Portable technology for postural control measurement: Comparing head position with center of pressure data

Article type: Research Article

Authors: Harel, Daphna^a | Lubetzky, Anat Vilnai^{b; *}

Affiliations: [a] Department of Applied Statistics, Social Science, and Humanities, New York University, New York, NY, USA | [b] Department of Physical Therapy, New York University, New York, NY, USA

Correspondence: [*] Corresponding author: Anat Vilnai Lubetzky, Department of Physical Therapy, New York University, 380 2^nd Avenue, 4^th Floor, New York, NY 10010, USA. Tel.: +1 212 998 9195; E-mail: anat@nyu.edu.

Abstract: BACKGROUND: Standing is a basic human function that healthy adults take for granted, yet it is a complex perceptual-motor process that requires sensation of position and motion from the sensory systems. OBJECTIVE: We assessed agreement between center of pressure data from a laboratory force-platform and head position data from an HTC Vive head-mounted display (HMD) for the evaluation of standing postural control. We investigated the impact of different statistical choices when assessing the relationship between two measurements. Specifically: 1) How does correlation and agreement statistics relate before and after logarithmic transformation? 2) Is there systemic or proportional bias between the force-platform and HMD measurements? METHODS: We tested 37 adults (26 controls, 11 with unilateral vestibular hypofunction) standing on foam, observing a static or dynamic visual scene projected from the HMD. We quantified anterior-posterior and medio-lateral sway via Directional Path, Root Mean Square Velocity, Variance, and Power Spectral Density (PSD) from a force-platform and the HMD. RESULTS: Intra-class correlations (ICCs) were moderate-to-good for the non-transformed data and good-to-excellent after logarithmic transformation for all outcomes except for PSD above 1 Hz. Correlations were higher than ICCs. Bland-Altman plots indicated proportional bias but not after logarithmic transformation. CONCLUSIONS: Both devices correlated linearly, and measure people’s postural responses but cannot be used interchangeably, mostly because they appear to diverge with larger sway as evident on Bland-Altman plots of non-transformed data. Agreement between devices was excellent for low frequency movement but poor for high frequency small corrective movements.

Keywords: Virtual reality, Bland-Altman, correlations, postural control, balance

DOI: 10.3233/THC-231338

Journal: Technology and Health Care, vol. 32, no. 5, pp. 2965-2979, 2024