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Comparison of the Berg Balance and Fullerton Advanced Balance Scale for Predicting Falls in Patients With Chronic Stroke

만성 뇌졸중 환자의 낙상 예측을 위한 버그균형 척도와 플러턴 어드밴스드 균형 척도의 비교

  • Kim, In-seop (Dept. of Physical Therapy, Daejeon Health Institute of Technology) ;
  • Nam, Taek-gil (Dept. of Physical Therapy, Daejeon Health Institute of Technology) ;
  • Kim, Gyoung-mo (Dept. of Physical Therapy, Daejeon Health Institute of Technology) ;
  • Kim, Jun-seop (Dept. of Physical Therapy, Daejeon Health Institute of Technology) ;
  • Kim, So-jeong (Dept. of Physical Therapy, Daejeon Health Institute of Technology) ;
  • Kang, Jeong-ha (Dept. of Physical Therapy, Daejeon Health Institute of Technology)
  • 김인섭 (대전보건대학교 물리치료학과) ;
  • 남택길 (대전보건대학교 물리치료학과) ;
  • 김경모 (대전보건대학교 물리치료학과) ;
  • 김준섭 (대전보건대학교 물리치료학과) ;
  • 김소정 (대전보건대학교 물리치료학과) ;
  • 강정하 (대전보건대학교 물리치료학과)
  • Received : 2018.01.05
  • Accepted : 2018.02.05
  • Published : 2018.02.19

Abstract

Background: The Berg Balance Scale (BBS) and the Fullerton Advanced Balance (FAB) scale have been used to assess balance function in patients with chronic stroke. These clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate the incidence of and risk factors of falls and compare the predictive values of the BBS and FAB scale relative to fall risk in patients with stroke through receiver operating characteristic analysis. Methods: Sixty-three patients with stroke (faller=34, non-faller=29) who could walk independently for 10 meters participated in this study. The BBS and FAB scale were administered. Then, we verified the cut-off score, sensitivity, specificity, and the area of under the curve. Results: In this study, the BBS and FAB scale did not predict fall risk in patients with stroke in the receiver operator characteristic curve analysis. A cut-off score of 37.5 points provided sensitivity of .47 and specificity of .35 on the BBS, and a cut-off score of 20.5 points provided sensitivity of .44 and specificity of .45 on the FAB scale. Conclusion: The BBS and FAB scale were not useful screening tools for predicting fall risk in patients with stroke in this study, but those who scored 37.5 or lower on the BBS and 20.5 or lower on the FAB scale had a high risk for falls.

Keywords

References

  1. Andersson AG, Kamwendo K, Appelros P. Fear of falling in stroke patients: Relationship with previous falls and functional characteristics. Int J Rehabil Res. 2008;31(3):261-264. https://doi.org/10.1097/MRR.0b013e3282fba390
  2. Belgen B, Beninato M, Sullivan PE, et al. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil. 2006;87(4):554-561. https://doi.org/10.1016/j.apmr.2005.12.027
  3. Berg K, Wood-Dauphinee S, Williams JI, et al. Measuring balance in the elderly: Preliminary development of an instrument. Physiother Can. 1989;41(6):304-311. https://doi.org/10.3138/ptc.41.6.304
  4. Berg KO, Maki BE, Williams JI, et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992;73(11):1073-1080.
  5. Bogle Thorbahn LD, Newton RA. Use of the Berg balance test to predict falls in elderly persons. Phys Ther. 1996;76(6):576-585. https://doi.org/10.1093/ptj/76.6.576
  6. Bonan IV, Colle FM, Guichard JP, et al. Reliance on visual information after stroke. Prt I: balance on dynamic posturography. Arch Phys Med Rehabil 2004;85(2):268-273. https://doi.org/10.1016/j.apmr.2003.06.017
  7. Boulgarides LK, McGinty SM, Willett JA, et al. Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Phys Ther. 2003;83(4):328-339.
  8. Brauer SG, Burns YR, Galley P. A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci. 2000;55(8):M469-M476. https://doi.org/10.1093/gerona/55.8.M469
  9. Cheng PT, Liaw MY, Wong MK, et al. The sit-to-stand movement in stroke patients and its correlation with falling. Arch Phys Med Rehabil 1998;79(9):1043-1046. https://doi.org/10.1016/S0003-9993(98)90168-X
  10. Eng J. Receiver operating characteristic analysis: A primer. Acad Radiol. 2005;12(7):909-916. https://doi.org/10.1016/j.acra.2005.04.005
  11. Fortinsky RH, Baker D, Gottschalk M, et al. Extent of implementation of evidence-based fall prevention practices for older patients in home health care. J Am Geriatr Soc. 2008;56(4):737-743. https://doi.org/10.1111/j.1532-5415.2007.01630
  12. Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: A modified version of the Berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther. 2003;15(2):114-128. https://doi.org/10.1097/01.PEP.0000068117.48023.18
  13. Friedman SM, Munoz B, West SK, et al. Falls and fear of falling: Which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002;50(8):1329-1335. https://doi.org/10.1046/j.1532-5415.2002.50352.x
  14. Geurts AC, de Haart M, van Nes IJ, et al. A review of standing balance recovery from stroke. Gait Posture. 2005;22(3):267-281. https://doi.org/10.1016/j.gaitpost.2004.10.002
  15. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med. 2000;45(1-2):23-41. https://doi.org/10.1016/S0167-5877(00)00115-X
  16. Hajian-Tilaki K. Receiver Operating Characteristic (ROC) curve analysis for medical diagnostic test evaluation. Caspian J Intern Med. 2013;4(2):627-635.
  17. Hernandez D, Rose DJ. Predicting which older adults will or will not fall using the Fullerton advanced balance scale. Arch Phys Med Rehabil. 2008;89(12):2309-2315. https://doi.org/10.1016/j.apmr.2008.05.020
  18. Hochstenbach J, Donders R, Mulder T, et al. Long-term outcome after stroke: A disabilityorientated approach. Int J Rehabil Res 1996;19(3):189-200. https://doi.org/10.1097/00004356-199609000-00001
  19. Jeon YJ, Kim GM. Comparison of the berg balance scale and fullerton advanced balance scale to predict falls in community-dwelling adults. J Phys Ther Sci. 2017;29(2):232-234. https://doi.org/10.1589/jpts.29.232
  20. Jung HY, Park JH, Shim JJ, et al. Reliability test of Korean version of Berg balance scale. J Korean Acad Rehabil Med. 2006;30(6):611-618.
  21. Kim GM. Comparison of the pediatric balance scale and Fullerton advanced balance scale for predicting falls in children with cerebral palsy. Phy Ther Korea. 2016;23(4):63-70. https://doi.org/10.12674/ptk.2016.23.4.063
  22. Kim GM. Content validity of a Korean-translated version of a Fullerton advanced balance scale: A pliot study. Phys Ther Korea. 2015;22(4):51-61. https://doi.org/10.12674/ptk.2015.22.4.051
  23. Kim GM. Reliability and validity study on the korean version of the fullerton advanced balance scale. Phys Ther Korea. 2016;23(1):31-37. https://doi.org/10.12674/ptk.2016.23.1.031
  24. Legters K. Fear of falling. Phys Ther. 2002;82(3):264-272.
  25. Li F, Harmer P, Fitzgerald K, et al. Tai chi and postural stability in patients with Parkinson's disease. N Engl J Med. 2012;366(6):511-519. https://doi.org/10.1056/NEJMoa1107911
  26. Liston RA, Brouwer BJ. Reliability and validity of measures obtained from stroke patients using the balance master. Arch Phys Med Rehabil. 1996;77(5):425-430. https://doi.org/10.1016/S0003-9993(96)90028-3
  27. Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83(3):237-252.
  28. Pang MY, Eng JJ. Fall-related self-efficacy, not balance and mobility performance, is related to accidental falls in chronic stroke survivors with low bone mineral density. Osteoporos Int. 2008;19(7):919-927 https://doi.org/10.1007/s00198-007-0519-5
  29. Rose DJ, Lucchese N, Wiersma LD. Development of a multidimensional balance scale for use with functionally independent older adults. Arch Phys Med Rehabil. 2006;87(11):1478-1485. https://doi.org/10.1016/j.apmr.2006.07.263
  30. Schlenstedt C, Brombacher S, Hartwigsen G, et al. Comparison of the Fullerton advanced balance scale, mini-BESTest, and Berg balance scale to predict falls in Parkinson disease. Phys Ther. 2016;96(4):494-501. https://doi.org/10.2522/ptj.20150249
  31. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up &go test. Phys Ther. 2000;80(9):896-903.
  32. Smania N, Corato E, Tinazzi M, et al. Effect of balance training on postural instability in patients with idiopathic Parkinson's disease. Neurorehabil Neural Repair. 2010;24(9):826-834. https://doi.org/10.1177/1545968310376057
  33. Smith MT, Baer GD. Achievement of simple mobility milestones after stroke. Arch Phys Med Rehabil. 1999;80(4):442-447. https://doi.org/10.1016/S0003-9993(99)90283-6
  34. Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240(4857):1285-1293. https://doi.org/10.1126/science.3287615
  35. Swets JA. ROC analysis applied to the evaluation of medical imaging techniques. Invest Radiol. 1979;14(2):109-121. https://doi.org/10.1097/00004424-197903000-00002
  36. Sze KH, Wong E, Leung HY, et al. Falls among chinese stroke patients during rehabilitation. Arch Phys Med Rehabil. 2001;82(9):1219-1225. https://doi.org/10.1053/apmr.2001.25094
  37. Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;331(13):821-827. https://doi.org/10.1056/NEJM199409293311301
  38. van de Port IG, Kwakkel G, Schepers VP, et al. Predicting mobility outcome one year after stroke: A prospective cohort study. J Rehabil Med. 2006;38(4):218-223. https://doi.org/10.1080/16501970600582930
  39. Weerdesteyn V, de Niet M, van Duijnhoven HJ, et al. Falls in individuals with stroke. J Rehabil Res Dev. 2008;45(8):1195-1213. https://doi.org/10.1682/JRRD.2007.09.0145
  40. Whitney S, Wrisley D, Furman J. Concurrent validity of the berg balance scale and the dynamic gait index in people with vestibular dysfunction. Physiother Res Int. 2003;8(4):178-186. https://doi.org/10.1002/pri.288
  41. Won JI. A Comparison of assessment tools for prediction of falls in patients with stroke. Phys Ther Korea. 2014;21(2):37-47. https://doi.org/10.12674/ptk.2014.21.2.037
  42. Yates JS, Lai SM, Duncan PW, et al. Falls in community-dwelling stroke survivors: An accumulated impairments model. J Rehabil Res Dev. 2002;39(3):385-394.