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Kim A, Kim Y, Ji M, Lim JY. Usefulness of the Kansas University Standing Balance Scale in inpatient rehabilitation: a retrospective validation study. Int J Rehabil Res 2024:00004356-990000000-00098. [PMID: 38954439 DOI: 10.1097/mrr.0000000000000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Adequate balance assessment is essential for designing rehabilitation programs and preventing falls. This study aimed to report the cross-cultural adaptation of the Korean version of the Kansas University Standing Balance Scale (KUSBS), investigate its concurrent and predictive validities, and examine aging-related differences. The adaptation was performed using a standard protocol. In this retrospective study, 1179 patients were included and classified into adult, young-old, old-old, and oldest-old groups. Furthermore, we compared the concurrent, discriminant, and predictive validities of the KUSBS and Berg Balance Scale (BBS). Nonparametric analysis was also conducted. The Spearman rho test revealed strong correlation coefficients between the KUSBS and BBS (r s > 0.7; P < 0.001). At admission, the relationship was strong in the adult, young-old, and old-old groups (r s = 0.931, 0.913, and 0.914, respectively; P < 0.001) but not the oldest-old group (r s = 0.790; P < 0.001). At discharge, the correlation coefficients were above 0.9 in all groups. Additionally, the relationship between the changes in both scales was moderate-to-strong (r s > 0.68; P < 0.001). The predictive validity for independent walking of the KUSBS was strong (r s = 0.791; P < 0.001) and significantly lower than that of the BBS (r s = 0.833; P < 0.001; Z = -3.001; P = 0.003). Furthermore, the cutoff value of the KUSBS at admission to predict independent ambulatory walkers at discharge was 3.5 in ordinal ranking in all age groups. The KUSBS is a reliable and effective tool for measuring balance in patients in inpatient rehabilitation.
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Affiliation(s)
- Asall Kim
- Seoul National University Bundang Hospital, Seongnam-si and
| | - Younji Kim
- School of Medicine, Ewha Woman's University Seoul Hospital, Seoul, Republic of Korea
| | - Myungki Ji
- Seoul National University Bundang Hospital, Seongnam-si and
| | - Jae-Young Lim
- Seoul National University Bundang Hospital, Seongnam-si and
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Balance and Fall Risk Assessment in Community-Dwelling Older Adults after Recovery from COVID-19: A Cross-Sectional Study. Sports (Basel) 2023; 11:sports11020028. [PMID: 36828313 PMCID: PMC9967781 DOI: 10.3390/sports11020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/02/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND SARS-CoV-2 atypical symptoms in older persons include falls, confusion, dizziness, and unusual weariness. Falls and their consequences are among the most prevalent causes of disability among older adults, significantly lowering quality of life and resulting in the loss of independence as well as impaired psychosocial functioning. The study purpose was to examine the impact of the SARS-CoV-2 infectious disease on balance in community-dwelling older adults. METHODS Sixty-four older adults aged ≥ 60 years from both sexes, 31 treated for SARS-CoV-2 infection and 33 matched normal controls participated in the study. The Biodex Stability System (BSS) and Berg Balance Scale (BBS) were used for evaluation of balance and fall risk. The correlation between the Biodex overall stability index and the Berg Balance Scale score was investigated. RESULTS When compared to controls, the SARS-CoV-2 group had significantly higher values of the Biodex overall stability index (OSI) (p = 0.011), anterior-posterior stability index (APSI) (p = 0.013), mediolateral stability index (MLSI) (p = 0.018), and fall risk index (FRI) (p = 0.008), as well as statistically lower scores on the Berg balance scale (p = 0.003). A moderate negative correlation was found between the two assessment tools in the SARS-CoV-2 group. CONCLUSION Balance impairment and an increased risk of falling are among the outcomes of SARS-CoV-2 in community-dwelling older adults.
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Lee K, Lee D, Hong S, Shin D, Jeong S, Shin H, Choi W, An S, Lee G. The relationship between sitting balance, trunk control and mobility with predictive for current mobility level in survivors of sub-acute stroke. PLoS One 2021; 16:e0251977. [PMID: 34351943 PMCID: PMC8341576 DOI: 10.1371/journal.pone.0251977] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 05/07/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the relationship between sitting balance, trunk control, and mobility, as well as whether the sitting balance and trunk control can predict mobility level in sub-acute stroke survivors. Methods This is a observational and cross-sectional study. Fifty-five hemiplegic stroke survivors were participated in this study. The Timed Up and Go Test (TUG) was used to estimate mobility, and the Sitting Balance Scale (SBS) was used to examining sitting balance. The Trunk Impairment Scale (TIS), Trunk Control Test (TCT), and Postural Assessment Scale for Stroke-trunk control (PASS-TC) were used for examining the trunk control. Spearman’s correlation was used to analyze the relationship between TUG, SBS, TIS, TCT, and PASS-TC. Results The TUG is significantly correlated with SBS (r = -0.78), TIS (r = -0.76), TCT (r = -0.65), and PASS-TC (r = -0.67). In addition, the receiver operation characteristic (ROC) curve showed as cut-off value of SBS as >28.5, TIS > 16.5, TCT >82, and PASS-TC >10.5. The area under the ROC curve in each of the four tests is moderately accurate for predicting the mobility of sub-acute stroke survivors (0.84 ~0.90) (0.7 < AUC ≤ 9 (moderate informative)). Implications The SBS showed the highest correlation for mobility using TUG in the hemiplegic stroke survivors. Also, SBS was revealed as the most dominant examination tool predicting the mobility by TUG, it can be explained the sitting postural balance is the variable predicting the mobility in survivors of sub-acute stroke.
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Affiliation(s)
- Kyeongbong Lee
- Department of Physical Therapy, Kangwon National University, Samcheok, Republic of Korea
| | - DongGeon Lee
- Department of Physical Therapy, Sinsegye Nursing Care Facility, Changwon, Republic of Korea
| | - SoungKyun Hong
- Department of Physical Therapy, Woosuk University, Wanju, Republic of Korea
| | - DooChul Shin
- Department of Physical Therapy, Kyungnam University, Changwon, Republic of Korea
| | - SeYeon Jeong
- Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, Republic of Korea
| | - HyeonHui Shin
- Department of Occupational Therapy, Dongseo University, Busan, Republic of Korea
| | - Wonjae Choi
- Department of Physical Therapy, Joongbu University, Geumsan, Republic of Korea
| | - SeungHeon An
- Department of Physical Therapy, National Rehabilitation Center, Seoul, Republic of Korea
| | - GyuChang Lee
- Department of Physical Therapy, Kyungnam University, Changwon, Republic of Korea
- * E-mail:
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Lee HH, Lee JW, Kim BR, Jung HJ, Choi DH, Lee J. Predicting independence of gait by assessing sitting balance through sitting posturography in patients with subacute hemiplegic stroke. Top Stroke Rehabil 2020; 28:258-267. [PMID: 32783510 DOI: 10.1080/10749357.2020.1806437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Post-stroke sitting balance is a known predictor of independence of gait after stroke. However, previous studies used only qualitative scales or measured static or dynamic sitting balance alone. OBJECTIVES To investigate whether quantitative parameters of sitting posturography at post-stroke 1 month can predict independent gait. METHODS In this prospective cohort study, we enrolled patients with first-ever stroke who could hold a sitting posture at post-stroke 1 month. Sitting balance was assessed using posturography at post-stroke 1 month. Independence of gait was assessed using functional ambulation categories at post-stroke 2 months. We predicted mobility independence at post-stroke 2 months according to sitting balance at post-stroke 1 month. We also assessed the correlation between sitting posturography parameters and clinical scales. RESULTS We enrolled 27 patients. The limit of stability deviation predicted independent gait at post stroke 2 months (cutoff, 78.4%). Further, there was a high degree of correlation between sitting posturography parameters (weight-bearing distribution deviation and limit of stability deviation) and Berg Balance Scale (ρ = 0.763, ρ = 0.777; p < .001, respectively), Scale for Assessment and Rating of Ataxia (ρ = -0.853, ρ = -0.929; p < .001, respectively), and Fugl-Meyer Assessment scale (upper extremities: ρ = 0.520, ρ = 0.480 [p = .005, p = .011, respectively]; lower extremities: ρ = 0.744, ρ = 0.564 [p < .001, p = .002, respectively]) scores. CONCLUSIONS Sitting posturography parameters is clinically useful because they can quantitatively assess post-stroke balance and neurological impairment and predict post-stroke independence of gait even when patients cannot reach their arms forward or stand upright.
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Affiliation(s)
- Hyun Haeng Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Jong Won Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Bo-Ram Kim
- Department of Rehabilitation Medicine, Gyeongin Rehabilitation Center Hospital, Incheon, Korea
| | - Ho Joong Jung
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Dong-Hee Choi
- Center for Neuroscience Research, Institute of Biomedical Science & Technology, Konkuk University, Seoul, Korea
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.,Center for Neuroscience Research, Institute of Biomedical Science & Technology, Konkuk University, Seoul, Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
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Studying the correlation between balance assessment by Biodex Stability System and Berg Scale in stroke individuals. J Bodyw Mov Ther 2019; 23:850-854. [DOI: 10.1016/j.jbmt.2019.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/05/2019] [Accepted: 04/30/2019] [Indexed: 11/22/2022]
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The Effect of Early Progressive Resistive Exercise Therapy on Balance Control of Patients With Total Knee Arthroplasty. TOPICS IN GERIATRIC REHABILITATION 2017. [DOI: 10.1097/tgr.0000000000000165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Jang HY, Kim YL, Lee SM. Perception and use of balance measures for stroke patients among physical therapists in South Korea. J Phys Ther Sci 2017; 29:255-260. [PMID: 28265152 PMCID: PMC5332983 DOI: 10.1589/jpts.29.255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/04/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study looked into physical therapists’ perception and use
of balance measures for stroke patients. [Subjects and Methods] Three hundred eighty two
physical therapists who understood the purpose of this study, agreed on their
participation in this study, were treating or treated stroke patients. A Cross-sectional
study based on self-administered questionnaire that had a total of 41 questions was
performed in South Korea. 382 questionnaires were used for analysis. [Results] Regarding
the questions about their perception and of personal measures, 287 persons
(75.1%) replied that Single Leg Stance test was the most useful.
According to the data analysis on their use of balance measures, Single Leg Stance Test
was used by 254 persons (66.5%, the highest percentage), Functional Reach
Test by 199 (52.1%). Also, stepwise multiple regression analysis was
conducted. As a result, the most influential factor was physical therapists’ perception of
personal measures, and their use was also influenced by their comprehensive perception of
measurement and their perception of balance factors. [Conclusion] This study revealed
physical therapists’ perception and use of balance measures for stroke patients and showed
that their perception of balance measures for stroke patients affected their use of
personal measures.
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Affiliation(s)
- Ho Young Jang
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - You Lim Kim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Suk Min Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
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Birnbaum M, Hill K, Kinsella R, Black S, Clark R, Brock K. Comprehensive clinical sitting balance measures for individuals following stroke: a systematic review on the methodological quality. Disabil Rehabil 2016; 40:616-630. [PMID: 28029054 DOI: 10.1080/09638288.2016.1261947] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this systematic review was to examine the psychometric properties of published clinical sitting measurement scales containing dynamic tasks in individuals following stroke. METHOD Databases, including Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, EMBASE, Cochrane, PubMed and Allied and Complementary Medicine Database (AMED) were searched from inception to December 2015. The search strategy included terms relating to sitting, balance and postural control. Two reviewers independently selected and extracted data from the identified articles and assessed the methodological quality of the papers using the COnsensus-based Standards for selection of health status Measurement INstruments (COSMIN) checklist. RESULTS Fourteen clinical sitting measurement scales (39 papers) containing dynamic tasks met the inclusion criteria and various measurement properties were evaluated. The methodological quality of the majority of the included studies was rated as poor to fair using the COSMIN checklist, with common limitations including small sample size and inappropriate use of statistical methods. CONCLUSIONS This review was unable to identify measures with sufficient psychometric properties to enable recommendation as preferred tools. However, measures were identified that warrant further specific psychometric investigations to fulfil requirements for a high quality measure. Implications for Rehabilitation Fourteen clinical sitting balance scales containing dynamic tasks are available to measure sitting balance with individuals following stroke. No single scale has sufficient psychometric properties to enable recommendation as a preferred tool for measuring sitting balance with stroke survivors. Use of a balance scale or dedicated sitting balance measure containing static and dynamic sitting items should be utilised to monitor progress for individuals following stroke with more severe deficits.
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Affiliation(s)
- Melissa Birnbaum
- a Physiotherapy Department , St. Vincent's Hospital Melbourne , Melbourne , Victoria , Australia.,b School of Physiotherapy and Exercise Science , Curtin University , Perth , Western Australia , Australia
| | - Keith Hill
- b School of Physiotherapy and Exercise Science , Curtin University , Perth , Western Australia , Australia
| | - Rita Kinsella
- a Physiotherapy Department , St. Vincent's Hospital Melbourne , Melbourne , Victoria , Australia
| | - Susan Black
- a Physiotherapy Department , St. Vincent's Hospital Melbourne , Melbourne , Victoria , Australia
| | - Ross Clark
- c Faculty of Science, Health, Education and Engineering , University of the Sunshine Coast , Sunshine Coast , Queensland , Australia
| | - Kim Brock
- a Physiotherapy Department , St. Vincent's Hospital Melbourne , Melbourne , Victoria , Australia
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Telenius EW, Engedal K, Bergland A. Inter-rater reliability of the Berg Balance Scale, 30 s chair stand test and 6 m walking test, and construct validity of the Berg Balance Scale in nursing home residents with mild-to-moderate dementia. BMJ Open 2015; 5:e008321. [PMID: 26346874 PMCID: PMC4563250 DOI: 10.1136/bmjopen-2015-008321] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE When testing physical function, patients must be alert and have the capacity to understand and respond to instructions. Patients with dementia may have difficulties fulfilling these requirements and, therefore, the reliability of the measures may be compromised. We aimed to assess the inter-rater reliability between pairs of observers independently rating the participant in the Berg Balance Scale (BBS), 30 s chair stand test (CST) and 6 m walking test. We also wanted to investigate the internal consistency of the BBS. DESIGN Cross-sectional study. SETTING We included 33 nursing home patients with a mild-to-moderate degree of dementia and tested them once with two evaluators present. One evaluator gave instructions and both evaluators scored the patients' performance. Weighted κ, intraclass correlation coefficient (ICC) model 2.1 with 95% CIs and minimal detectable change (MDC) were used to measure inter-rater reliability. Cronbach's α was calculated to evaluate the internal consistency of the BBS sum score. RESULTS The mean values of the BBS scored by the two evaluators were 38±13.7 and 38.0±13.8, respectively. Weighted κ scores for the BBS items varied from 0.83 to 1.0. ICC for the BBS's sum score was 0.99, and the MDC was 2.7% and 7%, respectively. The Cronbach's α of the BBS's sum score was 0.9. The ICC of the CST and 6 m walking test was 1 and 0.97, respectively. The MDC on the 6 m walking test was 0.08% and 15.2%, respectively. CONCLUSIONS The results reveal an excellent relative inter-rater reliability of the BBS, CST and 6 m walking test as well as high internal consistency for the BBS in a population of nursing home residents with mild-to-moderate dementia. The absolute reliability was 2.7 on the BBS and 0.08 on the 6 m walking test.
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Affiliation(s)
- Elisabeth Wiken Telenius
- Faculty of Health Sciences, Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Knut Engedal
- Department of Psychiatry, Norwegian Centre of Aging and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Astrid Bergland
- Faculty of Health Sciences, Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Winser SJ, Smith CM, Hale LA, Claydon LS, Whitney SL, Mehta P. Systematic review of the psychometric properties of balance measures for cerebellar ataxia. Clin Rehabil 2014; 29:69-79. [PMID: 24917589 DOI: 10.1177/0269215514536412] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To review systematically the psychometric properties of balance measures for use in people with cerebellar ataxia. DATA SOURCES Medline, AMED, CINAHL, Web of Science and EMBASE were searched between 1946 and April 2014. REVIEW METHODS Two reviewers independently searched data sources. Cerebellar-specific and generic measures of balance were considered. Included studies tested psychometric properties of balance measures in people with cerebellar ataxia of any cause. Quality of reported studies was rated using the Consensus Based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. RESULTS Twenty-one articles across which 16 measures had been tested were included for review. Using the COSMIN, quality of methodology in studies investigating psychometric properties of generic balance measures (n=10) was rated predominantly as 'poor'. Furthermore, responsiveness has not been tested for any generic measures in this population. The quality of studies investigating psychometric properties of balance sub-components of the cerebellar-specific measures (n=6) ranged from 'poor' to 'excellent'; however, Minimally Clinically Important Difference has not been determined for these cerebellar-specific measures. CONCLUSION The Posture and Gait (PG) sub-component of the International Cooperative Ataxia Rating Scale (ICARS) demonstrates the most robust psychometric properties with acceptable clinical utility.
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Affiliation(s)
- Stanley J Winser
- Centre for Health, Activity and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - Catherine M Smith
- Centre for Health, Activity and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - Leigh A Hale
- Centre for Health, Activity and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - Leica S Claydon
- Department of Allied Health and Medicine, Anglia Ruskin University, Chelmsford, UK
| | - Susan L Whitney
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pennsylvania, USA Rehabilitation Research Chair at King Saud University, Riyadh, Saudi Arabia
| | - Poonam Mehta
- Centre for Health, Activity and Rehabilitation Research, University of Otago, Dunedin, New Zealand
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van Bloemendaal M, van de Water ATM, van de Port IGL. Walking tests for stroke survivors: a systematic review of their measurement properties. Disabil Rehabil 2012; 34:2207-21. [PMID: 22583082 DOI: 10.3109/09638288.2012.680649] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To provide an overview of walking tests including their measurement properties that have been used in stroke survivors. METHOD Electronic databases were searched using specific search strategies. Retrieved studies were selected by using specified inclusion criteria. A modified consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist was applied for methodological quality assessment of the included studies. A quality assessment for statistical outcomes was used to assess measurement properties of the walking tests. Tests that were included were categorized according to the framework of the international classification of functioning, disability and health (ICF). RESULTS Thirty-two studies, evaluating 23 walking tests, were included. The tests assessed walking using the outcome measures of walking speed, walking distance, functional ambulation and walking on different surfaces. The methodological design and statistical methods of most studies evaluating reliability and criterion validity were sufficient, and found the outcome measures to be reliable and valid. However, data on measurement error, minimal important difference and minimal important change were lacking and responsiveness was correctly evaluated in one study only. CONCLUSIONS Many walking tests have been clinimetrically evaluated in stroke survivors. Most walking tests were found to be reliable and valid.
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Balance assessment practices and use of standardized balance measures among Ontario physical therapists. Phys Ther 2011; 91:1583-91. [PMID: 21868613 PMCID: PMC3206229 DOI: 10.2522/ptj.20110063] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. OBJECTIVE The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. DESIGN This was a cross-sectional study. METHODS A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. RESULTS Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed "Up & Go" Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. LIMITATIONS The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. CONCLUSIONS Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall.
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Chaudhry H, Bukiet B, Ji Z, Findley T. Measurement of balance in computer posturography: Comparison of methods—A brief review. J Bodyw Mov Ther 2011; 15:82-91. [DOI: 10.1016/j.jbmt.2008.03.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 03/07/2008] [Accepted: 03/16/2008] [Indexed: 10/22/2022]
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Amusat N. Assessment of sitting balance of patients with stroke undergoing inpatient rehabilitation. Physiother Theory Pract 2009; 25:138-44. [DOI: 10.1080/09593980802686839] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Busse ME, Tyson SF. Functional balance and mobility tests in healthy participants: reliability, error and influencing factors. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2008; 12:242-50. [PMID: 17966109 DOI: 10.1002/pri.383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Knowledge of the measurement error and reliability of measurement tools is required to judge whether true changes in performance have occurred. How a patient's performance relates to that of a healthy individual, and which factors would influence performance, also need to be considered to assess whether a patient's performance is 'normal'. The aim of the present study was to assess within-session and test-retest reliability, and measurement error, of a hierarchical series of functional tests of balance and walking in healthy participants. Obtaining indicative data in a group of healthy participants was an additional aim. METHOD Forty healthy participants aged 20-60 years were recruited from staff and students of Cardiff University. The participants completed eight functional balance and mobility tests on two occasions on the same day. Intra-class correlation co-efficients (ICCs), assessed within-session, and test-retest reliability and measurement error were calculated from the mean squares error term of a repeated measures analysis of variance (ANOVA). The relationship to the overall mean score was calculated and linear regression investigated the factors influencing performance. RESULTS Within-session and test-retest reliability for each of the tests was moderate to high (ICCs = 0.88-0.98 and 0.77-0.94, respectively). The overall measurement error was 3% to 11% of the mean scores. Age was the most frequent factor influencing performance; level of activity and body mass index (BMI) did not influence performance on any of the tests. CONCLUSIONS Functional balance and mobility tests are reliable but are subject to random error up to 11% of the mean. The present study provides initial reference data for physiotherapists in clinical practice. It is important to begin to develop a database of a standard range of scores to give a context with which to judge more accurately the importance and relevance of clinical measurements from patients.
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Affiliation(s)
- M E Busse
- Physiotherapy Dept. School of Healthcare Studies, Ty Dewi Sant, Cardiff University, Heath Park, Cardiff, CF14 4XN
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Hale L, Bray A, Littmann A. Assessing the balance capabilities of people with profound intellectual disabilities who have experienced a fall. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2007; 51:260-8. [PMID: 17326807 DOI: 10.1111/j.1365-2788.2006.00873.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Although it is common for people with intellectual disability (ID) to fall, the reasons for this have not yet been identified. This pilot study aimed to explore the balance capabilities of a sample of adults with profound ID who had experienced a fall, in order to identify possible reasons for falling and to identify potential tests that could be used to quantify balance capabilities in this population group. METHODS The neuromuscular systems and balance capabilities of 20 adults with profound ID were comprehensively assessed with a battery of tests, including computerized posturography. RESULTS Of the 20 participants, 15 described themselves as frequent fallers, and 10 participants reported serious injuries as a result of falling. Formalized assessment of the neuromuscular and balance capabilities proved to be challenging, with many participants unable to comprehend what was required of them in the performance of a number of the tests. All participants were observed to have an abnormal pattern of walking. Nine participants completed posturography testing, the main finding of which was that low motor control composite scores indicated a slowing of motor responses to postural perturbations. Other potential risk factors identified were concurrent medical problems, medication, the context and environment of falling, movement impulsiveness and distractibility, and visual deficits. CONCLUSION The reason why people with ID frequently fall appears complex and multifactorial. Larger studies are required to verify the potential risk factors identified in this pilot study. Many of the standardized outcome measures commonly used in physiotherapy practice to quantify balance capabilities are not suitable for use in this population group, as participants found it difficult to comprehend what was required of them. Allowing the person to become familiarized with both the test and the tester may help to alleviate this problem. Videotaping and quantifying observations of strategies people use to perform common movements such as walking or turning maybe a more appropriate measurement tool of balance capabilities of people with ID than current standardized measures. This method would require rigorous development.
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Affiliation(s)
- L Hale
- School of Physiotherapy, University of Otago, Dunedin, New Zealand.
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