Reliability and learning effects of repeated exposure to the Bertec Balance Advantage sensory organisation test in healthy individuals

Simon J. Summers, Susan Antcliff, Gordon Waddington, Sarah Wallwork

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)


    Background: The Sensory Organisation Test (SOT) of computerised dynamic posturography (CDP) is a well-established clinical test used to measure postural control. Advances in technology have enabled new CDP systems to use immersive virtual reality, such as the Bertec® Balance Advantage®. While the Bertec provides an innovative approach to posturography, the reliability and learning effects of the Bertec in administering the SOT has not been thoroughly investigated. Research question: To evaluate the reliability and performance during repeated administration of the Bertec® Balance Advantage® SOT. Methods: Fourteen healthy adults (age 27.17 ± 5.5years; 10 females) participated. Each participant performed five SOTs over three sessions. The first two sessions were approximately two days apart and the third one month later. In the first two sessions, two SOTs were conducted, and in the third session, one was performed. Composite, equilibrium, and ratio scores were used for analysis. Results: Poor within-session reliability was found in the first session for the composite score (ICC: 0.73, 95% CI: 0.32–0.91), which improved by the second session (ICC: 0.84, 95% CI: 0.58–0.94). Poor within-session reliability (ICC <0.5) was found for all ratio and equilibrium scores, except for the equilibrium score of condition 3, which demonstrated moderate reliability (ICC: 0.84, 95% CI: 0.57–0.95). Poor between-session reliability was found for all outcomes. There was an increase in the composite and equilibrium scores for conditions 5 and 6 over the 5 tests, which plateaued after the fourth test, and were retained at 1 month. Significance: The data demonstrate a steady increase in performance with repeated exposure to the Bertec SOT, which was maintained one month later, indicating a learning effect. We recommend that a minimum of two familiarisation sessions should be administered to establish baseline performance and improve reliability.

    Original languageEnglish
    Pages (from-to)205-211
    Number of pages7
    JournalGait and Posture
    Publication statusPublished - Mar 2022


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