Reliability of center of pressure measures for assessing the development of sitting postural control.

Objectives: To determine the reliability of linear and nonlinear tools, including intrasession and intersession reliability, when used to analyze the center of pressure (COP) time series during the development of infant sitting postural control.

Design: Longitudinal study.

Setting: University hospital laboratory.

Participants: Typically developing infants (N=33; mean +/- SD age at entry in the study, 152.4+/-17.6d).

Interventions: Not applicable.

Main Outcome Measures: Infants were tested twice in 1 week at each of the 4 months of the study. Sitting COP data were recorded for 3 trials at each session (2 each month within 1 week). The linear COP parameters of root mean square and range of sway for both the anterior-posterior and the medial-lateral directions, and the sway path, were calculated. The nonlinear parameters of approximate entropy, Lyapunov exponent, and correlation dimension for both directions were also calculated. Intrasession and intersession reliability was quantified by the intraclass correlation coefficient (ICC).

Results: The nonlinear tool of approximate entropy presented high intrasession and intersession ICC values compared with all other parameters evaluated. Generally, intrasession and intersession reliability increased in the last 2 months of the data collection and as sitting posture matured.

Conclusions: Our results showed that the evaluation of COP data is a reliable method of investigating the development of sitting postural control. The present study emphasizes the need for establishing COP reliability before using it as a method of examining intervention progress directed at improving the sitting postural abilities in infants with motor developmental delays.