> For the complete documentation index, see [llms.txt](https://newton-metrics.gitbook.io/newtonmetrics/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://newton-metrics.gitbook.io/newtonmetrics/modules/balance.md).
# Balance
This feature provides clinicians with a quantitative tool for assessing postural sway and balance in patients. Using advanced smartphone sensor technology, the app measures subtle movements during standardized balance tests, providing objective data to support clinical decision-making.
### How Balance Measurement Works
The app utilizes your smartphone's built-in accelerometer and gyroscope sensors to detect and measure tiny movements while the patient maintains different balance positions. Here's how it works:
* When held against the patient's stomach, at the navel level, the phone acts as a sensitive motion detector
* The sensors measure acceleration changes in multiple dimensions:
* Front-to-back sway (anterior-posterior)
* Side-to-side sway (medial-lateral)
* These movements are measured in mGal units (1 mGal = 1×10⁻⁵ m/s²), which capture very small changes in acceleration
* Higher sway scores indicate more movement during the test, while lower scores suggest better balance control
### Available Tests
#### mCTSIB (Modified Clinical Test of Sensory Integration in Balance)
Duration: 30 seconds per condition
* Condition 1: Eyes Open, Firm Surface
* Condition 2: Eyes Closed, Firm Surface
* Condition 3: Eyes Open, Foam Surface
* Condition 4: Eyes Closed, Foam Surface
#### Modified BESS (Balance Error Scoring System)
Duration: 20 seconds per condition
* Double Leg Stance
* Single Leg Stance (Left and Right)
* Tandem Stance (each stance can be performed on firm surface or foam pad)
#### Standard Balance Assessment
Duration: Customizable (default 30 seconds)
* Eyes Open
* Eyes Closed
* Single Leg Stance
* Tandem Stance
### Conducting a Test
1. **Patient Setup**
* Select the appropriate test from the menu
* Position the patient in the required stance
* Place the phone against their stomach at navel level
* Ensure the phone remains flat against the body
1. **Test Administration**
* Press "START TEST" when ready
* A 3-second countdown will begin
* The test will run for the predetermined duration:
* mBESS tests: 20 seconds
* Standard balance tests: customizable duration
* The phone will vibrate at the start and end of each test and at every second
1. **Results Review**
* After test completion, results show:
* Total sway score
* Front-to-back sway
* Side-to-side sway
* Test duration
* Results can be saved to the patient's record
* Historical data is viewable in graphs and tables
### Interpreting Results
#### Sway Measurements
* **Total Sway**: Overall movement during the test period
* **Front-to-back Sway**: Anterior-posterior movement
* **Side-to-side Sway**: Medial-lateral movement
#### Clinical Considerations
* Compare single leg measurements for asymmetries
* Track changes over time to monitor progress
* Consider environmental factors that may affect performance
* Use in conjunction with other clinical assessments
### Best Practices
1. **Consistency**
* Use the same phone position for all tests
* Maintain consistent testing conditions
* Follow standardized protocols for each test type
2. **Quality Assurance**
* Ensure phone is properly secured against patient
* Monitor for any phone movement during testing
* Tests will automatically stop if phone is tilted away from stomach
3. **Documentation**
* Record any pertinent observations
* Note any modifications to standard protocol
* Document environmental factors
### Technical Notes
* Keep phone charged above 20% for optimal sensor performance
* Ensure testing surface is level
* Maintain quiet testing environment
* Regular app updates may provide new features and improvements
---
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