Test-retest reliability of force plate-derived measures of reactive stepping

Abstract

BackgroundCharacterizing reactive stepping is important to describe the responses effectiveness. Measures of reactive stepping related to step initiation, execution, and termination phases have been frequently reported to characterize reactive balance control. However, the test-retest reliability of these measures are unknown. Research questionsWhat is the between- and within-session test-retest reliability of various force plate-derived measures of reactive stepping? MethodsNineteen young, healthy adults responded to 6 small (~8-10% of body weight) and 6 large perturbations (~13-15% of body weight) using an anterior lean-and-release system. Tests were conducted on two visits separated by at least two days. Participants were instructed to recover balance in as few steps as possible. Step onset, foot-off, swing, and restabilization times were extracted from force plates. Relative test-retest reliability was determined through intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs). Absolute test-retest reliability was assessed using the standard error of the measurement (SEM). ResultsFoot-off and swing times had the highest between- and within-session test-retest reliabilities regardless of perturbation size (between-session ICC=0.898-0.942; within-session ICC=0.455-0.753). Conversely, step onset and restabilization time had lower ICCs and wider CIs (between-session ICC=0.495-0.825; within-session ICC=-0.040-0.174). Between-session test-retest reliability was higher (ICC=0.495-0.942) for all measures than within-session test-retest reliability (ICC=-0.040-0.753). SEMs were low (3-10% of mean) for all measures, except time to restabilization (SEM=15-20% of mean), indicating good absolute reliability. SignificanceThese findings suggest multiple baseline sessions are needed for measuring restabilization and step onset times. The SEMs provide an index for measuring meaningful change due to an intervention.