Development and validity of composite scores for the instrumented-modified Clinical Test of Sensory Interaction in Balance in inpatients with subacute stroke.

BACKGROUND

The instrumented modified Clinical Test of Sensory Interaction on Balance (i-mCTSIB) assesses sensory contributions to postural control using Center of Pressure (CoP) data. Existing composite scores do not reflect task difficulty or sensory weighting across conditions.

OBJECTIVES

This study developed a regression-based new composite score and examined its ability to discriminate walking independence and its correlation with standard balance measures in subacute stroke.

METHODS

This study included 54 patients with first-ever stroke. Postural control was evaluated under four i-mCTSIB conditions combining visual input and surface type. Total CoP path length was recorded, and a composite score was derived using regression analysis. Discriminative ability for walking independence was assessed via receiver operating characteristic analysis, and area under the curve (AUC) values were compared. Measures with AUC > 0.80 were further tested for construct validity using the Mini-Balance Evaluation Systems Test (Mini-BESTest).

RESULTS

The i-mCTSIB composite score demonstrated an AUC of 0.84 (95 % CI: 0.69-0.98), exceeding the threshold of 0.80 and outperforming all individual test conditions, which showed AUCs below 0.80. The composite score also showed a moderate correlation with the Mini-BESTest (r̄ = 0.48, 95 % CI: 0.24-0.67, p < 0.001).

CONCLUSIONS

This study developed a novel composite score for the i-mCTSIB that quantitatively reflects sensory integration in postural control and demonstrated its superior ability to discriminate walking independence in patients with subacute stroke. Further investigations are required to evaluate whether these findings generalize to additional CoP parameters.