Sports Medicine Research: In the Lab & In the Field: Is There a Cheaper Alternative to Force Plates? (Sports Med Res)


Friday, October 18, 2013

Is There a Cheaper Alternative to Force Plates?

Accuracy of force and center of pressure measures of the Wii Balance Board

Bartlett HL, Ting LH, Bingham JT. Gait & Posture. 2013 August 1. [Epub ahead of print]

Take Home Message: The Wii Balance Board (WBB) cannot be used as a substitute for laboratory-grade force plates due to lower accuracy and precision measurements. Its affordability make it a popular choice so the WBB may be appropriate in scenarios where lower accuracy and precision are acceptable.

The Nintendo Wii Balance Board (WBB) offers a more affordable method of assessing postural control as compared to lab-grade force plates. It can provide ground reaction forces and center of pressure (COP) measures while a person stands or moves on the platform. However, it is unclear as to how appropriate the WBB is for measuring balance control, as the accuracy and reliability of force and COP measures for the product are uncertain. Therefore, Bartlett et al. evaluated the uncertainty metrics for static loads on the WBB so that it may be evaluated as an appropriate or inappropriate tool for balance measurement in humans. Specifically, this study determined the accuracy and repeatability of the measures. The authors evaluated nine WBBs and one laboratory-grade force plate. Of the nine WBBs, three were considered lightly used and six were considered heavily used. Bartlett et al validated the force and COP measures for each instrument by using calibrated masses to calculate a standard measurement uncertainty analysis, which assesses accuracy and repeatability. The authors found that the uncertainty of force and COP measurements among WBB were much higher than those recommended for posturography applications but the repeatability measures within the same board were better than across different boards. The measurements between lightly-used and heavily-used WBBs were not different.

Overall, the data from this study suggest that the WBB should not be used as a substitute for laboratory-grade force plates. However, these boards may be sufficient in measuring postural sway when changes or differences greater than 10mm are anticipated, but further validation still needs to be completed. If clinicians decide to incorporate a WBB into their practice the results suggest that we should use one WBB rather than multiple WBBs. It was also reassuring that lightly- and heavily-used boards performed similarly, which revealed these systems are durable. While the WBB is not a substitute for expensive force plates, it can still be used as a part of a rehabilitation program to improve balance and coordination as well as in scenarios where lower accuracy and precision are acceptable.

Questions for Discussion: Have you used WBBs to measure balance control in patients? Does the affordability of the WBB outweigh its lack of accuracy?

Written by: Laura Marley
Reviewed by: Lisa Chinn and Jeffrey Driban

Related Posts:
SMR Brief: Reliability of Wii Balance Boards - A Possible Clinical Assessment?

Bartlett HL, Ting LH, & Bingham JT (2013). Accuracy of force and center of pressure measures of the Wii Balance Board. Gait & Posture PMID: 23910725


Stephanie Huntsman said...

While I have not incorporated WBB into my practice as of yet, I have owned one since their inception for play. In the mid to late 2000s, a great deal of attention was being paid to "Wii-hab", and with the increased fixation on technology in addition to the increasing challenge of maintaining interest and motivation, this approach has great potential. Although an expensive, highly-accurate force plate is ideal, the fact that something is affordable and can provide, at the very least, a gross but precise estimate of what is going on is reason enough to me to consider incorporating a WBB into my practice. In addition, in the clinical setting, the WBB offers an affordable alternative, because minute accuracy is not as integral as in research--especially because most of us monitor balance visually; on that note, because the WBB can record data and performance, it could also save time by providing balance ability data without the need for the ATC to be hawking constantly, and enable the athlete to set and achieve goals beyond "balance for 30sec on a single leg".

Kelsey Croak said...

I agree with the points that Stephanie has made above, and would also like to add for consideration the intended purpose for implication of tools such as the WBB, as was mentioned in the blog. I think that the use of the WBB makes more sense for a clinical implication, where less accuracy may be acceptable. It has the potential to give patients feedback in an easy to understand and interactive way, for less cost. I don’t think you will find a clinician that would argue against that. A force plate may be better utlized for research and data collection purposes where accuracy is more important and thus researchers or clinicians may be willing to pay the increase cost in order to make sure that the data is more accurate. It all depends on how the tool is intended to be used.

Gabriella Basile said...

I believe if you incorporate an interesting and fun rehabilitation program you achieve better results. If you incorporate the WII balance board into an athletes rehabilitation program I think it would be beneficial. There are specific sport games and just the Wii Fit Plus game incorporates balance, strength, and yoga games that may help an athlete during rehabilitation. And I agree with Kelsey above, it depends on how the tool is intended to be used.

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