Validity and Responsiveness of Balance Measures using Pedalo®-Sensomove Balance Device in Patients with Diabetic Peripheral Neuropathy

Abstract

Introduction: It is important to assess the integrity of the balance system in order to estimate individual balance capabilities. Various static, dynamic and functional balance tests have been developed to evaluate performance. Aim: To assess the validity and responsiveness of Centre Of Pressure (COP) range and COP sway taken from Pedalo®- Sensomove balance device with clinical balance tests in diabetic Peripheral Neuropathy (DPN) patients. Materials and Methods: Twenty subjects (age: 60.45±8.79) with DPN were recruited to participate in an outpatient balance training program. Validity was assessed by correlating COP range and COP sway measured using Pedalo®-Sensomove balance system with Functional Reach Test (FRT), One Leg Stance (OLS) and Time Up and Go test (TUG). Responsiveness was assessed by comparing the COP range and COP sway, before and after the completion of balance training. Data analysis was done using SPSS version 21. The construct validity was established by evaluating the relationship of COP range and COP sway with FRT distance (using pearson correlation coeffecient) and OLS (using spearman correlation coefficient). The concurrent validity was examined by assessing the correlation of COP range and COP sway with TUG scores (using pearson correlation coefficent). Effect Size (ES) and Standardised Response Mean (SRM) were used to assess responsiveness. Results: There was a significant correlation between COP range front (p=0.001) and COP sway (Antero-Posterior (AP): p=0.022; Medio-Lateral (ML): p=0.047). OLS eyes open was also associated with COP range (front: p=0.029; right: p=0.025) and COP sway (AP: p≤0.001; ML: p≤0.001). OLS eyes closed and COP sway (AP: p=0.02; ML: p=0.038) were found to be negatively correlated. TUG score showed positive correlation with COP ranges (p≤0.039), and negatively correlated with COP sway (p≤0.023) in all directions. Following balance training, the change in the COP range and COP sway showed moderate to high ES (0.73 to 0.93) and SRM (0.827 to 1.38). Conclusion: The COP range and COP sway measured by Pedalo®-Sensomove balance device are valid measures of balance assessment in patients with DPN.

Keywords

• centre of pressure range
• centre of pressure sway
• functional reach test
• one leg stance
• postural control
• time up and go