title: Validity of the Nintendo Wii Balance Board to assess weight bearing asymmetry during sit-to-stand and return-to-sit task.
abstract: Weight bearing asymmetry is common in patients with unilateral lower limb musculoskeletal pathologies. The Nintendo Wii Balance Board (WBB) has been suggested as a low-cost and widely-available tool to measure weight bearing asymmetry in a clinical environment; however no study has evaluated the validity of this tool during dynamic tasks. Therefore, the purpose of this study was to determine the concurrent validity of force measurements acquired from the WBB as compared to laboratory force plates. Thirty-five individuals before, or within 1 year of total joint arthroplasty performed a sit-to-stand and return-to-sit task in two conditions. First, subjects performed the task with both feet placed on a single WBB. Second, the task was repeated with each foot placed on an individual laboratory force plate. Peak vertical ground reaction force (VGRF) under each foot and the inter-limb symmetry ratio were calculated. Validity was examined using Intraclass Correlation Coefficients (ICC), regression analysis, 95% limits of agreement and Bland-Altman plots. Force plates and the WBB exhibited excellent agreement for all outcome measurements (ICC=0.83-0.99). Bland-Altman plots showed no obvious relationship between the difference and the mean for the peak VGRF, but there was a consistent trend in which VGRF on the unaffected side was lower and VGRF on the affected side was higher when using the WBB. However, these consistent biases can be adjusted for by utilizing regression equations that estimate the force plate values based on the WBB force. The WBB may serve as a valid, suitable, and low-cost alternative to expensive, laboratory force plates for measuring weight bearing asymmetry in clinical settings.
authors.affiliation: Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States; Department of Physiotherapy, Faculty of Rehabilitation Sciences, The University of Jordan, Amman, Jordan. Electronic address: sumayah@udel.edu.
authors.forename: Sumayeh
authors.initials: S
authors.lastname: Abujaber
authors.affiliation: Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States.
authors.forename: Gregory
authors.initials: G
authors.lastname: Gillispie
authors.affiliation: Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States.
authors.forename: Adam
authors.initials: A
authors.lastname: Marmon
authors.affiliation: Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States; Department of Physical Therapy, University of Delaware, Newark, DE, United States.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zeni
mesh_terms: D000368:Aged; D005080:Exercise Test / Q000295:instrumentation*; D005260:Female; D005528:Foot / Q000502:physiology*; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology*
keywords: Concurrent validity; Force plate; Sit-to-stand; Weight bearing asymmetry; Wii Balance Board