A Step Forward in Balance Care: Psychometrics and Usability of the Stability, Agility, Strength (SAS) Mat
Abstract
Abstract Content -
Background: Tandem stance is a key measure of static balance, yet existing tests often lack standardization, rely on ordinal scoring, and fail to account for upper-limb support, reducing accuracy and sensitivity. The SAS Mat was developed to address these limitations. The Mat can be used as the SAS Measure of tandem balance, and as a balance training tool. This study evaluated its test–retest reliability, convergent validity, acceptability, and feasibility in healthy older adults.
Methods: A convenience sample of 44 community-dwelling adults aged ≥65 years, 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 repeated the SAS Mat assessment and watched a video demonstration of the SAS Mat as a balance training tool. Participants then completed a short survey exploring their perceptions of the SAS Mat as a balance assessment and training tool. Test-retest reliability and concurrent and discriminant validity were measured with Spearman’s correlation coefficients. Descriptive statistics of participant survey results were calculated.
Results: The SAS Measure showed moderate test-retest reliability (r=0.71, p<0.001, 95%CI: 0.51 to 0.83). Convergent 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 SAS Measure as “completely acceptable” (90%, 37/41) and felt confident during assessment (98%, 40/41). A majority believed SAS Mat training would improve balance (79%, 33/42) and expressed confidence in home use for balance training (88%, 37/42).
Conclusion: The SAS Mat is a promising assessment and training tool for balance. Future research should investigate its effectiveness as a balance training intervention.
Comments
Great assessment with practical applications
It was great to come across your poster again after seeing your work at previous events, really interesting to see how the SAS Mat is continuing to develop.
I liked the focus on improving the sensitivity and standardisation of tandem balance assessment, especially since many existing measures can be quite limited in clinical practice. The combination of assessment and training potential also makes it really appealing from a practical implementation perspective.
The usability and confidence findings were encouraging, especially the high proportion of participants who felt confident using it at home. It’ll be really interesting to see future research on whether SAS training translates into measurable improvements in balance and falls outcomes over longer periods
Reply
Hi Alicia - thank you for this feedback.
You're right... it would be great to have more research using the SAS Mat for training and home practice. Therapists who are using the SAS Mat certainly report that it helps to streamline their approach to Falls Prevention - and is helpful in teaching exercises correctly. Of course, we already know that all the exercises work - the trick is getting people to continue to practice well at home when we are not with them. Like the Neura Standing Tall program, the SAS Mat and program is one more tool to help achieve this. Perhaps Neura would be interested this research?