Evaluation of balance recovery stability from unpredictable perturbations through the compensatory arm and leg movements (CALM) scale
Following unpredictable large-magnitude stance perturbations diverse patterns of arm and leg movements are performed to recover balance stability. Stability of these compensatory movements could be properly estimated through qualitative evaluation. In the present study, we present a scale for evalua...
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| description | Following unpredictable large-magnitude stance perturbations diverse patterns of arm and leg movements are performed to recover balance stability. Stability of these compensatory movements could be properly estimated through qualitative evaluation. In the present study, we present a scale for evaluation of compensatory arm and leg movements (CALM) in response to unpredictable displacements of the support base in the mediolateral direction. We tested the CALM scale for intra- and inter-rater reliability, correlation with kinematics of arm and leg movement amplitudes, and sensitivity to mode (rotation, translation and combined) and magnitude (velocity) of support base displacements, and also to perturbation-based balance training. Results showed significant intra- and inter-rater coefficients of agreement, ranging from moderate (0.46-0.53) for inter-rater reliability in the arm and global scores, to very high (0.87-0.99) for inter-rater leg scores and all intra-rater scores. Analysis showed significant correlation values between scale scores and the respective movement amplitudes both for arm and leg movements. Assessment of sensitivity revealed that the scale discriminated the responses between perturbation modes, platform velocities, in addition to higher balance recovery stability as a result of perturbation-based balance training. As a conclusion, the CALM scale was shown to provide adequate integrative evaluation of compensatory arm and leg movements for balance recovery stability after challenging stance perturbations, with potential application in fall risk prediction. |
| doi_str_mv | 10.1371/journal.pone.0221398 |
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Stability of these compensatory movements could be properly estimated through qualitative evaluation. In the present study, we present a scale for evaluation of compensatory arm and leg movements (CALM) in response to unpredictable displacements of the support base in the mediolateral direction. We tested the CALM scale for intra- and inter-rater reliability, correlation with kinematics of arm and leg movement amplitudes, and sensitivity to mode (rotation, translation and combined) and magnitude (velocity) of support base displacements, and also to perturbation-based balance training. Results showed significant intra- and inter-rater coefficients of agreement, ranging from moderate (0.46-0.53) for inter-rater reliability in the arm and global scores, to very high (0.87-0.99) for inter-rater leg scores and all intra-rater scores. Analysis showed significant correlation values between scale scores and the respective movement amplitudes both for arm and leg movements. Assessment of sensitivity revealed that the scale discriminated the responses between perturbation modes, platform velocities, in addition to higher balance recovery stability as a result of perturbation-based balance training. As a conclusion, the CALM scale was shown to provide adequate integrative evaluation of compensatory arm and leg movements for balance recovery stability after challenging stance perturbations, with potential application in fall risk prediction.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0221398</identifier><identifier>PMID: 31461500</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accidental falls ; Adolescent ; Adult ; Amplitudes ; Analysis ; Arm ; Arm - physiology ; Balance ; Biology and Life Sciences ; Biomechanical Phenomena ; Correlation ; Correlation analysis ; Ecology and Environmental Sciences ; Electromyography ; Engineering ; Equilibrium (Physiology) ; Evaluation ; Falls ; Female ; Humans ; Kinematics ; Laboratories ; Leg ; Leg - physiology ; Lower Extremity - physiology ; Male ; Medicine and Health Sciences ; Movement - physiology ; Muscle Contraction - physiology ; Muscle, Skeletal - physiology ; Older people ; Perturbation ; Physical education ; Physical Sciences ; Postural Balance - physiology ; Posture ; Recovery ; Recovery (Medical) ; Reliability ; Risk factors ; Sensitivity ; Sensitivity analysis ; Social sciences ; Stability analysis ; Systematic review ; Training ; Young Adult</subject><ispartof>PloS one, 2019-08, Vol.14 (8), p.e0221398-e0221398</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Ribeiro de Souza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Stability of these compensatory movements could be properly estimated through qualitative evaluation. In the present study, we present a scale for evaluation of compensatory arm and leg movements (CALM) in response to unpredictable displacements of the support base in the mediolateral direction. We tested the CALM scale for intra- and inter-rater reliability, correlation with kinematics of arm and leg movement amplitudes, and sensitivity to mode (rotation, translation and combined) and magnitude (velocity) of support base displacements, and also to perturbation-based balance training. Results showed significant intra- and inter-rater coefficients of agreement, ranging from moderate (0.46-0.53) for inter-rater reliability in the arm and global scores, to very high (0.87-0.99) for inter-rater leg scores and all intra-rater scores. Analysis showed significant correlation values between scale scores and the respective movement amplitudes both for arm and leg movements. Assessment of sensitivity revealed that the scale discriminated the responses between perturbation modes, platform velocities, in addition to higher balance recovery stability as a result of perturbation-based balance training. As a conclusion, the CALM scale was shown to provide adequate integrative evaluation of compensatory arm and leg movements for balance recovery stability after challenging stance perturbations, with potential application in fall risk prediction.</description><subject>Accidental falls</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Amplitudes</subject><subject>Analysis</subject><subject>Arm</subject><subject>Arm - physiology</subject><subject>Balance</subject><subject>Biology and Life Sciences</subject><subject>Biomechanical Phenomena</subject><subject>Correlation</subject><subject>Correlation analysis</subject><subject>Ecology and Environmental Sciences</subject><subject>Electromyography</subject><subject>Engineering</subject><subject>Equilibrium (Physiology)</subject><subject>Evaluation</subject><subject>Falls</subject><subject>Female</subject><subject>Humans</subject><subject>Kinematics</subject><subject>Laboratories</subject><subject>Leg</subject><subject>Leg - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ribeiro de Souza, Caroline</au><au>Betelli, Marina Torres</au><au>Takazono, Patrícia Sayuri</au><au>de Oliveira, Julia Ávila</au><au>Coelho, Daniel Boari</au><au>Duysens, Jacques</au><au>Teixeira, Luis Augusto</au><au>Rogan, Slavko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of balance recovery stability from unpredictable perturbations through the compensatory arm and leg movements (CALM) scale</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-08-28</date><risdate>2019</risdate><volume>14</volume><issue>8</issue><spage>e0221398</spage><epage>e0221398</epage><pages>e0221398-e0221398</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Following unpredictable large-magnitude stance perturbations diverse patterns of arm and leg movements are performed to recover balance stability. Stability of these compensatory movements could be properly estimated through qualitative evaluation. In the present study, we present a scale for evaluation of compensatory arm and leg movements (CALM) in response to unpredictable displacements of the support base in the mediolateral direction. We tested the CALM scale for intra- and inter-rater reliability, correlation with kinematics of arm and leg movement amplitudes, and sensitivity to mode (rotation, translation and combined) and magnitude (velocity) of support base displacements, and also to perturbation-based balance training. Results showed significant intra- and inter-rater coefficients of agreement, ranging from moderate (0.46-0.53) for inter-rater reliability in the arm and global scores, to very high (0.87-0.99) for inter-rater leg scores and all intra-rater scores. Analysis showed significant correlation values between scale scores and the respective movement amplitudes both for arm and leg movements. Assessment of sensitivity revealed that the scale discriminated the responses between perturbation modes, platform velocities, in addition to higher balance recovery stability as a result of perturbation-based balance training. As a conclusion, the CALM scale was shown to provide adequate integrative evaluation of compensatory arm and leg movements for balance recovery stability after challenging stance perturbations, with potential application in fall risk prediction.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31461500</pmid><doi>10.1371/journal.pone.0221398</doi><orcidid>https://orcid.org/0000-0002-3883-8904</orcidid><orcidid>https://orcid.org/0000-0001-5595-4395</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Accidental falls Adolescent Adult Amplitudes Analysis Arm Arm - physiology Balance Biology and Life Sciences Biomechanical Phenomena Correlation Correlation analysis Ecology and Environmental Sciences Electromyography Engineering Equilibrium (Physiology) Evaluation Falls Female Humans Kinematics Laboratories Leg Leg - physiology Lower Extremity - physiology Male Medicine and Health Sciences Movement - physiology Muscle Contraction - physiology Muscle, Skeletal - physiology Older people Perturbation Physical education Physical Sciences Postural Balance - physiology Posture Recovery Recovery (Medical) Reliability Risk factors Sensitivity Sensitivity analysis Social sciences Stability analysis Systematic review Training Young Adult |
| title | Evaluation of balance recovery stability from unpredictable perturbations through the compensatory arm and leg movements (CALM) scale |
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