Differences between physical therapist ratings, self-ratings, and posturographic measures when assessing static balance exercise intensity.
Jamie Ferris, Jonathan Zwier, Wendy J Carender and 1 others
PMID 37250428WHAT IT FOUND
Patients rated balance exercises as less intense than therapists did.
Self-ratings predicted therapist ratings 46.6% per trial and 45.9% per exercise; trunk sway predicted 43.0% per trial and 52.4% per exercise.
Key findings
01PTs gave similar ratings to one another, ICC 0.868 per trial and 0.860 per exercise, and ratings increased with harder surface, stance, and visual conditions but decreased with head movement.
02Self-ratings were lower than PT ratings and predicted PT ratings 46.6% of the time per trial and 45.9% per exercise.
03Trunk sway predictions agreed with PT ratings 43.0% per trial and 52.4% per exercise, and a predicted rating of 5 agreed with PT ratings 92.7% of the time.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included 10 balance participants and 8 PT participants, so it may not reflect wider clinical populations or therapist experience levels. Only static standing exercises were assessed, and six harder exercises were excluded because they were too difficult for this group. PTs rated recorded videos after the trial, not live patients, and 21 PT ratings were missing from analysis. Trial order was not randomized, which may not match how patients perform exercises in clinic. The study measured ratings of intensity, not changes in balance or falls. Most balance participants had no vestibular dysfunction, and PT ratings decreased with head movement conditions.
Declared interests
The work was supported by National Science Foundation Grant No. 2125256 and the University of Michigan College of Engineering Miller Faculty Scholarship. The supplied text gives no other conflict-of-interest statement.
The easy way to misread this
Do not conclude that patient self-ratings or trunk sway can replace a PT's visual assessment. Agreement with PT ratings was 46.6% or 45.9% for self-ratings and 43.0% or 52.4% for trunk sway predictions.