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. 2025 May 16:19417381251334638.
doi: 10.1177/19417381251334638. Online ahead of print.

Steady or Swaying? Assessing the Reliability of the HUMAC Balance System in Athletes With Chronic Low Back Pain

Sumbul Ansari  1 , Saurabh Sharma  1
Affiliations

Steady or Swaying? Assessing the Reliability of the HUMAC Balance System in Athletes With Chronic Low Back Pain

Sumbul Ansari et al. Sports Health. .

Abstract

Background: Balance is a fundamental component of athletic performance. Chronic low back pain (CLBP) is a prevalent issue in athletes, impacting performance. Balance assessment plays a crucial role in CLBP rehabilitation. Reliable techniques are essential for balance assessment. The CSMi HUMAC balance system offers promise in this regard. This study aimed to assess the reliability of the HUMAC balance system and to determine the minimal detectable change (MDC) for center of pressure (CoP) indices (sway index [SI], overall stability index [OSI], mediolateral stability index [MLSI], and anteroposterior stability index [APSI]) during squats and limits of stability (LoS) outcomes.

Hypothesis: The HUMAC balance system will demonstrate high test-retest reliability, with intraclass correlation coefficients (ICCs) >0.80, when used to assess balance in athletes with CLBP.

Study design: Repeated measures design.

Level of evidence: Level 4.

Methods: A total of 15 athletes (aged 18-30 years) with CLBP were included. The athletes underwent assessment of balance parameters on 2 separate occasions separated by a 1-week interval. Reliability was assessed using ICC2,1, standard error of measurement (SEM), and Bland-Altman plots.

Results: Intrarater reliability for all CoP indices during squats and LoS tests showed excellent values (ICC, 0.84-0.98), with no significant systematic bias detected in Bland-Altman plots.

Conclusion: The HUMAC balance system is a reliable tool for assessing balance in athletes with CLBP.

Clinical relevance: The HUMAC balance system demonstrates reliability in assessing balance for athletes with CLBP. This will allow clinicians to monitor changes in balance and potentially track the effectiveness of interventions aimed at improving balance.

Keywords: athlete; balance; chronic low back pain; minimal detectable change; postural control; reliability; sport.

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Conflict of interest statement

The authors report no potential conflicts of interest in the development and publication of this article. (email: ssharma@jmi.ac.in)

Figures

Figure 1.
Figure 1.
Athlete’s standing position on the HUMAC balance platform.
Figure 2.
Figure 2.
Athlete performing squats on the HUMAC balance platform.
Figure 3.
Figure 3.
Representative center of pressure trajectory during the squat. A/P, anterioposterior; M/L, mediolateral.
Figure 4.
Figure 4.
Athlete performing the limits of stability test.
Figure 5.
Figure 5.
Sample record of the limits of stability test report.
Figure 6.
Figure 6.
Bland-Altman plot for the center of pressure indices during squats. Differences between test and retest scores are plotted against their means. Blue line, mean of the differences; dotted red line, 95% limits of agreement.
Figure 7.
Figure 7.
Bland-Altman plot for limits of stability (all directions). Differences between test and retest scores are plotted against their means. Blue line, mean of the differences; dotted red line, 95% limits of agreement.
See this image and copyright information in PMC

References

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