Evaluation of balance recovery stability from unpredictable perturbations through the compensatory arm and leg movements (CALM) scale

Author(s)

de Souza, Caroline Ribeiro ^{[1, 2]} ; Betelli, Marina Torres ^{[1, 2]} ; Takazono, Patricia Sayuri ^{[1, 2]} ; de Oliveira, Julia Avila ^{[1, 2]} ; Coelho, Daniel Boari ^[3] ; Duysens, Jacques ^[4] ; Teixeira, Luis Augusto ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Sch Phys Educ & Sport, Human Motor Syst Lab, Sao Paulo - Brazil

^[2] Fed Univ ABC, Brazil Ctr Engn Modeling & Appl Social Sci CECS, Sao Paulo - Brazil

^[3] Fed Univ ABC, Ctr Engn Modeling & Appl Social Sci CECS, Sao Paulo - Brazil

^[4] Katholieke Univ Leuven, Fac Kinesiol & Rehabil Sci, Dept Movement Sci, Leuven - Belgium

• Document type: Journal article
• Source: PLoS One; v. 14, n. 8 AUG 28 2019.
• Web of Science Citations: 0

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. (AU)

• FAPESP's process: 11/20265-3 - Central organization in generating anticipatory and reactive postural adjustments in the elderly
• Grantee: Luis Augusto Teixeira
• Support Opportunities: Regular Research Grants