Effects of Learning on Performance When Computerized Dynamic Posturography Assessments Are Repeated

Background: Computerized dynamic posturography is widely used to measure balance control performance. Clinically, performance is assessed by comparing individual data against standards obtained from a normative population. When performing repeated assessments to track performance changes, one must be concerned with the influence of learning effects. Subjects do not have the opportunity to practice before the first session, and often a second session is not performed prior to an experiment. Thus, the objective of this activity was to examine learning effects on balance control performance. We hypothesize that subjects will perform better on the second session when compared to the first, and that the difference will be greater for more difficult conditions. Methods: Data were collected from 204 subjects using the NeuroCom Equitest system during quiet stance with arms crossed at the chest on up to two sessions. All subjects performed standard sensory organization tests (SOTs) including 1) normal vision, fixed support; 2) absent vision, fixed support; 3) sway-referenced vision, fixed support; 4) normal vision, swayreferenced support; 5) absent vision, sway-referenced support; and 6) sway-referenced vision, sway-referenced support. 120 of these subjects performed modified sensory organization tests (mSOTs 2 and 5) which included static (20 back) and dynamic (20, 0.33Hz) head tilts. Median equilibrium scores (mEQ) were calculated from peak-to-peak anterior-posterior sway across trials. Data collected on the first session were then compared with the second to examine learning effect. Results: There were no differences in mEQ scores between the first and second sessions for SOTs 1, 2, and 4, while mEQ scores were higher for the second session when compared to the first for SOTs 3, 5, and 6 and for all mSOTs. Discussion: An additional familiarization session or practice trials prior to the first session may be necessary for more challenging SOT and mSOT conditions to minimize learning effect.