195
• 10 El-Kahky A M, Kingma H, Dolmans M, de Jong I. Balance control near the limit of stability in various sensory conditions in healthy subjects and patients suffering from vertigo or balance disorders: impact of sensory input on balance control.  Acta Otolaryngol. 2000;  120 508-516
• 11 Era P, Heikkinen E. Postural sway during standing and unexpected disturbance of balance in random samples of men of different ages.  J Gerontol. 1985;  40 287-295
• 12 Fleiss J L. Reliability of measurement.  In: Fleiss JL (ed.) The Design and Analysis of Clinical Experiments. New York, NY: John Wiley & Sons, Inc 1986: 1-32
• 13 Geurts A C, Nienhuis B, Mulder T W. Intrasubject variability of selected force-platform parameters in the quantification of postural control.  Arch Phys Med Rehabil. 1993;  74 1144-50
• 14 Good Balance. User's Manual, Version 2.54. Jyväskylä: Metitur, 2001. 
• 15 Hageman P A, Leibowitz J M, Blanke D. Age and sex effects on postural control measures.  Arch Phys Med Rehabil. 1995;  76 961-965
• 16 Hansen M S, Dieckmann B, Jensen K, Jakobsen B W. The reliability of balance tests performed on the kinesthetic ability trainer (KAT 2000).  Knee Surg Sports Traumatol Arthrosc. 2000;  8 180-185
• 17 Hofmann C. The Implementation of Normative Data in a Force Platform Based Postural Balance Measurement System. Diplomarbeit. Zwickau: Westsächsische Hochschule Zwickau (FH), Fachbereich Physikalische Technik/Informatik 1998
• 18 Kinzey S J, Armstrong C W. The reliability of the star-excursion test in assessing dynamic balance.  J Orthop Sorts Phys Ther. 1998;  27 356-360
• 19 Lamb K. Test-retest reliability in quantitative physical education research: a commentary.  Eur Phys Education Rev. 1998;  4 145-152
• 20 Lusa S. Job demands and assessment of the physical work capacity of fire fighters (Dissertation). Studies in sport, physical education and health 33. Jyväskylä (Finland): University of Jyväskylä 1994
• 21 Lusa S, Louhevaara V, Kinnunen K. Are the job demands on physical work capacity equal for young and aging firefighters?.  J Occup Med. 1994;  36 70-74
• 22 Punakallio A, Louhevaara V, Lusa-Moser S. Evaluation of a functional test for assessing dynamic balance of firefighters. In: Seppälä P, Luopajärvi T, Nygård C-H, Mattila M (eds) “From Experience to Innovation” IEA ’97.  Proceedings of the 13th Triennial Congress of the International Ergonomics Association, Tampere, Finland 1997. Volume 4 Musculoskeletal Disorders, Rehabilitation. Helsinki: Finnish Institute of Occupational Health 1997: 393-395
• 23 Punakallio A, Lusa-Moser S, Louhevaara V, Viikari-Juntura E, Ilmarinen R, Ollila J, Korhonen O, Luukkonen R, Lindqvist-Virkamaki S. Health, physical and mental capacity of firefighters in different age groups. In: Ilmarinen J, Louhevaara V (eds) FinnAge - Respect for the Aging: Action Programme to Promote Health, Work Ability and Well-Being of Aging Workers in 1990 - 96. People and Work. Research Reports 26. Helsinki: Finnish Institute of Occupational Health 1999: 117-127
• 24 Punakallio A. Balance abilities of different aged workers in physically demanding jobs.  J Occup Rehabil. 2003;  13 33-43
• 25 Rinne M B, Pasanen M E, Miilunpalo S I, Oja P. Test-retest reproducibility and inter-rater reliability of a motor skill test battery for adults.  Int J Sports Med. 2001;  22 192-200
• 26 Takala E P, Korhonen I, Viikari-Juntura E. Postural sway and stepping response among working population: reproducibility, long-term stability, and associations with symptoms of the low back.  Clin Biomech. 1997;  12 429-437
• 27 Williford H N, Duey W J, Olson M S, Howard R, Wang N. Relationship between fire suppression tasks and physical fitness.  Ergonomics. 1999;  42 1179-1186