Reliability and Construct Validity of Limits of Stability Test in Adolescents Using a Portable Forceplate System

Objective: To examine the reliability, convergent, and discriminant validity of the limits of stability (LOS) test to assess dynamic postural stability in adolescents using a portable forceplate system.

Design: Cross-sectional reliability observational study.

Setting: School setting.

Participants: Adolescents (N=36) completed all measures during the first session. To examine the reliability of the LOS test, a subset of 15 participants repeated the LOS test after 1 week.

Interventions: Not applicable.

Main outcome measures: Outcome measurements included the LOS test, Balance Error Scoring System, Instrumented Balance Error Scoring System, and Modified Clinical Test for Sensory Interaction on Balance.

Results: A significant relation was observed among LOS composite scores (r=.36-.87, P<.05). However, no relation was observed between LOS and static balance outcome measurements. The reliability of the LOS composite scores ranged from moderate to good (intraclass correlation coefficient model 2,1=.73-.96).

Conclusions: The results suggest that the LOS composite scores provide unique information about dynamic postural stability, and the LOS test completed at 100% of the theoretical limit appeared to be a reliable test of dynamic postural stability in adolescents. Clinicians should use dynamic balance measurement as part of their balance assessment and should not use static balance testing (eg, Balance Error Scoring System) to make inferences about dynamic balance, especially when balance assessment is used to determine rehabilitation outcomes, or when making return to play decisions after injury.