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Haleem F, Saeed A, Kundi M, Jalal A, Bilal M, Jalal M. Combined effects of strength and balance training versus aerobic training on balance, neuropathy symptoms and quality of life in patients with diabetic peripheral neuropathy. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2103. [PMID: 38887171 DOI: 10.1002/pri.2103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 02/10/2024] [Accepted: 05/28/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Diabetic peripheral neuropathy (DPN) occurs in >50% of diabetic patients and is a high risk-factor of balance problems and risk of falls. Impaired balance can lead to reduced function, which has a detrimental effect on patients' quality of life. Structured strength and balance training can result in sustained improvements in muscle strength, coordination, balance, functional status and quality of life. OBJECTIVE To determine the combined effects of strength and balance training versus aerobic training on balance, severity of symptoms of DPN, and quality of life in patients with DPN. METHODS This double blinded, two arm parallel design Randomized Clinical Trial. The study was conducted from March to December 2020 in the AIMS diabetic center Peshawar, Pakistan. Participants were selected through convenience sampling technique and randomly allocated into strength plus balance and aerobic training groups. Type 2 diabetic patients of both sexes, aged 40 to 80 years, with a Toronto neuropathy score ≥6 recruited, while patients with ulceration/infection of feet, medical/Surgical conditions, and non-ambulatory patients were excluded from this study. Intervention was applied 3 days a week for 8 weeks. The Toronto clinical neuropathy system was used to assess neuropathy severity, SF-36 to assess quality of life and the Berg balance scale was used for assessment of balance. Assessment was done at the baseline and after 8 weeks of intervention using SPSS. Version 22 was used for analysis. RESULTS The mean age of the participants was 60.80 ± 9.73. Between group analysis, which showed were statistically insignificant for neuropathy severity, balance and all domains of quality of life (p-value >0.05) except SF-36 General Health Perception Score, with Mean ± SD of 62.50 ± 7.54 in group A versus Mean ± SD of in group B 60.00 ± 15.98 (p-value = 0.05). Within group analysis showed statistically significant results for neuropathy severity, balance and all domains of quality of life (p-value<0.05). CONCLUSION This study concluded that there is a statistically significant effect of structured balance and strength training and aerobic training on severity of DPN, balance and quality of life. But there was no statistically significant difference in improvement between the two intervention groups.
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Affiliation(s)
| | - Aruba Saeed
- Department of Allied Health Sciences, City University of Science and Information Technology Peshawar, Peshawar, Pakistan
| | - Maryam Kundi
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University Islamabad, Islamabad, Pakistan
| | - Abdul Jalal
- Department of Physical Therapy, NCS University System Peshawar, Peshawar, Pakistan
| | - Muhammad Bilal
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University Islamabad, Islamabad, Pakistan
| | - Muhammad Jalal
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University Islamabad, Islamabad, Pakistan
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Caronni A, Picardi M, Scarano S, Malloggi C, Tropea P, Gilardone G, Aristidou E, Pintavalle G, Redaelli V, Antoniotti P, Corbo M. Pay attention: you can fall! The Mini-BESTest scale and the turning duration of the TUG test provide valid balance measures in neurological patients: a prospective study with falls as the balance criterion. Front Neurol 2023; 14:1228302. [PMID: 37745667 PMCID: PMC10516579 DOI: 10.3389/fneur.2023.1228302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
Background Balance, i.e., the ability not to fall, is often poor in neurological patients and this impairment increases their risk of falling. The Mini-Balance Evaluation System Test (Mini-BESTest), a rating scale, the Timed Up and Go (TUG) test, and gait measures are commonly used to quantify balance. This study assesses the criterion validity of these measures as balance measures. Methods The probability of being a faller within nine months was used as the balance criterion. The Mini-BESTest, TUG (instrumented with inertial sensors), and walking test were administered before and after inpatient rehabilitation. Multiple and LASSO logistic regressions were used for the analysis. The diagnostic accuracy of the model was assessed with the area under the curve (AUC) of the receiver operating characteristic curve. Mobility measure validity was compared with the Akaike Information Criterion (AIC). Results Two hundred and fourteen neurological patients (stroke, peripheral neuropathy, or parkinsonism) were recruited. In total, 82 patients fell at least once in the nine-month follow-up. The Mini-BESTest (AUC = 0.69; 95%CI: 0.62-0.76), the duration of the TUG turning phase (AUC = 0.69; 0.62-0.76), and other TUG measures were significant faller predictors in regression models. However, only the turning duration (AIC = 274.0) and Mini-BESTest (AIC = 276.1) substantially improved the prediction of a baseline model, which only included fall risk factors from the medical history (AIC = 281.7). The LASSO procedure selected gender, disease chronicity, urinary incontinence, the Mini-BESTest, and turning duration as optimal faller predictors. Conclusion The TUG turning duration and the Mini-BESTest predict the chance of being a faller. Their criterion validity as balance measures in neurological patients is substantial.
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Affiliation(s)
- Antonio Caronni
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Michela Picardi
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Stefano Scarano
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Chiara Malloggi
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milan, Italy
| | - Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Giulia Gilardone
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Evdoxia Aristidou
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | | | - Valentina Redaelli
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Paola Antoniotti
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
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Phyu SN, Wanpen S, Chatchawan U. Responsiveness of the Mini-Balance Evaluation System Test in Type 2 Diabetic Patients with Peripheral Neuropathy. J Multidiscip Healthc 2022; 15:3015-3028. [PMID: 36601428 PMCID: PMC9807068 DOI: 10.2147/jmdh.s392058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/16/2022] [Indexed: 12/30/2022] Open
Abstract
Background Mini-BESTest is an instrument for assessing the balance impairment; however, the use of the Mini-BESTest in type 2 diabetic patients with peripheral neuropathy is not well documented in the literature. The aim of this study was to examine the responsiveness and the minimal important change (MIC) of the Mini-BESTest after four weeks of the balance exercises. Methods A prospective single group pretest-posttest design was applied, and forty-eight type 2 diabetic patients with peripheral neuropathy were participated (mean age of 59.04 ± 7.533 years; 3 males and 45 females). All participants were given an intervention program including foot care and balance exercises (50-minute sessions, three times a week for four weeks). The responsiveness of the Mini-BESTest was determined using two approaches: 1) the distribution-based method evaluating the change scores (pre- and post-intervention), the effect size (ES), the standard response mean (SRM), the standard error of measurement (SEM) and the minimum detectable change (MDC95) and 2) the anchor-based method evaluating the MIC using the Global Rating of Change scale (GRC) as an external criterion. Results After the balance exercises treatment, the Mini-BESTest scores significantly improved (p < 0.001) with an ES of 3.9 and SRM of 4.32. SEM was 0.73 and MDC95 was 2.03 points. The area under the receiver operating characteristic (ROC) curve corresponded to 81%. The cutoff point of the Mini-BESTest was ≥5 points corresponding to the GRC ≤3 versus >3 for the discrimination of the Mini-BESTest between improvement and no improvement after exercises. Conclusion The Mini-BESTest can be demonstrated as high responsiveness according to the determination of the distribution-based and the anchor-based methods. The MIC of the Mini-BESTest was taken as ≥5 points and could be used as an outcome measure for the discriminated evaluation of type 2 diabetic patients with peripheral neuropathy.
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Affiliation(s)
- Sitt Nyein Phyu
- Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medicine Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Sawitri Wanpen
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Uraiwan Chatchawan
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medicine Sciences, Khon Kaen University, Khon Kaen, Thailand,School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,Correspondence: Uraiwan Chatchawan, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Muang, Khon Kaen, Thailand, Tel/Fax +6643202085, Email
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Reliability and Validity of Mini-Balance Evaluation System Test in Type 2 Diabetic Patients with Peripheral Neuropathy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116944. [PMID: 35682526 PMCID: PMC9180405 DOI: 10.3390/ijerph19116944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 01/27/2023]
Abstract
Type 2 diabetic peripheral neuropathy is known to cause balance limitations in static, dynamic, and functional activity. The Mini-BESTest, a shortened version of BESTest, was evolved to identify balance disorders within a short duration. No prior studies have yet been conducted to assess the usefulness of Mini-BESTest in the diagnosis of type 2 diabetic peripheral neuropathy. The current study aimed to examine the reliability and discriminant validity by comparing the Mini-BESTest scores between type 2 diabetic patients with peripheral neuropathy, divided into two 2 groups based on reporting scores of <4 and ≥4 in the MNSI questionnaire, respectively. Therefore, a cross-sectional study design was conducted including 44 type 2 diabetic patients (4 males and 40 females; aged 56.61 ± 7.7 years old). Diabetic peripheral neuropathy was diagnosed by physical assessment using the Michigan Neuropathy Screening Instrument (MNSI). Inter-rater (two physiotherapists) and Intra-rater (7−10 days) reliability of the Mini-BESTest were explored with intraclass correlation coefficients (ICC2,1) and (ICC3,1). The Mini-BESTest presented an excellent inter-rater reliability (ICC2,1= 0.95, 95% CI = 0.91−0.97, SEM = 0.61) and an excellent intra-rater reliability (ICC3,1 = 0.93, 95% CI = 0.87−0.96, SEM = 0.66), with confirmation by a good agreement presented by the Bland−Altman plots. The internal consistency measured with the overall Cronbach’s alpha showed an acceptable agreement (0.73). The MDC was 2.16. In addition, the Mini-BESTest scores in the type 2 diabetic neuropathy patients reporting MNSI questionnaire scores <4 was found to be significantly higher when compared with those reporting scores ≥4. The Mini-BESTest can be used as a highly reliable and valid clinical application in the population with type 2 diabetic peripheral neuropathy.
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Miyata K, Hasegawa S, Iwamoto H, Shinohara T, Usuda S. Section of the Balance Evaluation Systems Test (BESTest) Cutoff Values for Walking Speed Level in Older Women With Hip Fracture. J Geriatr Phys Ther 2021; 44:153-158. [PMID: 32049752 DOI: 10.1519/jpt.0000000000000261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE Hip fracture is a common injury in older adults, with a high proportion of hip fractures affecting women. After a hip fracture, the recovery of the patient's walking speed is very important; one of the key determinants of walking speed is balance. The Balance Evaluation Systems Test (BESTest), a clinical balance measure, categorizes balance into 6 postural control systems. However, the relationship between the walking speed level and the sections of the BESTest has not been explored for older women with hip fracture. Our objective was to establish section scores for the BESTest cutoff values for walking speed in older women with hip fracture. METHODS This was an observational study involving 46 older women 65 years or older with hip fracture. The BESTest was administered to all participants upon their discharge from the hospital. Participants were divided into groups on the basis of their walking speed levels, and receiver operating characteristic curves were determined for each section of the BESTest. We calculated the cutoff value, area under the curve (AUC), sensitivity, and specificity of each. RESULTS Section IV-Stability in Gait showed the highest AUC (0.92) compared with the other sections, and the cutoff value determined for the fast and slow walker groups was 64.3% (sensitivity = 0.82, specificity = 0.83). The sections with moderate AUC (0.7-0.9) were I-Biomechanical Constraints (cutoff = 70.0%), III-Anticipatory Postural Adjustments (cutoff = 66.5%), IV-Postural Responses (cutoff = 69.4%), and V-Sensory Orientation (cutoff = 83.4%). The sections with the highest sensitivity (0.82) were I-Biomechanical Constraints and VI-Stability in Gait, and that with the highest specificity (0.88) was II-Stability Limits and Verticality. CONCLUSIONS Five of the BESTest sections (I-Biomechanical Constraints, III-Anticipatory Postural Adjustments, IV-Postural Responses, V-Sensory Orientation, and IV-Stability in Gait) were able to differentiate between fast and slow walkers among older women with hip fracture. Balance during gait and anticipatory postural adjustments were shown to be important components of balance, and their cutoff values were indicators of the balance required to reach fast walking levels.
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Affiliation(s)
- Kazuhiro Miyata
- Department of Physical Therapy, Ibaraki Prefectural University of Health Science, Japan
| | - Satoshi Hasegawa
- Department of Rehabilitation, Public Nanokaichi Hospital, and Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Japan
| | - Hiroki Iwamoto
- Department of Rehabilitation Centre, Hidaka Rehabilitation Hospital, Japan
| | - Tomoyuki Shinohara
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Japan
| | - Shigeru Usuda
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Japan
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Lo CWT, Lin CY, Tsang WWN, Yan CH, Wong AYL. Psychometric Properties of Brief-Balance Evaluation Systems Test Among Multiple Populations: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2021; 103:155-175.e2. [PMID: 34015349 DOI: 10.1016/j.apmr.2021.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To synthesize evidence regarding the psychometric properties of the Brief-Balance Evaluation Systems Test (BESTest) in assessing postural controls across various populations. DATA SOURCES Articles were searched in 9 databases from inception to March 2020. STUDY SELECTION Two reviewers independently screened titles, abstracts, and full-text articles to include studies that reported at least 1 psychometric property of the Brief-BESTest. There were no language restrictions. DATA EXTRACTION The 2 independent reviewers extracted data (including psychometric properties of Brief-BESTest) from the included studies. The methodological quality of the included studies was appraised by the Consensus-based Standards for the Selection of Health Status Measurement Instruments checklist, and the quality of statistical outcomes was assessed by the Terwee et al method. A best-evidence synthesis for each measurement property of the Brief-BESTest in each population was conducted. DATA SYNTHESIS Twenty-four studies encompassing 13 populations were included. There was moderate to strong positive evidence to support the internal consistency (Cronbach α>0.82), criterion validity (ρ≥0.73, r≥0.71), and construct validity (ρ≥0.66, r≥0.50, area under curve>0.72) of the Brief-BESTest in different populations. Moderate to strong positive evidence supported the responsiveness of the Brief-BESTest in detecting changes in postural controls of patients 4 weeks after total knee arthroplasty or patients with subacute stroke after 4-week rehabilitation. However, there was strong negative evidence for the structural validity of this scale in patients with various neurologic conditions. The evidence for the reliability of individual items and measurement errors remains unknown. CONCLUSIONS The Brief-BESTest is a valid (criterion- and construct-related) tool to assess postural control in multiple populations. However, further studies on the reliability of individual items and minimal clinically important difference of the Brief-BESTest are warranted before recommending it as an alternative to the BESTest and Mini-BESTest in clinical research/practice.
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Affiliation(s)
- Cathy W T Lo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - William W N Tsang
- Department of Physiotherapy, School of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong SAR, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
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Wearable Focal Muscle Vibration on Pain, Balance, Mobility, and Sensation in Individuals with Diabetic Peripheral Neuropathy: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052415. [PMID: 33801216 PMCID: PMC7967773 DOI: 10.3390/ijerph18052415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 01/15/2023]
Abstract
People with diabetic peripheral neuropathy (DPN) experience a lower quality of life caused by associated pain, loss of sensation and mobility impairment. Current standard care for DPN is limited and lacking. This study explores the benefits of 4-week, in-home wearable focal muscle vibration (FMV) therapy on pain, balance, mobility, and sensation in people with DPN. Participants were randomized into three groups and received different FMV intensities. FMV was applied using a modified MyovoltTM wearable device to the tibialis anterior, distal quadriceps, and gastrocnemius/soleus muscles on both lower limbs for three days a week over four weeks. The outcomes included pain, balance, mobility, sensation, device usage log, feedback survey, and a semi-structured interview. In all, 23 participants completed the study. The results showed significant improvement in average pain (Pre: 4.00 ± 2.29; Post: 3.18 ± 2.26; p = 0.007), pain interference with walking ability (Pre: 4.14 ± 3.20; Post: 3.09 ± 1.976; p = 0.03), and standard and cognitive Timed Up-and-Go scores (Pre: 13.75 ± 5.34; Post: 12.65 ± 5.25; p = 0.04; Pre: 15.12 ± 6.60; Post: 12.71 ± 5.57; p = 0.003, respectively); the overall pain improvement was trending towards significance (Pre: 3.48 ± 2.56; Post: 2.87 ± 1.85; p = 0.051). Balance and sensations improved but not significantly. There was a trend towards significance (p = 0.088), correlation (r = 0.382) between changes in balance and baseline pain. The participants were highly satisfied with wearable FMV and were 100% compliant. FMV therapy was associated with improved pain, mobility, and sensation. Further study with a larger sample and better outcome measures are warranted.
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Aydoğan Arslan S, Demirci CS, Katirci Kirmaci Zİ, Uğurlu K, Keskin ED. Reliability and Validity of Turkish Version of The Brief-BESTest in Stroke Patients. Top Stroke Rehabil 2020; 28:488-497. [PMID: 33148123 DOI: 10.1080/10749357.2020.1841424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The Brief-BESTest is the short version of the BESTest used to evaluate balance and fall risk in a multiple disease populations. The clinicians need practical, short application scales to evaluate the risk of falling, balance and rehabilitation results. OBJECTIVE This study aims to investigate the validity and reliability of the Turkish version of the Brief-BESTest (Brief-BESTest-T) in stroke patients. METHODS This study included a total of 40 subacute and chronic stroke patients (mean age of 60.28 ± 9.96 years). The Brief-BESTest, Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Functional Reach Test (FRT), Falls Efficacy Scale (FES) and 10 m walking test were applied to the patients. RESULTS A strong correlation was observed between the1st and 2nd evaluation Brief-BESTest-T total scores (r = 0.933). Cronbach's alpha coefficient was excellent. According to the correlation analysis performed to test the inter-rater reliability, a very high correlation (r = 0.906) was observed between the Brief-BESTest-T total scores. A high correlation was found between the Brief-BESTest-T and BBS and TUG, while a moderate correlation was found between the FRT, FES, and 10 m walking test. The clinical cut-off point for the Brief-BESTest - T was determined to be 9 points with an AUC of 0.872. There were no floor and ceiling effects found. CONCLUSIONS This study showed that the Brief-BESTest-T had excellent internal consistency, intra-rater, and inter-rater reliability. Its concurrent, discriminant, and known-groups validity were also good and had no substantial floor and ceiling effects.
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Affiliation(s)
- Saniye Aydoğan Arslan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kırıkkale University, Kırıkkale, Turkey
| | - Cevher Savcun Demirci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey
| | - Zekiye İpek Katirci Kirmaci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, SANKO University, Gaziantep, Turkey
| | - Kübra Uğurlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kırıkkale University, Kırıkkale, Turkey
| | - Esra Dilek Keskin
- Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, Kırıkkale University, Kırıkkale, Turkey
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Álvarez-Barbosa F, Del Pozo-Cruz J, Sañudo B, Alfonso-Rosa RM. Is the Wii balance board a valid and reliable instrument to assess postural stability in older adults with type 2 diabetes mellitus? Diabetes Res Clin Pract 2020; 166:108313. [PMID: 32653505 DOI: 10.1016/j.diabres.2020.108313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/17/2020] [Accepted: 07/07/2020] [Indexed: 01/27/2023]
Abstract
AIMS Evaluate the validity and reliability of the data from the Wii balance board (WBB), against a force platform (FP) in patients with type 2 diabetes mellitus (T2DM). METHODS Forty-three adults with T2DM (age 62.1 ± 12.1 yrs) in the validity trial and 27 (age 63.5 ± 10.8 yrs) in the reliability study, were tested. Total COP area (mm) and range of antero-posterior (AP) and medio-lateral (ML) COP excursion were collected simultaneously on a FP and a WBB. RESULTS Mean CoP sway path values were similar in all conditions in the FP when compared with the WBB. Regression model shows that WBB is able to explain most of the variation in CoP sway path data of the FP (between 42 and 72%) for all testing conditions, indicating that the WBB has good concurrent validity. Test-retest reliability for WBB was excellent, except for the COP sway area in the 'eyes open' condition (ICC = 0.55). Both conditions showed modest to excellent reliability in the AP (0.73-0.90) and the ML (0.77-0.91) directions. CONCLUSION The WBB has been shown to be a valid and reliable method to quantify the COP displacement during different balance tests in older adults with T2DM.
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Affiliation(s)
| | - Jesús Del Pozo-Cruz
- Department of Physical Education and Sport, University of Seville, Seville, Spain.
| | - Borja Sañudo
- Department of Physical Education and Sport, University of Seville, Seville, Spain.
| | - Rosa M Alfonso-Rosa
- Departamento Motricidad Humana y Rendimiento Deportivo, Universidad de Sevilla, Sevilla, Spain.
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Castellini G, Gianola S, Stucovitz E, Tramacere I, Banfi G, Moja L. Diagnostic test accuracy of an automated device as a screening tool for fall risk assessment in community-residing elderly: A STARD compliant study. Medicine (Baltimore) 2019; 98:e17105. [PMID: 31574809 PMCID: PMC6775395 DOI: 10.1097/md.0000000000017105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/14/2019] [Accepted: 08/16/2019] [Indexed: 12/04/2022] Open
Abstract
We aimed to determine the accuracy and failure of OAK device, an automated screening, for the assessment of fall risk in a prospective cohort of healthy adults aged over 65 years. The algorithm for fall risk assessment of the centers for disease control and prevention (CDC) was used as reference standard. Of the 183 individuals recruited, the CDC algorithm classified 80 as being at moderate/high risk and 103 at low risk of falling. OAK device failure incidence was 4.9% (confidence interval [CI] upper limit 7.7%), below the preset threshold for futility-early termination of the study (i.e., not above 15%). The OAK device showed a sensitivity of 84% and a specificity of 67% (receiver operating characteristic [ROC] area 82%; 95% confidence interval [CI] 76-88%), not reaching the preplanned target sensitivity (not lower than 85%). Diagnostic accuracy was not far from the sensitivity levels similar to those obtained with other fall risk assessment. However, some limitations can be considered.ClinicalTrials.gov identifier: NCT02655796.
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Affiliation(s)
- Greta Castellini
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology
| | - Silvia Gianola
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology
| | - Elena Stucovitz
- IRCCS Istituto Ortopedico Galeazzi, Motion Analysis Laboratory
| | - Irene Tramacere
- Scientific Direction, Fondazione IRCCS, Istituto Neurologico Carlo Besta
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Scientific Directorate
- Vita-Salute San Raffaele University
| | - Lorenzo Moja
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Magnani PE, Genovez MB, Porto JM, Zanellato NFG, Alvarenga IC, Freire RC, de Abreu DCC. Use of the BESTest and the Mini-BESTest for Fall Risk Prediction in Community-Dwelling Older Adults Between 60 and 102 Years of Age. J Geriatr Phys Ther 2019; 43:179-184. [DOI: 10.1519/jpt.0000000000000236] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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12
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Miyata K, Kaizu Y, Usuda S. Prediction of falling risk after discharge in ambulatory stroke or history of fracture patients using Balance Evaluation Systems Test (BESTest). J Phys Ther Sci 2018; 30:514-519. [PMID: 29706697 PMCID: PMC5908993 DOI: 10.1589/jpts.30.514] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 01/09/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to clarify the relationships between falls and
sections of the Balance Evaluation Systems Test (BESTest) in patients with stroke or those
with a history of fracture. [Subjects and Methods] This longitudinal study included 51
self-ambulatory inpatients. Balance was assessed 1 week prior to discharge using the
BESTest, and the incidence of falls within 6 months after discharge was investigated.
Relationships between falling and balance components were analyzed using the
t-test or the Mann-Whitney U test and receiver operating characteristic
(ROC) curve analysis. [Results] Five subjects were dropped out before follow-up at 6
months. Falls were reported by 10 of the remaining 46 participants. Scores for two
sections (Anticipatory Postural Adjustments and Sensory Orientation) were significantly
lower in fallers than in non-fallers with stroke. Four of the six sections (Biomechanical
Constraints, Anticipatory Postural Adjustments, Sensory Orientation, and Stability in
Gait) showed areas under the ROC curves >0.8 (0.82, 0.83, 0.84, and 0.81,
respectively). In patients with a history of fractures, all sections were not
significantly different between fallers and non-fallers. [Conclusion] Anticipatory
Postural Adjustments and Sensory Orientation sections of the BESTest were related to
future occurrence of fall after discharge in self-ambulatory stroke patients.
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Affiliation(s)
- Kazuhiro Miyata
- Department of Physical Therapy, Ibaraki Prefectural University of Health Science: 4669-2 Ami-Machi, Inashiki-gun, Ibaraki 300-0394, Japan.,Graduate School of Health Sciences, Gunma University, Japan
| | - Yoichi Kaizu
- Department of Rehabilitation Center, Hidaka Hospital, Japan
| | - Shigeru Usuda
- Graduate School of Health Sciences, Gunma University, Japan
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Jácome C, Flores I, Martins F, Castro C, McPhee CC, Shepherd E, Demain S, Figueiredo D, Marques A. Validity, reliability and minimal detectable change of the balance evaluation systems test (BESTest), mini-BESTest and brief-BESTest in patients with end-stage renal disease. Disabil Rehabil 2017; 40:3171-3176. [DOI: 10.1080/09638288.2017.1375034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Cristina Jácome
- Lab 3R – Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Inês Flores
- School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Filipa Martins
- School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Conceição Castro
- CentroDial, Centro de Hemodiálise S.A, São João da Madeira, Portugal
| | | | - Ellen Shepherd
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Sara Demain
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Daniela Figueiredo
- School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Center for Health Technology and Services Research (Cintesis.UA), University of Aveiro, Aveiro, Portugal
| | - Alda Marques
- Lab 3R – Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Institute for Research in Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
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