Table 1.
Descriptive summary of balance test protocols and scoring of assessments included in the SiMPly Rehab balance testing battery.
| Assessment | Protocol | Scoring |
|---|---|---|
| BESS (22, 29, 30) |
6 poses (eyes closed, barefoot, 20 s each, hands on hips) 1) double leg stance (feet together), hard surface 2) single leg stance (stand on non-dominant foot), hard surface 3) tandem leg stance (non-dominant foot in back), hard surface 4) double leg stance (feet together), foam surface 5) single leg stance (stand on non-dominant foot), foam surface 6) tandem leg stance (non-dominant foot in back), foam surface |
Participants are scored on the number of errors made (deviations from proper stance) for a maximum of 10 errors per pose. Errors included: Lifting hands off iliac crests, opening eyes, stepping, stumbling or falling, remaining out of the proper test position for more than 5 s, moving hip into more than 30° of flexion or abduction, lifting forefoot or heel. For full scoring details see Riemann et al. (22), JSR. |
| NIH-SBT (23, 31) |
5 poses (50 s each, arms crossed on chest) 1) feet together, eyes open, hard surface 2) feet together, eyes closed, hard surface 3) feet together, eyes open, foam surface 4) feet together, eyes closed, form surface 5) tandem stance, eyes open, hard surface Stop rules are incorporated into the application. |
Scores are generated automatically by NIH software. Three scores were used for data analysis: 1. age-corrected standard score (normative mean = 100, SD = 15) 2. ratio 1 = pose 2 / pose 1 3. ratio 2 = pose 4 / pose 1 Lower age-corrected scores are indicative of greater motor dysfunction. Lower ratios reflect better performance. |
| FGA (24, 32) |
10 tasks 1) gait on level surface 2) gait with changes in walking speed 3) gait with horizontal head turns 4) gait with vertical head turns 5) gait with pivot turn 6) step over obstacle 7) gait with narrow base of support 8) gait with eyes closed 9) gait while ambulating backwards 10) steps |
Performance for each task is scored on an ordinal scale from 0 to 3 with lower scores indicative of greater impairment. |
| FGA-A (25) |
6 tasks 1) tandem gait with head motion 2) tandem gait backwards 3) walking with rapid horizontal head turns 4) walking with rapid vertical head turns 5) walking backwards with rapid horizontal head turns 6) walking backwards with rapid vertical head turns |
Performance for each task is scored on an ordinal scale from 0 to 3 with lower scores indicative of greater impairment. |
| TGT (26) |
4 trials Walk heel-to-toe for 3 m and return to starting point (time recorded), repeat 3 times (four trials total) |
Best time of four trials used for scoring. Shorter times reflect better performance. |
| BBS (33) |
14 tasks 1) sitting to standing 2) standing unsupported 3) sitting with back unsupported with feet supported on floor or stool 4) standing to sitting 5) transfers (between chairs) 6) standing unsupported with eyes closed 7) standing unsupported with feet together 8) reaching forward with outstretched arm while standing 9) pick up object from the floor in a standing position 10) turning to look behind over left and right shoulders while standing 11) turn 360 degrees |
Performance of each task is scored on a five-point scale range from 0 to 4. A score of 0 is indicative of the lowest level of function and a score of 4 is indicative of the highest level of function. |
| 12) place alternate foot on step or stool while standing unsupported 13) standing unsupported on foot in front 14) standing on one leg |
||
| WWTT (28, 34) |
3 tasks 1) WWTT-gait: Walk 6 m at normal pace and return to starting point. 2) WWTT-simple: Walk 6 m at normal pace and return to starting point while reciting the alphabet. 2) WWTT-complex: Walk 6 m at normal pace and return to starting point while reciting alternating letters of the alphabet. Time recorded for all tasks. |
Reduced performance in dual task conditions (task 2 and 3) is described as dual task cost (DTC). Relative DTC is calculated as follows: |
Detailed descriptions of protocols and scoring can be found in references cited for each assessment. BESS, Balance Error Scoring System; NIH-SBT, National Institutes of Health Standing Balance Test; FGA, Functional Gait Assessment; FGA-A, Advanced Functional Gait Assessment; BBS, Berg Balance Scale; TGT, Tandem Gait Test; WWTT, Walking While Talking Test.