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Abasıyanık Z, Kahraman T, Baba C, Sağıcı Ö, Ertekin Ö, Özakbaş S. Discriminative ability of the original and short form of the Activities-specific Balance Confidence scale and its individual items for falls in people with multiple sclerosis. Acta Neurol Belg 2024; 124:957-964. [PMID: 38483733 PMCID: PMC11139692 DOI: 10.1007/s13760-024-02515-y] [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: 09/25/2023] [Accepted: 02/23/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Balance confidence is an essential component of fall risk assessment in persons with multiple sclerosis (pwMS). AIMS The aims of this cross-sectional study were to 1) investigate the ability of the 16-item Activities-specific Balance Confidence scale (ABC-16), 6-item Activities-specific Balance Confidence scale (ABC-6), and each item of the ABC-16 for distinguishing fallers and 2) determine cutoff scores for these scales to discriminate fallers and non-fallers in pwMS. METHODS One hundred and fifty-six participants [fallers/non-fallers: 60 (38.5%)/96 (61.5%), median EDSS: 1.5] were enrolled. Balance confidence was assessed using the ABC-16 and ABC-6. The self-reported number of falls in the past three months was recorded. Descriptive assessments, including walking, balance, and cognition were performed. Logistic regression and receiver operating characteristic analyses were conducted to estimate the sensitivities and specificities of the ABC-16 and ABC-6. RESULTS Both the ABC-16 (AUC: 0.85) and ABC-6 (AUC: 0.84) had the discriminative ability for falls. Each item of the ABC-16 scale was a significantly related to falls [odds ratio (OR) range: 1.38 to 1.89]. Items 8 and 10 had the highest odds ratio (OR: 1.85; 95%CI: 1.47-2.33, OR: 1.89; 95%CI: 1.49-2.40; respectively). We found cutoff scores of ≤ 70 of 100 (sensitivity: 71.67, specificity: 86.46) and ≤ 65/100 (sensitivity: 76.67, specificity: 79.17) in discrimination between fallers and non-fallers for the ABC-16 and ABC-6, respectively. CONCLUSION Both original and short forms of the ABC scale are an efficient tool for discriminating fallers and non-fallers in pwMS. Although all items are related to falls, outdoor walking activities have the strongest associations with falls than other items.
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Affiliation(s)
- Zuhal Abasıyanık
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey.
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Cavid Baba
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Özge Sağıcı
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Özge Ertekin
- Department of Neurological Physiotherapy-Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Serkan Özakbaş
- Izmir University of Economics, Medical Point Hospital, Izmir, Turkey
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Barati M, Hansson EE, Taheri-Kharameh Z, Topolski TD. Translation, validity and reliability of the persian version of the rapid assessment of physical activity questionnaire. BMC Geriatr 2024; 24:452. [PMID: 38783168 PMCID: PMC11119009 DOI: 10.1186/s12877-024-05065-3] [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: 11/03/2023] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE The purpose of this study was to produce a valid and reliable Persian version of the Rapid Assessment of Physical Activity (RAPA) questionnaire, which previously has been shown to be valid and reliable for assessing physical activity among older adults. METHODS Permission was obtained from the scale developer, who provided a copy of the the Linguistic Validation of the RAPA Qestionnaire, which utilizes a forward-backward translation methodology. Content validity, face validity, and construct validity of the questionnaire were then determined. Comparison of known groups (older adults with more or less than 50% balance confidence) was used to assess construct validity and the Leiden-Padua (LEIPAD) quality of life questionnaire were used to assess convergent validity. Three hundred older adults, who were members of the Qom retirement centers, participated in the study. Thirty participants completed the RAPA twice with a one-week interval to determine test-retest reliability. RESULTS Results of comparisons of known groups showed that the mean RAPA score of the older people with greater balance confidence was significantly higher. Significant correlations between most of the scores obtained from both RAPA and the LEIPAD questionnaires confirmed the convergent validity of the questionnaire. Intraclass Correlation Coefficient (ICC) was as high as 0.94 showing that the test-retest reliability was good. CONCLUSION This study showed the Persian RAPA is a reliable and valid instrument for measuring physical activity among older individuals in both research and clinical contexts.
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Affiliation(s)
- Majid Barati
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, 6517838695, Iran
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | | | - Zahra Taheri-Kharameh
- Spiritual Health Research Center, School of religion and health, Qom University of Medical Sciences, Qom, Iran.
- Department of Public Health, School of Health, Qom University of Medical Sciences, Qom, Iran.
| | - Tari D Topolski
- Department of Health Services, University of Washington, Seattle, WC, 89101, Iran
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Mochizuki G, Dang N, Inness EL, Chandra T, Foster E, Comper P, Bayley MT, Danells C. Measurement Properties of the Activities-Specific Balance Confidence Scale in Adults From the General Population With Concussion: A Report From the Toronto Concussion Study. Arch Phys Med Rehabil 2024:S0003-9993(24)00991-2. [PMID: 38719165 DOI: 10.1016/j.apmr.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE The aim of this study was to establish the internal consistency and construct validity of the Activities-specific Balance Confidence (ABC) Scale and ABC-6 in adults from the general population with concussion. DESIGN Prospective analysis. SETTING Outpatient concussion care clinic. PARTICIPANTS Adults from the general population with concussion referred to a concussion care clinic within 7 days of injury (N=511). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Balance confidence was assessed with the Activities-specific Balance Confidence (ABC) Scale and the ABC-6. Concussion symptoms were characterized using the Sport Concussion Assessment Tool version 5 (SCAT5) symptom checklist. Instrumented measures of balance and gait included center of pressure velocity and double support time, respectively. Balance was also assessed using the mBESS. RESULTS The ABC and ABC-6 were strongly correlated (ρ=0.980, P<.001). Cronbach α for ABC and ABC-6 was 0.966 and 0.940, respectively. Factor analysis verified the existence of 2 components of the ABC, 1 including all items of the ABC-6 as well as 3 additional items. ABC and ABC-6 were moderately significantly correlated with SCAT5 symptom number, severity, and symptom domain (ρ=-0.350 to -0.604). However, correlations between ABC and ABC-6 with instrumented measures of balance and gait were not statistically significant, except for double support time during dual-task gait with ABC-6 (ρ=-0.218). CONCLUSIONS In community-dwelling adults with concussion, the ABC and ABC-6 have good internal consistency. Convergent validity is stronger for symptom endorsement measures within SCAT5 domains, which has a similar construct (subjectivity) to balance confidence. Both the ABC and ABC-6 are valid measures of balance self-efficacy in adults from the general population with concussion. The ABC-6 may be a useful tool for characterizing the effect of concussion on perceptions of the ability to perform functional tasks that challenge balance and mobility.
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Affiliation(s)
- George Mochizuki
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada; UHN-Toronto Rehabilitation Institute, Toronto, Canada.
| | - Norman Dang
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada
| | - Elizabeth L Inness
- UHN-Toronto Rehabilitation Institute, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - Evan Foster
- UHN-Toronto Rehabilitation Institute, Toronto, Canada
| | - Paul Comper
- UHN-Toronto Rehabilitation Institute, Toronto, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Mark T Bayley
- UHN-Toronto Rehabilitation Institute, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Cynthia Danells
- UHN-Toronto Rehabilitation Institute, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Castillejos-Carrasco-Muñoz R, Ibáñez-Vera AJ, Peinado-Rubia AB, Tapia-Toca MC, Paez-Mantilla D, Lomas-Vega R. Psychometric Properties of the Short Version of the Activities-Specific Balance Confidence Scale in Vestibular Patients. Otol Neurotol 2023; 44:e188-e193. [PMID: 36728312 DOI: 10.1097/mao.0000000000003807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND This study aimed to analyze the psychometric properties of the Activities-specific Balance Confidence Scale Short Version (ABC-6) in vestibular patients. METHODS The sample consisted of 87 subjects aged over 18 years with vestibular pathology. Construct validity, internal consistency, test-retest reliability, concurrent validity, and capacity to discriminate between subjects with or without risk of falling as measured with the ABC-16 standard version were analyzed. RESULTS The ABC-6 showed a unifactorial structure. Cronbach's alpha was 0.873. The reliability was moderate for each of the items and substantial for the total score (intraclass correlation coefficient = 0.778). The standard error of measurement was 10.24, with a minimum detectable change of 20.07. The ABC-6 version showed a strong correlation with physical and functional measures, moderate correlation with emotional measures, and poor correlation with the Physical Component Summary of SF-12 and retrospective 12-month falls. A cutoff point ≤55 showed a sensitivity = 94.44% and a specificity = 92.75% in differentiating between patients with or without risk of falling measured with the ABC-16 standard version, with an area under the curve = 0.975. CONCLUSIONS The ABC-6 showed acceptable psychometric properties for measuring balance confidence and risk of falling in vestibular patients.
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Rice LA, Peters J, Fliflet A, Sung J, Rice IM. The influence of shoulder pain and fear of falling on level and non-level transfer technique. J Spinal Cord Med 2022; 45:364-372. [PMID: 35007474 PMCID: PMC9135433 DOI: 10.1080/10790268.2021.1971922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Level and non-level transfers are essential tasks of daily living for wheelchair users. Minimal research has examined the role of shoulder pain and fear of falling on transfer quality. The purpose of this study is to (1) examine the association between shoulder pain, fear of falling (FoF) and transfer quality and (2) explore the feasibility of assessing non-level transfers to-and-from the floor. METHODS Cross-sectional design was used to explore shoulder pain, FoF, and transfer quality in 30 manual wheelchair users (aged 18-42; 15 males). Participant demographic information (age, sex, race, disability, and years using wheelchair), Spinal Cord Injury-Fall Concern Scale (SCI-FCS), and Wheelchair User Shoulder Pain Index (WUSPI) was collected. Three types of transfers: (1) level, (2) uphill, and (3) floor-to-table were graded by a trained researcher using the Transfer Assessment Instrument (TAI) 3.0. Kruskal-Wallis test was used to determine differences in transfer quality based on condition. Spearman correlation was used to determine associations between demographic data, WUSPI, SCI-FCS, and transfer quality scores. RESULTS All participants safely completed the uphill non-level transfer; 27 safely completed the floor-to-table non-level transfer. Statistical analysis revealed no difference in TAI score across transfer conditions. Spearman correlation revealed a significant correlation between WUSPI and SCI-FCS scores (r = .68, P = .01) and WUSPI and uphill TAI scores (r = -.45, P = .01). CONCLUSION Increases in shoulder pain are related to decreased uphill transfer quality and increased FoF. Non-level transfers to-and-from the floor are feasible within clinical or laboratory settings.
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Affiliation(s)
- Laura A. Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Joseph Peters
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Alex Fliflet
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - JongHun Sung
- Department of Human Performance and Sport Studies, College of Education, Idaho State University, Pocatello, Idaho, USA
| | - Ian M. Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Characterizing gaze and postural stability deficits in people with multiple sclerosis. Mult Scler Relat Disord 2021; 55:103205. [PMID: 34438218 DOI: 10.1016/j.msard.2021.103205] [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: 03/24/2021] [Revised: 07/28/2021] [Accepted: 08/06/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND People with Multiple Sclerosis (PwMS) experience a wide range of symptoms that can alter function and limit activity and community participation. Symptoms including sensory changes, weakness, fatigue and others have been well documented. However, symptoms related to changes in vestibular related function, including gaze and postural stability have not been fully explored. While some recent studies have begun to provide insight into these deficits in PwMS and have explored the use of rehabilitation paradigms for their management, much remains unknown about the full extent of these deficits. Therefore, this study aimed to characterize the presence of gaze and postural stability deficits in measures across the World Health Organization International Classification of Functioning, Disability, and Health (WHO ICF) and to examine how deficits in domains of body structure and function and activity contribute to participation level limitations. METHODS Baseline data from 41 PwMS (mean(SD) age = 53.9(11.2), 78% female) enrolled as part of a randomized clinical trial were used in this analysis. Measures of gaze and postural stability from the ICF domains of body structure and function (Vestibular ocular reflex [VOR] gain and postural sway area), activity (computerized dynamic visual acuity [cDVA] and MiniBEST test), and participation (Dizziness handicap inventory [DHI] and Activities Balance Confidence [ABC] scale) along with demographic data were used to characterize the sample. To explore relationships between ICF domains for gaze and postural stability, univariate correlations were performed between measures from each domain using Pearson's correlations. Separate multivariate regression models examined how measures from the body structure and function and activity domains contributed to the variance in the participation level outcomes. Variance explained by the models was quantified using R-squared statistic and contribution of the independent variables were quantified using the beta coefficient (p < 0.05). RESULTS Correlation analysis demonstrated significant relationships in the postural stability measures across domains. Specifically, between postural sway area on a firm surface and MiniBEST test score (r = -.48;p < 0.01) and MiniBEST test score and ABC score (r = 0.5;p < 0.01). Significant correlations were also found between the gaze stability measures of horizontal and vertical VOR gain (r = .68;p < 0.001), horizontal VOR gain and dynamic visual acuity (r = .38;p = 0.02), and vertical VOR gain and dynamic visual acuity (r = .54;p < 0.001). Regression models assessing postural stability, found that only the MiniBEST score significantly contributed to the variance in ABC score (p = 0.01) and the full model explained 34% of the variance in ABC score. Regression modeling of gaze stability outcomes did not produce any variable that significantly contributed to the variance in DHI score and the full model explained 18% of the variance in DHI score. CONCLUSIONS PwMS in this sample demonstrated deficits in gaze and postural stability across the domains of the WHO ICF compared to past samples of PwMS and healthy cohorts. Correlation between measures in the different domains were present, but no strong relationship between measures of body structure and function, activity and participation level outcomes were observed. This lack of relationship across the domains is likely contributed to the relatively small sample size, the high level of variability observed in the outcomes, and the diverse presentation often seen in PwMS.
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Hsieh K, Fanning J, Frechette M, Sosnoff J. Usability of a Fall Risk mHealth App for People With Multiple Sclerosis: Mixed Methods Study. JMIR Hum Factors 2021; 8:e25604. [PMID: 33749609 PMCID: PMC8080269 DOI: 10.2196/25604] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/20/2021] [Accepted: 02/22/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic, neurodegenerative disease that causes a range of motor, sensory, and cognitive symptoms. Due to these symptoms, people with MS are at a high risk for falls, fall-related injuries, and reductions in quality of life. There is no cure for MS, and managing symptoms and disease progression is important to maintain a high quality of life. Mobile health (mHealth) apps are commonly used by people with MS to help manage their health. However, there are limited health apps for people with MS designed to evaluate fall risk. A fall risk app can increase access to fall risk assessments and improve self-management. When designing mHealth apps, a user-centered approach is critical for improving use and adoption. OBJECTIVE The purpose of this study is to undergo a user-centered approach to test and refine the usability of the app through an iterative design process. METHODS The fall risk app Steady-MS is an extension of Steady, a fall risk app for older adults. Steady-MS consists of 2 components: a 25-item questionnaire about demographics and MS symptoms and 5 standing balance tasks. Data from the questionnaire and balance tasks were inputted into an algorithm to compute a fall risk score. Two iterations of semistructured interviews (n=5 participants per iteration) were performed to evaluate usability. People with MS used Steady-MS on a smartphone, thinking out loud. Interviews were recorded, transcribed, and developed into codes and themes. People with MS also completed the System Usability Scale. RESULTS A total of 3 themes were identified: intuitive navigation, efficiency of use, and perceived value. Overall, the participants found Steady-MS efficient to use and useful to learn their fall risk score. There were challenges related to cognitive overload during the balance tasks. Modifications were made, and after the second iteration, people with MS reported that the app was intuitive and efficient. Average System Usability Scale scores were 95.5 in both iterations, representing excellent usability. CONCLUSIONS Steady-MS is the first mHealth app for people with MS to assess their overall risk of falling and is usable by a subset of people with MS. People with MS found Steady-MS to be usable and useful for understanding their risk of falling. When developing future mHealth apps for people with MS, it is important to prevent cognitive overload through simple and clear instructions and present scores that are understood and interpreted correctly through visuals and text. These findings underscore the importance of user-centered design and provide a foundation for the future development of tools to assess and prevent scalable falls for people with MS. Future steps include understanding the validity of the fall risk algorithm and evaluating the clinical utility of the app.
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Affiliation(s)
- Katherine Hsieh
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Mikaela Frechette
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jacob Sosnoff
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Department of Physical Therapy and Rehabilitation Sciences, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
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Ishige S, Wakui S, Miyazawa Y, Naito H. Psychometric properties of a short version of the Activities-specific Balance Confidence scale-Japanese (Short ABC-J) in community-dwelling people with stroke. Physiother Theory Pract 2021; 38:1756-1769. [PMID: 33678113 DOI: 10.1080/09593985.2021.1888342] [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: 10/22/2022]
Abstract
Background and Purpose: The Activities-specific Balance Confidence (ABC) scale has been widely used as patient-reported outcome measures for community stroke rehabilitation and its short version is beginning to be used. This study aimed to assess the psychometric properties of the short version of the ABC scale-Japanese (Short ABC-J).Methods: Eighty-four participants with chronic stroke (mean age was 66.4 ± 9.7 years, mean time post stroke was 4.7 ± 3.5 years) including 66 test-retest samples were analyzed. The Short ABC-J was assessed with the ABC-J, the Falls Efficacy Scale-International (FES-I), the Berg Balance Scale (BBS), and the Timed Up and Go Test (TUG-T). Results: The internal consistency was good (Cronbach's alpha 0.90), reproducibility was excellent [intra-class correlation coefficient (ICC2,1) 0.92], and levels of absolute reliability were acceptable (standard error of measurement and minimal detectable change 8.32 and 23.07, respectively). Concurrent, convergent, and discriminative validity were supported for the FES-I, ABC-J, BBS, and TUG-T (all |rho| > 0.60, p < .001), and identifying balance and mobility (the area under the curve estimates ≥ 0.80) and discriminative power of the Short ABC-J were better than those of the FES-I and equal to or better than those of ABC-J. Conclusion: The Short ABC-J has good psychometric properties and is a valid and reliable measure of balance self-efficacy in Japanese community-dwelling people with chronic stroke. Further replication studies as well as other psychometric studies are needed.
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Affiliation(s)
- Satomi Ishige
- Graduate School of Health and Sports Science, Juntendo University, Inzai-city, Chiba, Japan.,Department of Rehabilitation, Ushioda General Hospital, Yokohama-city, Kanagawa, Japan
| | - Sawako Wakui
- Graduate School of Health and Sports Science, Juntendo University, Inzai-city, Chiba, Japan
| | - Yumi Miyazawa
- Department of Neurology, Ushioda General Hospital, Yokohama-city, Kanagawa, Japan
| | - Hisashi Naito
- Graduate School of Health and Sports Science, Juntendo University, Inzai-city, Chiba, Japan
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Ibrahim ZM, Ali OI, Moawd SA, Eid MM, Taha MM. Low Vibrational Training as an Additional Intervention for Postural Balance, Balance Confidence and Functional Mobility in Type 2 Diabetic Patients with Lower Limb Burn Injury: A Randomized Clinical Trial. Diabetes Metab Syndr Obes 2021; 14:3617-3626. [PMID: 34408458 PMCID: PMC8364844 DOI: 10.2147/dmso.s307414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/25/2021] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Burn injury with pre-existing diabetes has poorer outcomes and complications. Balance and functional mobility are disturbed in diabetic patients with burn injury which increase the risk of total morbidity. The aim of the current study was to evaluate the impact of vibrational training as an additional intervention on postural balance, balance confidence and functional mobility in type 2 diabetic patients with lower limb burn injury. PATIENTS AND METHODS Thirty-eight type 2 diabetic patients of both sexes with healed lower limb burn were randomly assigned into two equal groups: the vibration group and the control group. The vibration group received whole body vibration (WBV), 3 sessions a week for 8 weeks, in addition to the selected exercise program (balance exercises and resisted exercises), while the control group only received the selected exercise program. Biodex Balance System was used to assess the dynamic balance score, the Activities-specific Balance Scale to assess balance confidence and the timed up and go test to assess the functional mobility. All measurements were obtained before and at the end of the study after 8 weeks of treatment. RESULTS Marked improvement in all dynamic balance indices; overall stability index, antero-posterior stability index and medio-lateral stability index, balance confidence and the functional mobility were obtained in both the vibration and the control groups (P< 0.05), whereas post-treatment comparison between groups revealed a statistically significant difference in favor of the vibration group in all measured variables. CONCLUSION Based on the results of the current study, it is possible to conclude that adding WBV training for an 8-week duration to a selected exercise program (balancing and resisted exercises) seems to be effective; in improving postural balance, balance confidence, as well as improving the functional mobility in type 2 diabetic patients with lower limb burn injury.
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Affiliation(s)
- Zizi M Ibrahim
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Correspondence: Zizi M Ibrahim Email
| | - Olfat Ibrahim Ali
- Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Samah A Moawd
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabi
- Department of Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Marwa M Eid
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Department of Physical Therapy, Faculty of Applied Medical Science, Taif University, Taif, Saudi Arabia
| | - Mona Mohamed Taha
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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