A Perturbed Postural Balance Test Using an Instrumented Treadmill – Precision and Accuracy of Belt Movement and Test-Retest Reliability of Balance Measures

Abstract

A perturbed postural balance test can be used to investigate balance control under mechanical disturbances. The test is typically performed using purpose-built movable force plates. As instrumented treadmills become increasingly common in biomechanics laboratories and in clinical settings, these devices could be potentially used to assess and train balance control. The purpose of the study was to investigate how an instrumented treadmill applies to perturbed postural balance test. This was investigated by assessing the precision and reliability of the treadmill belt movement and the test-retest reliability of perturbed postural balance test over 5 days. Postural balance variables were calculated from the center of pressure trajectory and included peak displacement, time to peak displacement, and recovery displacement. Additionally, the study investigated short-term learning effects over the 5 days. Eight healthy participants (aged 24–43 years) were assessed for 5 consecutive days with four different perturbation protocols. Center of pressure (COP) data were collected using the force plates of the treadmill while participant and belt movements were measured with an optical motion capture system. The results show that the treadmill can reliably deliver the intended perturbations with <1% deviation in total displacement and with minimal variability between days and participants (typical errors 0.06–2.71%). However, the treadmill was not able to reach the programmed 4 m/s2 acceleration, reaching only about 75% of it. Test–retest reliability of the selected postural balance variables ranged from poor to good (ICC 0.156–0.752) with typical errors between 4.3 and 28.2%. Learning effects were detected based on linear or quadratic trends (p < 0.05) in peak displacement of the slow forward and fast backward protocols and in time to peak displacement in slow and fast backward protocols. The participants altered the initial location of the COP relative to the foot depending on the direction of the perturbation. In conclusion, the precision and accuracy of belt movement were found to be excellent. Test-retest reliability of the balance test utilizing an instrumented treadmill ranged from poor to good which is, in line with previous investigations using purpose-built devices for perturbed postural balance assessment.