Approximately 40%-60% of all amputations are lower limb amputations (LLAs) related to diabetes mellitus (DM). The importance of quality of life (QoL) is increasingly recognized as after amputation. ...The objective of this cross-sectional study was to compare QoL (evaluated by Berg Balance Scale, BBS) in DM patients with unilateral transtibial amputation (TTA) using prosthesis (group A) with that of patients amputated due to other causes (group B). Overall, 32 patients completed two questionnaires: the 36-Item Health Survey (SF - 36) for QoL assessment and the Trinity Amputation and Prosthesis Experience Scale-Revised (TAPES-R). In group A, patients were significantly older ( P < .05) with shorter periods of prosthesis use ( P < .05) and had significantly lower ( P = .008) adjustment to limitation (TAPES-R). Correlations were found between BBS score and SF-36, including physical functioning ( P < .001, r = 0.682), energy and fatigue ( P < .001, r = 0.643) and emotional well-being ( P < .001, r = 0.644). In the TAPES-R, a large negative correlation was found between BBS and activity restriction ( P = .001, r = -0.595). Poorer balance ability, greater activity limitation, and worse psychosocial adjustment to the prosthesis were found in patients with unilateral TTA and DM compared to TTA prosthesis users without DM.
The balance-scale task, proposed by Inhelder and Piaget, illustrates children understanding of weight-distance relationships. Piaget used the clinical interview method in order to investigate ...children's reasoning. Over the last five decades, Siegler's Rule-Assessment Approach has been used to explain children reasoning in the balance-scale task according to rules children would use to solve the task. However, this approach does not take into account some key perceptual properties of the task. This study evaluates whether different task demands would alter children's errors. Forty children (twenty children aged 4–5 years and twenty children aged 9–10 years) predicted the movement of both arms of 16 balance-scale problems administered online. Nine 4–5-year-olds produced non-plausible responses whereas none of the 9–10-year-olds provided non-plausible responses. These results seem to indicate a basic misunderstanding of the scale from some younger children, one that eludes traditional measures used with this task.
Identifying individuals at risk for falls during inpatient stroke rehabilitation can ensure timely implementation of falls prevention strategies to minimize the negative personal and health system ...consequences of falls.
To compare sociodemographic and clinical characteristics of fallers and non-fallers; and evaluate the ability of the Berg Balance Scale (BBS) and Morse Falls Scale (MFS) to predict falls in an inpatient stroke rehabilitation setting.
A longitudinal study involving a secondary analysis of health record data from 818 patients with stroke admitted to an urban, rehabilitation hospital was conducted. A fall was defined as having ≥1 fall during the hospital stay. Cut-points on the BBS and MFS, alone and in combination, that optimized sensitivity and specificity for predicting falls, were identified.
Low admission BBS score and admission to a low-intensity rehabilitation program were associated with falling (p < .05). Optimal cut-points were 29 for the BBS (sensitivity: 82.4%; specificity: 57.4%) and 30 for the MFS (sensitivity: 73.2%; specificity: 31.4%) when used alone. Cut-points of 45 (BBS) and 30 (MFS) in combination optimized sensitivity (74.1%) and specificity (42.7%).
A BBS cut-point of 29 alone appears superior to using the MFS alone or combined with the BBS to predict falls.
To determine the minimum detectable change at 95% confidence for the Berg Balance Scale in a group of elderly people, undergoing physiotherapy rehabilitation.
Multi-centre, test-retest design.
...Cross-sectional sample of convenience of people over 65 years (n = 118) without a previous history of stroke, Parkinson's disease or recent hip arthroplasty. RATERS: Physiotherapists working with elderly people, drawn from the Physiotherapy Research into Older People group, ranging in experience from newly qualified to 39 years qualified.
Each participant was assessed using the Berg Balance Scale and again within 48 hours by the same physiotherapist. The minimum detectable change at 95% was established.
A change of 4 points is needed to be 95% confident that true change has occurred if a patient scores within 45-56 initially, 5 points if they score within 35-44, 7 points if they score within 25-34 and, finally, 5 points if their initial score is within 0-24 on the Berg Balance Scale.
A clinician with a working knowledge of these minimum detectable change values can be up to 95% confident that a true change or not a true change in a patients' functional balance has occurred and can therefore alter their interventions accordingly to ensure quality, focused rehabilitation.
Objective
: linguistic and cultural adaptation of the original version of Berg Balance Scale (BBS) and assessment its psychometric properties.
Patients and methods
. The staff of the Validation ...Center of International Scales and Questionnaires of the Research Center of Neurology received consent from Katherine Berg to validate the BSS in Russia. We carried out the linguocultural ratification during the validation study and prepared a Russian version of the scale. To assess the psychometric properties of the scale (reliability, validity, and sensitivity), we evaluated 55 patients (30 females and 25 males) aged 22–88 years with different neurological disorders (vascular and demyelinating diseases of the central nervous system, peripheral neuropathy, and movement disorders). We analyzed the differences of the total BBS score and the number of patients with high and low risk of falls at the end of rehabilitation compared to baseline to assess the dynamics of changes.
Results and discussion
. We successfully performed the translation and linguocultural adaptation of the BBS. The scale represents a high level of validity (expert score: 8.6 out of 10 points), reliability (Pearson's correlation coefficient r=0.98, р<0.0001; Cronbach's alpha α=0.94 р<0.001; Cohen's kappa κ=0.71, p<0.0001) and sensitivity (р<0.0001). After a two-week rehabilitation course, the risk of falls significantly decreased (χ2 =4.42; р=0.035); however, the level of independence of movement did not change significantly (F=0.94; р=0.636).
Conclusion
. The Russian version of the BBS was officially adapted based on the results of the accomplished validation study and is recommended for use both in routine clinical practice and in clinical trials by neurologists and rehabilitologists. The scale is available for downloading by QR code and on the website of Validation Center of International Scales and Questionnaires of the Research Center of Neurology.
OBJECTIVES: To assess the predictive value of five performance‐based measures for the onset of difficulty in activities of daily living (ADLs).
DESIGN: A prospective cohort study; home visits every 6 ...months for 18 months.
SETTING: Community‐based.
PARTICIPANTS: Community‐dwelling older adults, n=110, (mean age 80.3±7.0; range 67–98) who reported no difficulty in basic ADLs.
MEASUREMENTS: The Short Physical Performance Battery (SPPB), gait speed, Berg Balance Scale (BBS), grip strength, and Timed Up and Go Test (TUG) were evaluated at baseline. Seven ADL items were assessed at baseline and 6, 12, and 18 months. The onset of ADL disability was self‐report of difficulty in any of the seven ADL items. Logistic regression models were fitted for each of the physical performance measures to predict onset of ADL difficulty at 6, 12, and 18 months.
RESULTS: After controlling for age, comorbid conditions, and sex, the BBS was the most consistent and best predictor for the onset of ADL difficulty over an 18‐month period (6 months, c‐statistic=0.725, (95% confidence interval (CI)=0.60–0.85; 12 months, c‐statistic=0.840 95% CI=0.75, 0.93; 18 months, c‐statistic=0.821, 95% CI=0.71, 0.93). The SPPB showed excellent predictive value for the onset of difficulty at 12 months. Ninety‐five, 89, and 75 older adults completed the 6, 12, and 18‐month follow‐up visits, respectively.
CONCLUSION: BBS, followed by SPPB, TUG, gait speed, and grip strength, were predictive of the onset of ADL difficulty over an 18‐month period in community‐dwelling older adults. Screening nondisabled older adults with simple performance tests could allow clinicians to identify those at risk for ADL difficulty and may help to detect early functional decline.
The biomechanical relationship between horse and rider in equine-assisted activities and therapies has been largely unexplored. The three-dimensional stimulation of the horse's gait has potential to ...improve rider musculature and coordination, especially in an older adult population. This study utilized dual-axis goniometers and video motion capture tracking to simultaneously track horse and rider hip flexion and extension. Ten older adult riders participated in 8 weeks of horseback riding lessons, where pelvis kinematics and balance assessments were compared between Weeks 1 and 8. Pelvic roll of the rider and horses' hip flexion and extension were successfully tracked and summed improvements in balance assessments were also evident after 8 weeks of horseback riding lessons. Future research will assess deeper kinematic relationships between a horse's gait and rider biomechanical responses.
Cerebrospinal fluid tap test is a common procedure to predict the efficacy of ventriculoperitoneal shunt for idiopathic normal pressure hydrocephalus. Objective tests after cerebrospinal fluid tap ...test are used to establish the surgical indication, but subjective improvements may also be important in selection of surgical candidates. The aim of this study was to evaluate surgical outcomes of patients with ventriculoperitoneal shunt for idiopathic normal pressure hydrocephalus, comparing patients showing objective improvement with patients improving only on subjective assessments.
In this retrospective analysis, patients were divided into 2 groups: group 1 included patients with improvement on objective evaluation after cerebrospinal fluid tap test; group 2 included patients who showed only subjective improvement. The surgical outcomes of the 2 groups were compared.
Of 28 included patients, 17 were objective responders (group 1), and 11 were subjective responders (group 2). Clinical and radiological characteristics were similar. The only significant difference was the baseline Berg Balance Scale, which was lower in objective responders (P = 0.0015). At 3 months after surgery and at last follow-up, there was no difference in surgical outcomes between the 2 groups. However, in the group of subjective responders, a continuous improvement for incontinence and gait was more frequently observed (P = 0.04 and P < 0.001, respectively).
Surgical outcomes after ventriculoperitoneal shunt were similar between the 2 groups, with a more favorable trend in terms of symptom improvement for subjective responders. Subjective assessment seems to be an important factor to consider in preoperative evaluation.
This study aimed to evaluate sarcopenia and locomotive syndrome in Korean elderly patients, analyze the closely related factors, and determine the threshold for distinguishing participants with ...sarcopenia, locomotive syndrome, and non-disease. To this end, we enrolled 210 subjects aged 65 years or more and classified them into the sarcopenia (
= 36) and locomotive syndrome (
= 164) groups; a control group was also included (
= 10). We evaluated the characteristics of these patients using the Timed Up and Go (TUG) test and Berg Balance Scale (BBS) and performed statistical analysis. Our findings showed statistically significant differences between the groups, leading to the derivation of a significant threshold value. The threshold value of the TUG test between the control and locomotive syndrome groups was 9.47 s; the threshold value of the BBS was 54 points, respectively. The threshold value of the TUG test between the locomotive syndrome and sarcopenia groups was 10.27 s, and the threshold value of the BBS was 50 points, respectively. These findings suggest that sarcopenia is closely related to locomotive syndrome, and that sarcopenia and locomotive syndrome can be identified using a physical therapy diagnostic evaluation tool.
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