BTrackS limits of stability test is a reliable assessment of volitional dynamic postural control

BACKGROUND

Unconstrained limits of stability assessment reveals aspects of volitional postural sway control that are inaccessible by other means. Prior versions of this assessment include instructions to sway towards predefined targets, and may not capture the full capability of the individual.

RESEARCH QUESTION

This study sought to establish the test-retest reliability of a novel limits of stability protocol.

METHODS

Volitional sway area was determined during unconstrained trials, where participants were instructed to explore their ability to sway towards the perimeter of their base of support. Visual feedback was provided via computer monitor. Forty healthy young adults (mean age = 20.2 ± 1.3, 15 males, 25 females) participated in this study. Trials were collected in three sessions, repeated at the same time of the same day, with one week between. Reliability was assessed using IntraClass Correlation Coefficients (ICC), considering the total area of sway as well as quadrant level area.

RESULTS

Reliability was moderate between the first and second session (0.583), and much higher 0.921) between the second and third session. The quadrant level reliability was poor to excellent (0.183-0.791), with similar trends between the three sessions.

SIGNIFICANCE

Ultimately, these results indicate that the novel limits of stability test is reliable. However, it is recommended that a practice trial be conducted prior to baseline establishment.

Comparing dependent kappa coefficients obtained on multilevel data

Reliability and agreement are two notions of paramount importance in medical and behavioral sciences. They provide information about the quality of the measurements. When the scale is categorical, reliability and agreement can be quantified through different kappa coefficients. The present paper provides two simple alternatives to more advanced modeling techniques, which are not always adequate in case of a very limited number of subjects, when comparing several dependent kappa coefficients obtained on multilevel data. This situation frequently arises in medical sciences, where multilevel data are common. Dependent kappa coefficients can result from the assessment of the same individuals at various occasions or when each member of a group is compared to an expert, for example. The method is based on simple matrix calculations and is available in the R package “multiagree”. Moreover, the statistical properties of the proposed method are studied using simulations. Although this paper focuses on kappa coefficients, the method easily extends to other statistical measures.

Recording the human brainstem frequency-following-response in the free-field

BACKGROUND

The human auditory brainstem frequency-following response (FFR) is an objective measure used to investigate the brainstem's encoding ability of sounds. Traditionally, FFRs are recorded under close-field conditions (earphones), but free-field stimulations (loudspeaker) have yet to be attempted, which would increase the applications of FFRs by making this technique accessible to those who cannot wear inserted transducers. Here we test the feasibility and reliability of measuring speech ABRs across free and close-field.

NEW METHOD

The FFR was evoked by a 40-ms consonant-vowel (cv) /da/ syllable which was presented in the standard close-field conditions with insert earphones, and in a novel free-field condition via a loudspeaker.

RESULTS

A well-defined FFR was observed for each stimulating method (free or close-field). We show that it is possible and reliable to elicit FFRs from a speaker and that these do not systematically differ from those elicited by conventional earphones.

COMPARISON WITH EXISTING METHOD

Neural responses were subjected to a comparative within-subjects analysis, using standard measures found in the literature in order to quantify and compare the intrinsic (amplitude, noise, consistency), acoustic (latency, spectral amplitude) and reliability properties (intraclass correlation coefficients and Bland and Altman limits of agreement) of the neural signal.

CONCLUSIONS

Reliable FFRs can be elicited using free-field presentation with comparable to acoustical, intrinsic and reliability properties as those elicited by standard close-field presentations.