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Feasibility and Reliability of a New Test of Neurological Function in Balance and Brain Health

Frederick R. Carrick1, 2, 3, 4*, Kis Mihaly5, Ahmed Hankir6, Mahera Abdulrahman7, 8, Guido Pagnacco9, 10, Matthew M. Antonucci9, 11 and Elena Oggero9, 10
  • 1 Centre for Mental Health Research in association with University of Cambridge, Department of Neurology, United Kingdom
  • 2 University of Central Florida College of Medicine, Neurology, United States
  • 3 Massachusetts General Hospital Health Professions Institute, United States
  • 4 Carrick Institute, Department of Neurology, United States
  • 5 University of Toronto, Neurosurgery, Canada
  • 6 Centre for Mental Health Research in association with University of Cambridge, Department of Psychiatry, United Kingdom
  • 7 Dubai Health Authority, Department of Medical Education and Research, United Arab Emirates
  • 8 Dubai Medical College, Department of Primary Health Care, United Arab Emirates
  • 9 Carrick Institute, United States
  • 10 University of Wyoming, United States
  • 11 Plasticity Brain Centers, United States

Purpose: A number of different balance assessment techniques are currently available and widely used in healthcare. These include both subjective and objective assessments. Providing quantitative measures of balance and posture is a valuable aid in clinical assessment and in recent years several devices have been introduced that have demonstrated the accurate measure of balance via deviation of center of mass utilizing software algorithms and mobile devices 1,2. The purpose of this study was to assess the accuracy of EQ Balance against SwayTM Balance System (Sway), another balance device that is currently established as an accurate measure of balance, and to evaluate the test-retest reliability of EQ Balance. Both devices utilize software, and a proprietary algorithm that translates the mobile device accelerometers output in to the measurement of human balance. Methods: 70 individuals presenting to a Sports Medicine and Concussion Clinic volunteered to participate in the assessment of balance utilizing Sway and EQ Balance simultaneously. The group included 25 males and 45 females (mean age: 37.8 ± 14.8, range: 13-65) with and without concussion or other neurological conditions (39 concussed vs. 31 non-neurologically injured, or healthy). Participants performed five postures while holding the mobile device against their chest. Sway and EQ Balance were administered simultaneously and two trials were completed on each participant. The measurement recorded using both devices was termed the “balance score.” Results: No adverse effects or complications were encountered during or after performance testing. EQ Balance and Sway Balance were in statistical agreement for both healthy and concussed groups according to the Spearman’s rho non-parametric test of correlation (all participants rs = 0.85, healthy rs= 0.79, concussed rs = 0.83, p<0.001). Consistency of the EQ Balance measure was conducted by calculating the intra-class correlation (ICC) on two consecutive EQ Balance tests. The ICC for the cohort was ICC=0.87 (p<0.001). Across the cohort, EQ Balance measured significantly poorer balance scores in subjects with diagnosed concussion. Conclusions: The statistical agreement between the two measures supports substantial equivalence of EQ Balance to Sway Balance for the average balance score across all 5 stances. The ICC analysis demonstrates strong consistency of the task output between test sessions. Concussed patients scored worse than healthy controls as did Males when compared to Females, all with statistical significance. Although some concussed patients scored well, there was a clear demarcation of low balance scores by only some concussed patients.

References

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Keywords: balance, concussion, Neurology - Clinical, mTBI = mild TBI, functional neurology.

Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019.

Presentation Type: Poster Presentation

Topic: Clinical Neuroscience

Citation: Carrick FR, Mihaly K, Hankir A, Abdulrahman M, Pagnacco G, Antonucci MM and Oggero E (2019). Feasibility and Reliability of a New Test of Neurological Function in Balance and Brain Health. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00017

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Received: 15 Apr 2019; Published Online: 27 Sep 2019.

* Correspondence: Prof. Frederick R Carrick, Centre for Mental Health Research in association with University of Cambridge, Department of Neurology, Cambridge, United Kingdom, drfrcarrick@post.harvard.edu