Validity and Responsiveness of a Modified Balance Error Scoring System Assessment Using a Mobile Device Application in Patients Recovering from Ankle Sprain.
Michael S Crowell, Eliot Thomasma, Erin Florkiewicz and 4 others
PMID 38576835WHAT IT FOUND
A smartphone app scoring static balance distinguished acute ankle sprains from healthy controls and tracked improvement after four weeks of rehab.
The single-leg stance on the injured side was the most sensitive test position. This offers a portable, objective alternative to manual balance error counting.
Key findings
01The SWAY app total score was significantly lower in participants with acute ankle sprains compared to healthy controls, with a large effect size.
02The app detected significant improvements in static balance after four weeks of rehabilitation, returning scores to a level not statistically different from healthy controls.
03The single-leg stance on the injured side showed the largest difference between groups and is suggested as the most efficient single test position for detecting deficits.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study population was young, active military cadets, so results may not generalize to older adults or those with other comorbidities. Balance was only assessed at two time points (baseline and four weeks), limiting the ability to see the full trajectory of recovery. The SWAY app uses a proprietary, undisclosed algorithm, making it difficult to know exactly how the score is calculated. There was no long-term follow-up to determine if the app can detect subtle lingering deficits that predict chronic ankle instability.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not assume the app's total score is the best single metric for diagnosis. The study found that the single-leg stance on the injured side had a larger effect size than the total score for distinguishing injured from healthy participants, suggesting the total score may dilute the most sensitive information.