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SPINAL BALANCE AND FORCE PLATE ANALYSIS: REPEATABILITY ANALYSIS IN VOLUNTEERS

Maimonides Medical Centre, Brooklyn, New York, NY, USA

Analysis of balance is emerging as an important parameter in spinal deformity. Force plate technology permits a quantitative study of balance through centre of pressure (COP) measurement. COP measurements obtained from the force plate approximate the projected centre of gravity. In a standing subject the COP reflects the projected centre of gravity however repeatability and reliability of such analysis is lacking.

COP measurements were obtained from eight asymptomatic volunteers (mean age 32) with no history of back pain or previous spinal surgery. Each subject stood on a Zebris force plate platform for 30 seconds daily. 15 sets of data were acquired for each subject. For one subject, an additional 15 sets of data were collected on one day for comparison to the longitudinal data.

Intra- versus inter-subject reliability analysis revealed a Cronbach’s alpha value >0.9 for the following COP movement parameters: distance travelled over 30 seconds, distance travelled in the first and last five seconds, and average speed. Comparison of the mean intra- versus inter-subject coefficients of variation revealed significant differences for all parameters (p<0.004).

COP movement parameters are reliable in terms of intra-subject repeatability and can detect significant individual subject movement patterns. This suggests that COP movement patterns over time are idiosyncratic for each individual. While the repeatability of COP measurement has been established, the sensitivity to change with pathology and in response to treatment for spinal pathology remains to be evaluated.

Correspondence should be addressed to Jeremy C T Fairbank at The Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX7 7LD, UK