A preliminary study comparing challenging standing and walking balance tasks to discriminate between experts and novices
Gomez Del Campo, Ana Cecilia
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There are no established techniques to reliably discriminate between groups of healthy individuals based on balance skill. Current balance assessment techniques often fail to detect subtle differences in balance skill, which poses a challenge for both diagnosing balance impairments and assessing progress after rehabilitation. Our objective was to test whether balance performance on challenging standing and walking balance tasks could discriminate between highly skilled and untrained individuals. We compared single leg stance and beam walking performance in professional ballet dancers and healthy young adults without dance training. First, we tested whether group-level differences existed in beam walking distance or time standing, fractal dimension, and mean velocity during both eyes open and eyes closed single limb stance. We then tested whether any of these variables could predict group membership across individuals. We found that beam walking distance, along with time standing and fractal dimension during eyes closed single limb stance, were the most effective metrics for discriminating experts from novices. Distance walked had the highest true positive rate (sensitivity of identifying experts) at 0.90, but also had a false positive rate of 0.43. Time standing and fractal dimension during eyes closed single limb stance had slightly lower sensitivity but overall better discriminatory power as quantified by the area under the Receiver-Operating curve. For both eyes closed single limb stance and beam walking, 88% of subjects failed to achieve perfect performance across all trials. For eyes open single limb stance, only 29% of subjects failed to achieve perfect performance across all trials. Eyes open single limb stance metrics failed to reliably classify experts and novices. This suggests that challenging tasks that elicit frequent balance failures may be able to more accurately identify individual differences in balance skill.