# An Engineering-Based Balance Assessment and Training Platform

> **NIH VA I21** · BALTIMORE VA MEDICAL CENTER · 2021 · —

## Abstract

Falls are by far the leading cause of accidental injury and death in older adults. The Veteran population is
more severely affected by falls since it is significantly older than the overall population (45% over 65 years of
age vs. 13%), and has a higher prevalence of disability. Thus, Veterans would benefit substantially more
from an accurate diagnosis and treatment of balance function. Despite its importance, much is still unknown
about the manner in which balance is compromised by age and disease. Therapeutic interventions for people
who are at risk of falling have proven to be of limited utility. Engineering methods are well suited to study and
evaluate balance; but have to date been applied to overly simplified scenarios that lack the complexity to
probe the musculoskeletal and neurophysiological bases for balance and falls.
The long term objective of this research, which began with a VA Rehabilitation Research & Development
(RR&D) Career Development Award (CDA-2), is to develop improved directives and protocols for the diagnosis
and treatment of balance-related posture and movement coordination problems. This proposal significantly
advances engineering and psychophysical methods to address existing gaps in the diagnosis and treatment of
balance impairments through the development of a Balance Assessment and Training Platform (BATP). The
goal of the BATP is to quantitatively assess and improve at-risk individuals’ ability to maintain balance when
disturbed by volitional movements of the body and its parts—an important class of balance disturbances
integral to many activities of daily living that can precipitate falls. The BATP’s Assessment Module quickly
establishes the subject’s Limit of Balance (LoB), and then measures performance in a reaching task while at
the LoB. These better expose balance deficits for identification and evaluation. The BATP’s Training Module’s
goal is to increase subjects’ LoB by continuously challenging them to perform the reaching task at their
current LoB, and when they demonstrate proficiency expanding the reaching task to increase their LoB. The
BATP focuses on performance at and just beyond the limits of balance, unlike most such tests and training
protocols that do not challenge subjects in this way. The BATP’s most immediate and salient metric is the LoB
for standing reach; and we hypothesize that expanding this LoB, as the BATP is designed to do, will improve
balance function and make individuals more resistant to falls (in the context of expected balance
disturbances).
Confirmation of this hypothesis could provide a new perspective on existing training protocols’ modest
success rates, and direction for the design of new protocols with the potential to significantly improve these
rates. We believe that the performance metrics and analytical results produced by the BATP can form the
basis for new diagnostic measures that more reliably and precisely quantify and explain balance
performance problems; as well as ...

## Key facts

- **NIH application ID:** 10450625
- **Project number:** 5I21RX003020-03
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** Joseph Edward Barton
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-07-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10450625

## Citation

> US National Institutes of Health, RePORTER application 10450625, An Engineering-Based Balance Assessment and Training Platform (5I21RX003020-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10450625. Licensed CC0.

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