Development, Reliability, and Validity Assessment of a Portable 3D Camera-Based System for Quantifying Postural Sway and Balance

Accurate assessment of postural sway is essential for evaluating balance disorders, rehabilitation outcomes, and fall risk. Traditional laboratory-based motion capture systems provide precise center-of-pressure (CoP) measurements, but are expensive, non-portable, and impractical for widespread clinical use. This study describes the development and testing (reliability and validity) of a portable three-dimensional (3D) camera system (Intel RealSense D415) for quantifying sway and balance. Test–retest reliability was evaluated in healthy adults (n = 10; 6 males, 4 females; mean age 22.3 ± 1.6 years), yielding intraclass correlation coefficients ICC = 0.84–0.86 (95% CI: 0.61–0.95). Concurrent validity, established against a laboratory-based optical motion capture system (Optotrak), demonstrated strong correlations with a mean absolute percentage error of 10.5% relative to Optotrak-derived path length measurements and high levels of agreement. Operating at 30 Hz with end-to-end latency of <40 ms, the RealSense-based system provides a reliable, valid, and portable alternative to lab-based systems. Low-cost markerless motion capture systems based on standard RGB cameras have been validated for postural risk assessment, showing good consistency with gold-standard Vicon systems. These preliminary findings suggest that the system shows promise as a low-cost alternative; however, further validation in clinical populations is required before clinical deployment.