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The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study

Seated postural control is essential for wheelchair users to maintain proper position while performing activities of daily living. Clinical tests are commonly used to measure seated postural control, yet they are subjective and lack sensitivity. Lab-based measures are highly sensitive but are limite...

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Autores principales: Frechette, Mikaela L., Abou, Libak, Rice, Laura A., Sosnoff, Jacob J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750873/
https://www.ncbi.nlm.nih.gov/pubmed/33367273
http://dx.doi.org/10.3389/fspor.2020.540930
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author Frechette, Mikaela L.
Abou, Libak
Rice, Laura A.
Sosnoff, Jacob J.
author_facet Frechette, Mikaela L.
Abou, Libak
Rice, Laura A.
Sosnoff, Jacob J.
author_sort Frechette, Mikaela L.
collection PubMed
description Seated postural control is essential for wheelchair users to maintain proper position while performing activities of daily living. Clinical tests are commonly used to measure seated postural control, yet they are subjective and lack sensitivity. Lab-based measures are highly sensitive but are limited in scope and restricted to research settings. Establishing a valid, reliable, and accessible measurement tool of seated postural control is necessary for remote, objective assessments. Therefore, the purpose of this study was to examine the validity, reliability, and sensitivity of smartphone-based postural control assessments in wheelchair users. Eleven participants (age: 35.4 ± 17.9) completed two experimental visits 1-week apart consisting of three clinical tests: Trunk Control Test (TCT), Function in Sitting Test (FIST), and Tee-shirt Test, as well as, standardized instrumented balance tasks that manipulated vision (eyes open and closed), and trunk movement (functional reach and stability boundary). During these tasks, participants held a smartphone instrumented with a research-grade accelerometer to their chest. Maximum and root mean square (RMS) acceleration in the medial-lateral (ML) and anterior-posterior (AP) axes were derived. Participants were grouped into non-impaired and impaired postural groups based on FIST scores. Spearman rank-order correlations were conducted between the two devices' outcome measurements and between these measures and those of the clinical tests. Receiver operating characteristic (ROC) curves and the area under the curves (AUC) were determined to distinguish participants with and without impaired postural control. The reliability of outcome variables was assessed using inter-class correlations. Strong correlations between outputs derived from the smartphone and research-grade accelerometer were seen across balance tasks (ρ = −0.75–1.00; p ≤ 0.01). Numerous significant moderate correlations between clinical test outcomes and smartphone and research-grade RMS ML accelerometry were seen (ρ = −0.62 to 0.83 (p ≤ 0.044)]. On both devices, the AUC for ROC plots were significant for RMS ML sway during the eyes open task and functional stability boundary (p < 0.05). Reliability of smartphone accelerometry was comparable to the research-grade accelerometer and clinical tests. This pilot study illustrated that smartphone-based accelerometry may be able to provide a valid and reliable assessment of seated postural control and have the ability to distinguish between those with and without impaired postural control.
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spelling pubmed-77508732020-12-22 The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study Frechette, Mikaela L. Abou, Libak Rice, Laura A. Sosnoff, Jacob J. Front Sports Act Living Sports and Active Living Seated postural control is essential for wheelchair users to maintain proper position while performing activities of daily living. Clinical tests are commonly used to measure seated postural control, yet they are subjective and lack sensitivity. Lab-based measures are highly sensitive but are limited in scope and restricted to research settings. Establishing a valid, reliable, and accessible measurement tool of seated postural control is necessary for remote, objective assessments. Therefore, the purpose of this study was to examine the validity, reliability, and sensitivity of smartphone-based postural control assessments in wheelchair users. Eleven participants (age: 35.4 ± 17.9) completed two experimental visits 1-week apart consisting of three clinical tests: Trunk Control Test (TCT), Function in Sitting Test (FIST), and Tee-shirt Test, as well as, standardized instrumented balance tasks that manipulated vision (eyes open and closed), and trunk movement (functional reach and stability boundary). During these tasks, participants held a smartphone instrumented with a research-grade accelerometer to their chest. Maximum and root mean square (RMS) acceleration in the medial-lateral (ML) and anterior-posterior (AP) axes were derived. Participants were grouped into non-impaired and impaired postural groups based on FIST scores. Spearman rank-order correlations were conducted between the two devices' outcome measurements and between these measures and those of the clinical tests. Receiver operating characteristic (ROC) curves and the area under the curves (AUC) were determined to distinguish participants with and without impaired postural control. The reliability of outcome variables was assessed using inter-class correlations. Strong correlations between outputs derived from the smartphone and research-grade accelerometer were seen across balance tasks (ρ = −0.75–1.00; p ≤ 0.01). Numerous significant moderate correlations between clinical test outcomes and smartphone and research-grade RMS ML accelerometry were seen (ρ = −0.62 to 0.83 (p ≤ 0.044)]. On both devices, the AUC for ROC plots were significant for RMS ML sway during the eyes open task and functional stability boundary (p < 0.05). Reliability of smartphone accelerometry was comparable to the research-grade accelerometer and clinical tests. This pilot study illustrated that smartphone-based accelerometry may be able to provide a valid and reliable assessment of seated postural control and have the ability to distinguish between those with and without impaired postural control. Frontiers Media S.A. 2020-12-17 /pmc/articles/PMC7750873/ /pubmed/33367273 http://dx.doi.org/10.3389/fspor.2020.540930 Text en Copyright © 2020 Frechette, Abou, Rice and Sosnoff. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Sports and Active Living
Frechette, Mikaela L.
Abou, Libak
Rice, Laura A.
Sosnoff, Jacob J.
The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study
title The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study
title_full The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study
title_fullStr The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study
title_full_unstemmed The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study
title_short The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study
title_sort validity, reliability, and sensitivity of a smartphone-based seated postural control assessment in wheelchair users: a pilot study
topic Sports and Active Living
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750873/
https://www.ncbi.nlm.nih.gov/pubmed/33367273
http://dx.doi.org/10.3389/fspor.2020.540930
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