Psychometric properties, acceptability, and feasibility of the Stability, Agility, Strength (SAS) Mat for balance assessment with potential for training

Background: Existing tests of tandem balance have several limitations, including limited sensitivity, floor and ceiling effects, and assistance-related bias. The Strength Agility Stability (SAS) Mat was developed to address these limitations and can be used as the SAS Measure of tandem balance, and a balance training tool. We assessed the Measure’s test–retest reliability and concurrent validity, and the Mat’s acceptability and feasibility as a balance assessment and training tool for healthy older adults.

Methods: A convenience sample of 44 community-dwelling adults aged ≥ 65 years (mean age 72.59, SD 7.15), with independent mobility (± walking aid) and no severe medical conditions, completed two sessions 4–7 days apart. In session 1, participants completed the SAS Measure, the Four Stage Balance Test (FSBT), and Timed Up and Go Test (TUGT). In session 2, participants completed the SAS Measure and a survey about the SAS Mat as an assessment and potential training tool. Test-retest reliability and validity were measured with Intraclass and Spearman’s correlation coefficients. Descriptive statistics were calculated for survey responses on perceived acceptability and feasibility of the SAS Mat.

Results: The SAS Measure showed moderate test-retest reliability (Spearman’s r = 0.71, p < 0.001, 95%CI: 0.51 to 0.83; ICC[3,1] = 0.65, p < 0.001, 95%CI: 0.43 to 0.80). Concurrent validity was good with the FSBT (r = 0.67, p < 0.001, 95%CI: 0.46 to 0.81) and acceptable with the TUGT (r=-0.42, p = 0.014, 95%CI: − 0.64 to − 0.14). Most participants rated the SAS Measure as “completely acceptable” (90%, 37/41), believed the SAS Mat would improve balance (79%, 33/42), and expressed confidence in home use for balance training (88%, 37/42).

Conclusion: Preliminary evidence supports the validity and reliability of the SAS Measure as an emerging balance assessment tool, with promising acceptability and feasibility for assessment and potential training use. Future research should investigate its effectiveness as a balance training tool.