BALANCE TRAINING: DOES ANTICIPATED BALANCE CONFIDENCE CORRELATE WITH ACTUAL BALANCE CONFIDENCE FOR DIFFERENT UNSTABLE OBJECTS?

Background Sports rehabilitation professionals often prescribe unstable objects for balance training. Unfortunately, there is a lack of measurement of balance confidence when incorporating these objects. Currently, there is no consensus on the optimal balance confidence measure or proposed progression of unstable objects. Understanding the influence of balance confidence on task performance using unstable objects may help professionals better prescribe a balance training program. Purpose The primary purpose of this investigation was to explore the correlation between anticipated and actual balance confidence on different unstable objects during static double leg and single leg stance. The secondary purpose was to explore the correlation between anticipated and actual unstable object difficulty rankings. Study Design Repeated measure observational, controlled trial. Methods Sixty-five active, healthy adults (M = 35, F = 30) (mean age = 24.38 ± 3.56) underwent two testing sessions. During session one, participants took an online survey, rating their anticipated balance confidence after observing images of different unstable objects. During session two, participants stood on each unstable object under two conditions (static double leg stance and single leg stance) and rated their actual balance confidence. The main outcome measure was an ordinal balance confidence score adapted from the activities-specific balance confidence scale. Statistical analysis included subject demographic calculations and appropriate non-parametric tests. Results For the double leg stance and single leg stance conditions, there was a very strong correlation between anticipated and actual balance confidence scores on the stable surface (ρ = 1.0, p = <.001). There was a weak correlation between scores for foam pad, air-filled discs, Bosu® (dome up), Bosu® (dome down), and wobble board for both conditions. For unstable object rankings, there was a very strong correlation between scores (ρ=1.0, p = <.001). The objects were ranked by perceived difficulty as follows: Level 1 (easy)- ground, Level 2- foam pad, Level 3- air-filled discs, Level 4- Bosu®, and Level 5 (difficult)- wobble board. Conclusion Study findings suggest that actual measures of balance confidence may provide insight into a patient's confidence level and may help with prescribing and progressing their program. The suggested unstable object difficulty rankings may help professionals better match the objects to their patients to produce optimal outcomes. Level of Evidence 2c.