Table 10.
Clinical postural stability studies.
| References | Year | Severity | Population | Sample size | Age | Sex (%male) | Motor test | Method | Parameters | < 5 yrs | 6–10 yrs | 11–25 yrs | >25 yrs | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Geurts et al. (74) | 1999 | Mild | Hospital Persistent symptoms | T:15;C:20 | T:35.9 C:35.4 | T:53.3% C:60% | Postural control: Eyes open, closed or with simple cognitive task | Balance board 2x 30 secs per variable | Anteroposterior sway | + | |||||
| Lateral sway | + | ||||||||||||||
| Weight shifting | + | ||||||||||||||
| Wright et al. (69) | 2018 | Mild | Military veterans | T:9;C:19 | T:25.95 C:33.57 | T/C: 45% | Postural control Firm or foam, eyes open or closed, static or rolling scene | Virtual environment TBI screening 3 × 30secs per variable |
Sway area | - | |||||
| Pan et al. (65) | 2015 | Mild | Military veterans Non-symptomatic | T:6, C:10 | T:26.5 C: Not stated | T:100% C:Not stated |
Postural control: On floor or foam; Eyes open or closed | Markers on sacrum, pelvis, C7 and shoulder. | Pelvic postural sway | - | |||||
| Pelvic sway path length | - | ||||||||||||||
| Pitch trunk angle | - | ||||||||||||||
| Roll Trunk angle | - | ||||||||||||||
| Postural control+ perturbation: On floor or foam; Eyes open or closed | Upper trunk sway path length | - | |||||||||||||
| Pelvic sway path length | - | ||||||||||||||
| Oscillations | - | ||||||||||||||
| Military veterans Symptomatic | T:8; C:10 | T:87.5% C:Not stated |
Postural control: On floor or foam; Eyes open or closed | Pelvic postural sway | + | ||||||||||
| Pelvic sway path length | + | ||||||||||||||
| Pitch trunk angle | + | ||||||||||||||
| Roll trunk angle | + | ||||||||||||||
| Postural control+ perturbation: On floor or foam; Eyes open or closed | Upper trunk sway path length | + | |||||||||||||
| Pelvic sway path length | - | ||||||||||||||
| Oscillations | + | ||||||||||||||
| Rosenblum et al. (68) | 2020 | Mild | College Athletes | T:91;C:129 | T:18.9; C:19.1 | T:56.6% C:56.6% |
Sensory organization test Fixed/ sway surface, eyes open/closed, surrounding/sway-referenced surrounding, | Smart Balance Master System 3 × 20secs per variable |
Anterior-posterior sway (equilibrium score) | - | |||||
| Somatosensory sensory ratio | - | ||||||||||||||
| Visual sensory ratio | - | ||||||||||||||
| Vestibular sensory ratio | - | ||||||||||||||
| Ustinova (73) | 2017 | Mild | College Athletes | T:13; C:13 | T:34.9 C:33.8 | T:30.8% C:38.4% |
Functional reach Interception of targets via arm at 5 fixed location | 3D video game 30 reflective body markers 10 × 90sec games |
Postural angular displacement | - | |||||
| Postural angular velocity | + | ||||||||||||||
| Arm angular displacement | - | ||||||||||||||
| Arm angular velocity | + | ||||||||||||||
| Wright et al. (69) | 2018 | Combination | Military veterans | T:14; C:19 | T:25.95 C:33.57 | T/C: 45% | Postural control Firm or foam, eyes open or closed, static or rolling scene | Virtual environment TBI screening 3 × 30secs per variable |
Sway area | + | |||||
| Helmich et al. (78) | 2016 | Combination | University students w/o symptoms | T:13; C:10 | T:29 C:27 | T:Not stated C:40% |
Postural control Stable vs. unstable surface, eyes open, closed or blurred | Force platform 10 × 10sec trials per variable |
COP path | - | |||||
| COP area | - | ||||||||||||||
| Effort of balance | - | ||||||||||||||
| Balance Error Scoring System | Score | - | |||||||||||||
| University students with symptoms | T:7; C:10 | T:26 C:26 | T:Not stated C:40% |
Postural control Stable vs. unstable surface, eyes open, closed or blurred | COP path | - | |||||||||
| COP area | - | ||||||||||||||
| Effort of balance | + | ||||||||||||||
| Balance Error Scoring System | Score | + | |||||||||||||
| Degani et al. (72) | 2017 | Combination | Community | T:11; C:11 | T: 29.4; C: 26.8 | T:45.5% C:36% |
Postural control Natural stance vs crossed arms | Force platform 10 mins |
Body sway area | + | |||||
| Amplitude of COP displacement | + | ||||||||||||||
| Mean velocity of COP displacement | + | ||||||||||||||
| Frequency of COP displacement | + | ||||||||||||||
| Regularity of COP displacement | + | ||||||||||||||
| De Beaumont et al. (76) | 2011 | Combination | Collegiate athletes | T:21; C:15 | T/C: 22.3 | T/C: 100% |
Postural control | Force platform 2 × 30 sec trials |
Regularity of COP displacement | + | |||||
| Amplitude of COP displacement | - | ||||||||||||||
| Johnston et al. (60) | 2020 | Combination | Collegiate athletes | T:30; C:90 | T:20.3 C:20.2 | T/C: 83.5% | Y Balance test (Stand on one leg, reach other in anterior, posteromedial and posterolateral direction) | Lumbar inertial sensor 3 trials | Anterior | Reach distance | - | ||||
| Regularity | - | ||||||||||||||
| Amplitude | - | ||||||||||||||
| Posteromedial | Reach distance | - | |||||||||||||
| Regularity | - | ||||||||||||||
| Amplitude | - | ||||||||||||||
| Posterolateral | Reach distance | - | |||||||||||||
| Regularity | - | ||||||||||||||
| Amplitude | - | ||||||||||||||
| Ledwidge et al. (134) | 2020 | Combination | Collegiate athletes | T:21; C:24 | T:20.17 C:20.03 | T:90% C:79% | BESS balance test Feet together, non-dominant only, tandem on firm or foam surface | - | Score | - | |||||
| Lee et al. (71) | 2020 | Combination | College students | T:11; C:14 | T:28.7 C:22 | T:52% C:35.7 |
Postural stability | Force platform 120 sec |
Body sway area | - | |||||
| Amplitude | - | ||||||||||||||
| Mean velocity | - | ||||||||||||||
| Frequency | - | ||||||||||||||
| Regularity | - | ||||||||||||||
| Asynchrony AP and ML | - | ||||||||||||||
| Reilly et al. (70) | 2020 | Combination | Community | T:27; C:27 | T:26.1 C:28.6 | T:44.4% C:77.8% |
Postural stability | Bipedal only | Force platform | Mean velocity | - | ||||
| Path length | - | ||||||||||||||
| AP sway | - | ||||||||||||||
| ML sway | - | ||||||||||||||
| Body sway area | - | ||||||||||||||
| Regularity (AP) | - | ||||||||||||||
| Regularity (ML) | - | ||||||||||||||
| Bipedal + cog task | Mean velocity | - | |||||||||||||
| Path length | - | ||||||||||||||
| AP sway | + | ||||||||||||||
| ML sway | - | ||||||||||||||
| Body sway area | + | ||||||||||||||
| Regularity (AP) | + | ||||||||||||||
| Regularity (ML) | - | ||||||||||||||
| Unipedal only | Mean velocity | - | |||||||||||||
| Path length | - | ||||||||||||||
| AP sway | - | ||||||||||||||
| ML sway | - | ||||||||||||||
| Body sway area | - | ||||||||||||||
| Regularity (AP) | + | ||||||||||||||
| Regularity (ML) | + | ||||||||||||||
| Unipedal + cog task | Mean velocity | - | |||||||||||||
| Path length | - | ||||||||||||||
| AP sway | - | ||||||||||||||
| ML sway | + | ||||||||||||||
| Body sway area | + | ||||||||||||||
| Regularity (AP) | + | ||||||||||||||
| Regularity (ML) | + | ||||||||||||||
| Rosenblum et al. (68) | 2020 | Combination | College Athletes | T177;C:129 | T:19.1 C:19.1 | T:57.6% C:56.6% |
Sensory organization test Fixed/ sway surface, eyes open/closed, surrounding/sway-referenced surrounding, | Smart Balance Master System 3 × 20secs per variable |
Anterior-posterior sway (equilibrium score) | - | |||||
| Somatosensory sensory ratio | - | ||||||||||||||
| Visual sensory ratio | - | ||||||||||||||
| Vestibular sensory ratio | - | ||||||||||||||
| Sosnoff et al. (63) | 2011 | Combination | College athletes | T:62; C:162 | T/C: 20.04 | T/C: 67.8% |
Sensory organization test Fixed/ sway surface, eyes open/closed, surrounding/sway-referenced surrounding | NeuroCom Smart Balance Master 3 × each test |
Composite balance score | - | |||||
| Somatosensory sensory ratio | - | ||||||||||||||
| Visual sensory ratio | - | ||||||||||||||
| Vestibular sensory ratio | - | ||||||||||||||
| Regularity (AP) | + | ||||||||||||||
| Regularity (ML) | + | ||||||||||||||
| Walker et al. (52) | 2018 | Combination | Military veterans | T:248; C:47 | T:36 C:40.5 | T:88% C:79.5% |
Sensory organization test | Eyes open/fixed surface | NeuroCom Smart Balance Master 3 × each test | Equilibrium score | - | ||||
| Eyes closed/fixed surface | Equilibrium score | + | |||||||||||||
| Eyes open/fixed surface/sway surroundings | Equilibrium score | + | |||||||||||||
| Eyes open, sway surface, fixed surroundings | Equilibrium score | - | |||||||||||||
| Eyes closed, sway surrounding | Equilibrium score | - | |||||||||||||
| Eyes open, sway surface, sway surrounding | Equilibrium score | - | |||||||||||||
| Composite score | Equilibrium score | + | |||||||||||||
| Walker et al. (52) | 2018 | Combination | Military veterans | T:414; C:78 | T:36 C:40.5 | T:88.2% C:79.5% |
Sensory organization test | Eyes open/fixed surface | Equilibrium score | - | |||||
| Eyes closed/fixed surface | Equilibrium score | + | |||||||||||||
| Eyes open/fixed surface/sway surroundings | Equilibrium score | + | |||||||||||||
| Eyes open, sway surface, fixed surroundings | Equilibrium score | ||||||||||||||
| Eyes closed, sway surrounding | Equilibrium score | ||||||||||||||
| Eyes open, sway surface, sway surrounding | Equilibrium score | ||||||||||||||
| Wright et al. (69) | 2018 | rmTBI | Military veterans | T:5;C:19 | T:25.95 C:33.57 | T/C: 45% | Postural control Firm or foam, eyes open or closed, static or rolling scene | Virtual environment TBI screening 3 × 30secs per variable |
Sway area | + | |||||
| Rosenblum et al. (68) | 2020 | rmTBI | College Athletes | 2*TBI:52 3*TBI:34; C: 129 |
2*T:19.1 3*T:19.8 C:18.1 | 2*T:62% 3*T:52% C:56.6% |
Sensory organization test Fixed/ sway surface, eyes open/closed, surrounding/sway-referenced surrounding, | Smart Balance Master System 3 × 20secs per variable |
Anterior-posterior sway (equilibrium score) | - | |||||
| Somatosensory sensory ratio | - | ||||||||||||||
| Visual sensory ratio | - | ||||||||||||||
| Vestibular sensory ratio | - | ||||||||||||||
| Walker et al. (52) | 2018 | rmTBI | Military veterans | T:248; C:47 | T:41 C:46 | T:88.3% C:78.7% |
Sensory organization test | Eyes open/fixed surface | NeuroCom Smart Balance Master 3 × each test | Equilibrium score | - | ||||
| Eyes closed/fixed surface | Equilibrium score | + | |||||||||||||
| Eyes open/fixed surface/sway surroundings | Equilibrium score | + | |||||||||||||
| Eyes open, sway surface, fixed surroundings | Equilibrium score | + | |||||||||||||
| Eyes closed, sway surface | Equilibrium score | + | |||||||||||||
| Eyes open, sway surface, sway surrounding | Equilibrium score | - | |||||||||||||
| Composite score | Composite Equilibrium Score | + | |||||||||||||
| Useros Olmo et al. (57) | 2020 | Mod-sev | Hospital | T:20; C:19 | T:36.1 C:38.2 | T:85% C:89.5% |
Postural control | Standing only | Force platform 2 mins recording | Displacement of COP | + | ||||
| Standing + numerical cog task | + | ||||||||||||||
| Standing + spatial memory cog task | + | ||||||||||||||
| Zhang et al. (83) | 2002 | Mod-sev | Rehabilitation | T:10; C:10 | T:30.6 C:31.8 | T:50% C:50% |
Functional reach | Unpredictable | Force platform Board with two lights | Stability ratio | ** | ||||
| L predictable | ** | ||||||||||||||
| R predictable | *** | ||||||||||||||
| Arce | 2004 | Severe | Community | T:7; C:10 | T:26.4 C: 24.9 | T:100% C:100% |
Postural control: Bimanual lifting | No load × 3 | Tetrax posturography system- two force platforms | Stability score: standing | + | ||||
| 4kg × 6 | Forward weight shift | - | |||||||||||||
| 8kg × 6 | % change vertical ground reaction force | - | |||||||||||||
| Buster et al. (77) | 2013 | Severe | Community | T;10: C:10 | T:36; C:24 | Not stated | Berg Balance test | None | Score | + | |||||
| Dynamic posturography | Tilt platform 3 × 120 secs | Dynamic movement analysis score | + | ||||||||||||
+p < 0.05, -, not significant, ***strong power, **medium power.