# Reproducibility of stabilometric measurements using the Wii Balance Board under static and imbalance conditions

Antonios Dina, Thomas Provot, Thierry Odent, Manon Bocahut, Christophe

Brunet, Nathanael Gomez, Mbene Sarr, Sébastien Laporte

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Antonios Dina, Thomas Provot, Thierry Odent, Manon Bocahut, Christophe Brunet, et al. Reproducibility of stabilometric measurements using the Wii Balance Board under static and imbalance conditions. Multidisciplinary Biomechanics Journal, 2025, 50th congress of the., 10.46298/mbj.16221. hal-05191775v2

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# Reproducibility of stabilometric measurements using the Wii Balance Board under static and imbalance conditions

Antonios Dina<sup>a, b*</sup>, Thomas Provot<sup>a</sup>, Thierry Odent<sup>b</sup>, Manon Bocahut<sup>a</sup>, Christophe Brunet<sup>a</sup>, Nathanael Gomez<sup>a</sup>, Mbene Sarra<sup>a</sup>, Sébastien Laporte<sup>a</sup>

<sup>a</sup> Arts et Métiers Institute of Technology, EPF Engineering School, Université Sorbonne Paris Nord, IBHGC-Institut de Biomécanique Humaine Georges Charpak, F-75013 Paris, France

<sup>b</sup> Service de chirurgie orthopédique pédiatrique, Hôpital pédiatrique Gatien de Clocheville, Faculté de médecine, université de Tours, 49 Bd Béranger, 37044 Tours, France

* Corresponding author: antonios.dina@ensam.eu

Received date: 05/04/2025

Accepted date: 27/06/2025

Publication date: 27/10/2025

**Keywords:** Wii Balance Board, stabilometry, postural control, reproducibility, static and imbalance conditions, center of mass, center of pressure

© 2025 The Authors

Licence CC-BY 4.0

Published by Société de Biomécanique

## 1. Introduction

The Nintendo Wii Balance Board (WBB) has become an increasingly popular tool for assessing postural control due to its low cost, ease of use and portability. It offers a practical alternative to expensive force plates and complex instrumentation. Numerous studies have supported its reliability and validity when compared to established force platform technologies for the assessment of static standing balance (Clark et al. 2018, Clark et al. 2010). Our study aims to validate the reproducibility of the WBB in both static and imbalance assessments by testing under different proprioceptive conditions, specifically with eyes open and closed. This investigation will confirm the suitability of the WBB for routine use in both research and clinical settings, including everyday practice in outpatient clinics.

## 2. Methods

This prospective study enrolled 32 healthy participants (16 females and 16 males) between the ages of 18 and 25 years with a body mass index between 16.5 and 30. Participants underwent standardised balance tests under identical conditions as described in the literature (Mouzat et al. 2005). Two sessions were performed, three weeks apart to assess reproducibility. Each session consisted of four tests separated by 2 min rest: 1 min static stance with visual reference and arms at sides, and a 30 s ‘limits of stability’ test in imbalance. For the “imbalance” condition, participants

performed a limits of stability test over 30 seconds, divided into three phases: 10 seconds of initial standing position, progressive forward leaning at their own pace to their maximum limit without lifting heels, and maintenance of this maximum position until the end of the 30-second period. The tests were repeated with eyes closed (Figure 1).

<figure><img src="image_3.png" /><figcaption>**Figure 1:** Static stance and limits of stability tests with and without visual reference.</figcaption></figure>
<table><caption>**Table 1:** Reproducibility of stabilometric parameters between sessions</caption><thead><tr><th>Parameter</th><th>Static EO</th><th>Static EC</th><th>Imbalance EO</th><th>Imbalance EC</th></tr></thead><tbody><tr><td>Asymmetry Ratio (S1)</td><td>0.989 ± 0.070</td><td>0.990 ± 0.078</td><td>0.989 ± 0.067</td><td>0.969 ± 0.068</td></tr><tr><td>Asymmetry Ratio (S2)</td><td>0.990 ± 0.069</td><td>0.974 ± 0.076</td><td>0.973 ± 0.054</td><td>0.965 ± 0.060</td></tr><tr><td>CoM Displacement (mm) (S1)</td><td>153.5 ± 36.7</td><td>191.0 ± 46.2</td><td>68.6 ± 17.0</td><td>90.6 ± 25.9</td></tr><tr><td>CoM Displacement (mm) (S2)</td><td>158.6 ± 39.3</td><td>199.7 ± 57.9</td><td>69.1 ± 18.6</td><td>94.3 ± 21.1</td></tr><tr><td>Mean Velocity (mm/s) (S1)</td><td>2.22 ± 0.52</td><td>2.77 ± 0.67</td><td>4.011 ± 1,065</td><td>5.36 ± 1.52</td></tr><tr><td>Mean Velocity (mm/s) (S2)</td><td>2.32 ± 0.60</td><td>2.91 ± 0.83</td><td>4.031 ± 1,07</td><td>5.53 ± 1.30</td></tr><tr><td>Sway Area (mm²) (S1)</td><td>23.38 ± 16.26</td><td>21.98 ± 13.86</td><td>27.64 ± 21.92</td><td>33.03 ± 21.46</td></tr><tr><td>Sway Area (mm²) (S2)</td><td>22.83 ± 17.53</td><td>28.03 ± 19.34</td><td>35.17 ± 32.71</td><td>39.27 ± 29.32</td></tr></tbody></table>

Note: No significant differences were found between sessions (p > 0.05) for any parameter.

EO = Eyes Open; EC = Eyes Closed; S1 = Session 1; S2 = Session 2.

Data were recorded using the WBB at a frequency of 100 Hz to capture the centre of pressure (CoP) signals (Leach et al. 2014). The CoP data were then converted to centre of mass (CoM) metrics using an established biomechanical model (Gagey et al. 2012). Parameters measured included postural asymmetry ratio, CoM displacement and mean velocity, CoM surface area and total sway length, and Romberg quotient. These parameters were chosen for their ability to provide a comprehensive assessment of postural control.

Statistical analysis included normality testing of the data distribution, followed by paired comparisons using Student's t-test for normally distributed data and Wilcoxon test for non-normally distributed data to evaluate between-session differences (p > 0.05). For reproducibility assessment, we established acceptable error margins of less than 10% between sessions.

## 3. Results and discussion

Our study confirms that the WBB provides reproducible stabilometric measurements in both static and imbalanced conditions under varying sensory inputs (Table 1). The close between-session agreement in key parameters supports the validity of the WBB as a cost-effective alternative to traditional force platforms. These consistent results indicate that the WBB can accurately capture subtle variations in postural control, reinforcing its utility for clinical assessment of balance, particularly in populations where traditional force platforms are not feasible.

Converting CoP to CoM metrics enhances biomechanical relevance and offers insight into stability and compensatory strategies. The mean between-session differences were 2.8% for asymmetry ratio, 3.5% for CoM displacement, 4.2% for velocity, and 9.7% for sway area, all within our pre-established acceptable error margin of 10%.

While our study used human participants rather than mechanical testing apparatus, this approach provides ecological validity by assessing the WBB's performance in real-world clinical scenarios. Although a mechanical apparatus would isolate sensor performance from human variability, our approach deliberately evaluates the WBB in its intended use context. The non-significant differences between sessions, despite inherent human postural variability, strengthen our conclusion that the WBB is sufficiently reliable for clinical applications. We consider reproducibility “good” when between-session differences remain below clinically meaningful thresholds, which our results demonstrate.

Despite the promising results obtained in a sample of healthy young adults, the limited sample size requires further investigation in larger and more diverse populations. In addition, future research should address potential limitations related to sensor noise and calibration variability in order to optimise the accuracy of the WBB in different settings.

Overall, the excellent reproducibility demonstrated in our study, consistent with previous literature (Clark et al. 2010), highlights the potential of the WBB for
widespread use in both research and clinical practice. This tool could serve as an accessible means for regular postural assessment, facilitating early detection and monitoring of balance disorders.

## 4. Conclusions

Our study shows that the WBB provides stabilometric data in static and imbalance tests, with eyes open and closed. Its consistent performance supports its use as an affordable clinical tool for postural assessment.

## Acknowledgements

We thank all study participants for their invaluable contribution, as well as our colleagues for their support in data collection and analysis. Special thanks to our institutions for providing the necessary resources and facilities.

## Conflict of Interest Statement

None

## Contributor Roles

AD: formal analysis, methodology, software, supervision, validation, review & editing; TP: formal analysis, funding acquisition, methodology, project administration, software, resources, supervision, validation, visualization, review & editing; TO: formal analysis, validation, visualization, review & editing; MB, CB, NG, MS: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, writing – original draft; SL: formal analysis, methodology, validation, review & editing.

## Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

## References

Clark, R. A., Bryant, A. L., Pua, Y., McCrory, P., Bennell, K., & Hunt, M. (2010). Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance. *Gait & Posture, 31*, 307–310. https://doi.org/10.1016/j.gaitpost.2009.11.012

Clark, R. A., Mentiplay, B. F., Pua, Y. H., & Bower, K. J. (2018). Reliability and validity of the Wii Balance Board for assessment of standing balance: A

systematic review. *Gait & Posture, 61*, 40–54. https://doi.org/10.1016/j.gaitpost.2017.12.027

Mouzat, A., Dabonneville, M., Roux, D., Borges, N., & Bertrand, P. (2005). Position des pieds et paramètres stabilométriques. *Staps, 67*, 59–71.

Leach, J. M., Mancini, M., Peterka, R. J., Hayes, T. L., & Horak, F. B. (2014). Validating and calibrating the Nintendo Wii Balance Board to derive reliable center of pressure measures. *Sensors, 14*(10), 18244–18267. https://doi.org/10.3390/s141018244

Gagey, B., Bourdeaux, O., & Gagey, P. M. (2012, June 24–28). From the center of pressure to the center of gravity through a simple calculation. *ISPGR Congress, Trondheim, Norway.*