Techbalance® como ferramenta de avaliação de equilíbrio em pacientes com indicação de artroplastia total do joelho: estudo transversal metodológico de análise psicométrica

Abstract

Knee osteoarthritis (KOA) is a chronic degenerative disease whose prevalence increases with aging. There is an association between this condition and an increased risk of falls. Falls are considered both a cause of trauma and a risk factor for increased morbidity and mortality in older adults. Techbalance® is a tool designed to assess fall risk and postural balance through an anamnesis questionnaire and sensorimotor analysis using a smartphone application. The use of mobile devices for balance assessment may help identify patients at higher risk of falling, thereby enhancing awareness and optimizing care. The aim of this study is to evaluate the psychometric properties of TechBalance® as an instrument for assessing balance and fall risk in patients with KOA who are candidates for total knee arthroplasty (TKA). A cross-sectional methodological study was conducted to evaluate the following psychometric properties: construct validity, internal consistency, test-retest reliability, agreement, and the presence of ceiling and floor effects. Patients over 50 years of age, diagnosed with primary KOA, and in the preoperative phase for TKA at Pedro Ernesto University Hospital were included. A total of 102 participants were assessed through the application of TechBalance®, in association with the balance domain of the Performance Oriented Mobility Assessment (POMA-B) and the Timed Up and Go (TUG) test. Among these participants, 64 underwent TechBalance® retesting. Construct validity showed a positive convergent correlation with the TUG (rho = 0.705; p < 0.05) and a negative convergent correlation with the POMA-B (rho = –0.743; p < 0.05). The sensorimotor analysis demonstrated satisfactory internal consistency (Cronbach’s ⍺ = 0.902; McDonald’s ω = 0.904). Test-retest reliability (ICC = 0.972; 95% CI = 0.957–0.982) and agreement (MDC95 = 6,986; MDC90 = 5.864) were considered satisfactory. No ceiling or floor effects were observed in the sample. The study findings suggest that TechBalance® provides satisfactory validity evidence for balance assessment in this population. A structural analysis using factor analysis or item response theory may contribute to its further refinement. Future research may explore its longitudinal performance through responsiveness analysis.