The relevance of clinical balance assessment tools to differentiate balance deficits

Abstract

Control of balance is complex and involves maintaining postures, facilitating movement, and recovering equilibrium. Balance control consists of controlling the body center of mass over its limits of stability. Clinical balance assessment can help to assess fall risk and/or determine the underlying reasons for balance disorders. Most functional balance assessment scales assess fall risk and the need for balance rehabilitation but do not differentiate types of balance deficits. A system approach to clinical balance assessment can differentiate different kinds of balance disorders and a physiological approach can determine underlying sensorimotor mechanisms contributing to balance disorders. Objective measures of balance using computerized systems and wearable inertial sensors can bring more sensitive, specific and responsive balance testing to clinical practice.

Fig. 1

The six different balance control systems evaluated with the BESTest (left) and the five physiological mechanisms evaluated with the PPA (right).

Fig. 2

Photo of subject wearing an inertial sensor on the lower trunk with arms and feet in a prescribed posture (A) and horizontal acceleration trajectories for two representative subjects, during quiet stance (B) and step initiation (C). Adapted from Mancini, et al, 2009, 2010.