Can force-plate measurement be trusted for balance diagnostics? Frequency-domain force-plate performance assessment for quiet-standing studies

Older adults face an increased risk of falls that may have severe consequences for their well-being. Routine, accessible clinical screening may help mitigate fall risk through early detection of balance impairments. Portable force plates offer a convenient and practical solution for balance assessment in clinical settings. A new force-plate-based balance measure, the intersection-point-height, has shown particularly promising results in its ability to distinguish between healthy and impaired balance behaviors. However, the intersection-point-height measure requires measurement of shear force during standing, which exhibits magnitudes of less than 0.2% of normal forces (body weight), taxing the dynamic range of most sensor technologies. The ability of existing force plates to measure such low-magnitude shear forces observed during quiet standing is currently unknown. This study presents a force-plate performance assessment method to evaluate shear-force measurement errors and quantify the uncertainty of the intersection-point-height measure. The method was applied to test a commonly used laboratory-grade portable force plate. While the device successfully captured sagittal-plane intersection-point-height at the lowest frequencies, low signal strength prevented precise readings in the frontal plane. Thus, the tested device only marginally met the precision required for quiet-standing analysis, underscoring the critical need for systematic performance validation of portable force plates prior to clinical use. Future efforts should focus on evaluating alternative portable force plates and exploring economical design improvements to enhance shear-force measurement precision.