Validity and reliability of the NIH Toolbox® Standing Balance Test As compared to the Biodex Balance System SD

ABSTRACT

Background/ Purpose

The NIH Toolbox® was developed to assess functions among motor, sensory, emotional, and cognitive domains. The motor domain of the NIH Toolbox® includes an assessment for standing balance. Studies have validated early versions of the balance assessment for ages 3 through 85; however, no studies have examined the reliability and validity in its current version (using iPod Touch) against established balance measurements such as the Biodex SD modified clinical test of sensory integration of balance (m-CTSIB).

Subjects

Ninety-three community dwelling older adults (38 males 55 females) ≥60 years old (SD 74 ± 6).

Methods

One-day assessment using the NIH Toolbox® and the Biodex SD m-CTSIB. Intraclass correlation coefficients (ICC_3,1) were used to measure the test–retest reliability, and Pearson’s product correlation examined criterion validity.

Results

The overall composite of the Biodex SD m-CTSIB and NIH Toolbox® showed moderate test-retest reliability (ICC_3,1 = 0.71, MDC = 1.21) (ICC_3,1 = 0.84, MDC = 0.65,) respectively. The NIH Toolbox® Theta Score and Biodex overall Sway Index (SI) shows acceptable reliability criterion validity (r = 0.52) indicating moderate overlap in constructs.

Conclusions

The NIH Toolbox®balance assessment demonstrates acceptable criterion validity compared to the Biodex SD m-CTSIB. The NIH Toolbox® is a valid, reliable, and accessible device; therefore, the NIH Toolbox® should be considered for use in clinical evaluations.

KEYWORDS:

• Postural balance
• Biodex Balance System SD
• accelerometer
• sway
• community dwelling older adults

Acknowledgments

This work was supported by the Richard Tucker Gerontology Applied Research Grant through the Learning Institute for Elders at The University of Central Florida.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the LIFE @UCF [Richard Tucker Applied Gerontology Grant].