Patients experience falls frequently after stroke. Preserved or acquired balance skills decrease fall risk and improve independence. Feasibility of Fullerton Advanced Balance Scale (FAB) has been ...shown in balance assessment in some neurological diseases except stroke.
The purpose of this study was to investigate the reliability and validity of Turkish version of FAB (FAB-T) in patients with stroke (PwS).
This cross-sectional study included 51 PwS (60.64 ± 7.66 years). Reliability analyses were conducted with Cronbach's alpha, intraclass correlation coefficient (ICC), and Spearman correlation analysis. Intra-rater and inter-rater reliability were assessed with three raters. FAB-T, Stroke Rehabilitation Assessment of Movement (STREAM), Brunnstrom Recovery Stages (BRS), Barthel Index (BI), and 36-Item Short Form Health Survey (SF-36) were used for convergent validity. Correlations of FAB-T with Berg Balance Scale (BBS) and Mini-Balance Evaluation Systems Test (Mini-BESTest) were measured for concurrent validity. Spearman correlation analysis was used for convergent and concurrent validity. For predictive validity patients' self-reports of falling were analyzed with ROC.
Intra-rater (ICC = 0.998) and inter-rater reliability (ICCs = 0.984; 0.984; 0.990), and internal consistency (Cronbach's alpha = 0.930) were excellent. FAB-T had good correlations with STREAM (ρ = 0.677) and BI (ρ = 0.628), moderate correlations with BRS (ρ = 0.504 and ρ = 0.579) and physical function of SF-36 (ρ = 0.436). FAB-T excellently correlated with Mini-BESTest and BBS (ρ = 0.928 and ρ = 0.942). The cutoff score of FAB-T was determined to be 21.5 points, with sensitivity of 84% and specificity of 61% (AUC = 0.749).
FAB-T is a reliable and valid balance assessment tool with an acceptable accuracy of fall prediction in PwS.
Background: The Mini-BESTest is a recently developed balance assessment tool that incorporates challenging dynamic balance tasks. Few studies have compared the psychometric properties of the ...Mini-BESTest to the commonly used Berg Balance Scale (BBS). However, the utility of these scales in relationship to post stroke walking speeds has not been explored.
Objectives: The purpose of this study was to compare the sensitivity and specificity of the Mini-BESTest and BBS to evaluate walking speeds in individuals with stroke.
Design: A retrospective exploratory design.
Methods: Forty-one individuals with chronic stroke were evaluated with the Mini-BESTest, BBS, and 10-meter self-selected walk test (10MWT). Based on their self-selected gait speeds (below or above 0.8 m/s), participants were classified as slow and fast walkers.
Results: Significant linear correlations were observed between the Mini-BESTest vs. BBS (r = 0.72, p ≤ 0.001), Mini-BESTest vs. 10MWT (r = 0.58, p ≤ 0.001), and BBS vs. 10MWT (r = 0.30, p = 0.05). Independent t-tests comparing the balance scores for the slow and fast walkers revealed significant group differences for the Mini-BESTest (p = 0.003), but not for the BBS (p = 0.09). The Mini-BESTest demonstrated higher sensitivity (93%) and specificity (64%) compared to the BBS (sensitivity 81%, specificity 56%) for discriminating participants into slow and fast walkers.
Conclusions: The Mini-BESTest has a greater discriminative ability than the BBS to categorize individuals with stroke into slow and fast walkers.
Using a crossover-design, we assessed changes in 30-second chair stand test (30 s-CST), Timed Up-and-Go (TUG) and Berg Balance Scale (BBS) and energy and fatigue in older adults (N = 11) after ...performance of mental tasks. A Wilcoxon Sign Rank Test and a Friedman's rank test were used to assess changes in 30 s-CST, TUG, BBS and energy and fatigue respectively. A linear mixed model was used to assess joint variance and random forest classifier and support vector machine (SVM) algorithms were used to verify results. Statistically significant declines in feelings of energy (p=.003), specifically mental energy (p=.015), and BBS (p<.001), specifically during the "standing with eyes closed" (SEC), was noted for participants on days when they completed mental tasks compared to days they did not. The random-forest and SVM algorithms predicted with 79% and 80% accuracy respectively whether the SEC item of the BBS was performed after a decline a mental energy.
To evaluate the balance skills and falling risk in children with a congenital bilateral profound sensorineural hearing loss (CBPSNHL).
25 children with CBPSNHL and healthy 25 children with similar ...age and gender were included in the study. The flamingo balance test, the tandem stance test, and the one-leg standing test were performed to assess the patients' static balance skills. The pediatric balance scale (PBS) was used to evaluate the dynamic balance. Visual analog scale (VAS) was applied to the patients assess the frequency of falls.
The flamingo balance test, the tandem stance test, and the one-leg standing test in the children with CBPSNHL were all significantly worse than the control group. Although the scores of PBS in patients with CBPSNHL were significantly lower than the control group (p < 0.001), the results of both groups were consistent with a low risk of falls. There was no significant difference between the VAS scores indicating the frequency of falls among the groups (p = 0.552).
Static and dynamic balance skills of the children with CBPSNHL are significantly impaired compared to their healthy peers. Children with CBPSNHL also have a lower risk of falling just like their healthy peers and there is no significant difference between their falling frequencies. Balance skills of children with CBPSNHL can be assessed quickly and effectively on a hard floor (eyes closed), with a tandem standing test or a one-leg standing test.
Abstract Introduction The relationship between freezing of gait (FOG) and postural instability in Parkinson's disease (PD) is unclear. We analyzed the impact of FOG on postural control. Methods 31 PD ...patients with FOG (PD+FOG), 27 PD patients without FOG (PD-FOG) and 22 healthy control (HC) were assessed in the ON state. Postural control was measured with the Fullerton Advanced Balance (FAB) scale and with center of pressure (COP) analysis during quiet stance and maximal voluntary forward/backward leaning. Results The groups were balanced concerning age, disease duration and disease severity. PD+FOG performed significantly worse in the FAB scale (21.8 ± 5.8) compared to PD-FOG (25.6 ± 5.0) and HC (34.9 ± 2.4) (mean ± SD, p < 0.01). PD+FOG had impaired ability to voluntary lean forward, difficulties to stand on foam with eyes closed and reduced limits of stability compared to PD-FOG ( p < 0.05). During quiet stance the average anterior–posterior COP position was significantly displaced towards posterior in PD+FOG in comparison to PD-FOG and HC ( p < 0.05). The COP position correlated with severity of FOG ( p < 0.01). PD+FOG and PD-FOG did not differ in average COP sway excursion, sway velocity, sway regularity and postural control asymmetry. Conclusions PD+FOG have reduced postural control compared to PD-FOG and HC. Our results show a relationship between the anterior–posterior COP position during quiet stance and FOG. The COP shift towards posterior in PD+FOG leads to a restricted precondition to generate forward progression during gait initiation. This may contribute to the occurrence of FOG or might be a compensatory strategy to avoid forward falls.
•The BBS and PBS are valid and reliable functional balance tests and can differentiate functional balance ability among levels of GMFCS-E&R I to IV for adolescents with cerebral palsy.•PBS would be ...an easier test for examining static functional balance than the BBS in adolescents with moderate cerebral palsy.•BBS could be an appropriate functional test for adolescents with mild cerebral palsy.
The Berg balance scale (BBS) and the paediatric balance scale (PBS) are reliable tools for measuring balance ability. However, reports of BBS and PBS scores in adolescent cerebral palsy have been limited. The objectives of this study were to investigate functional balance capacities, as tested with the BBS and PBS in adolescents with cerebral palsy, to compare the total PBS and BBS scores between Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) levels and to compare the static balance PBS and BBS scores within each GMFCS-E&R level. Fifty-eight school-aged adolescents with cerebral palsy between the ages of 12 and 18 years with GMFCS-E&R levels of I to IV were recruited. The Kruskal–Wallis test was utilized to compare the median scores for the PBS and BBS between the different GMFCS-E&R levels. Wilcoxon signed-rank tests were performed to examine the differences in the static balance scores between the PBS and the BBS within the same GMFCS-E&R levels. The results reveal that there were differences in the BBS and PBS scores among the four GMFCS-E&R levels. A significant difference was found between the BBS and PBS scores only among the patients with cerebral palsy and level III GMFCS-E&R. The BBS and PBS are valid and reliable tools for clinical examination and for distinguishing between levels of functional balance in adolescents with cerebral palsy.
Falls are a major cause of morbidity and long-term hospitalization among growing older population. An automated and accurate fall-risk assessment system is vital to identify high fall-risk population ...and to prevent falls by early intervention. Therefore, this paper provides an objective, cost-effective, and unsupervised method to obtain functional balance and mobility assessment-based fall-risk of community-dwelling older adults. More specifically, waist-mounted triaxial accelerometer signals acquired from directed routine (supervised control movements) are used to estimate the well-known clinical assessment scoreBerg balance scale (BBS). The trunk acceleration signals are used to extract features and to find the optimal subset of features for each training data during repeated tenfold cross validation of the BBS estimation model. The average of two BBS estimates based on test and retest yielded a strong correlation p = 0.86 with the standard BBS score. Also, high correlation (p = 0.90) and low root-mean-square error (1.66) was observed between the two estimates of each subject. The proposed method is well suited for the assessment of balance impairment and prescreening of quantitative fall-risk in an unsupervised setting. It has the potential to act as a surrogate of the standard clinical assessment-BBS.
Introduction
Breast cancer is the most common cancer disease of women in industrialized countries. Neurotoxic chemotherapy drugs are known to harm peripheral nerves and cause a chemotherapy-induced ...peripheral neuropathy (CIPN). CIPN is one of the most common adverse events associated with Paclitaxel chemotherapy and may remain present long after the termination of chemotherapy. Thus, it reduces the patients’ quality of life (QoL) both during chemotherapy and onwards, and can impose a danger on breast cancer survivors due to an increased risk of falling and fall-related injuries.
Methods
The aim of this randomized-controlled trial (RCT) (
n
= 36) (IG: intervention group,
n
= 17) (CG: control group,
n
= 19) was to determine whether sensorimotor exercises have a positive effect on physical and psychological parameters in breast cancer patients undergoing neurotoxic chemotherapy (Paclitaxel).
Results
As a result, we were able to show significant improvements in postural stability in monopedal stance left leg 16.17 ± 3.67 vs. 21.55 ± 5.33 (
p
< 0.001) and right leg 15.14 ± 2.30 vs. 20.85 ± 5.05 (
p
< 0.001) and in bipedal stance T1 vs. T0, − 0.49 (IG) vs. + 1.14 (CG)
p
= 0.039.
Discussion
These results in posturography correlate with the clinical presentation with intervention group patients scoring significantly better on the Fullerton Advanced Balance Scale 37.71 ± 2.73 vs. 34.47 ± 3.98 (
p
= 0.004). Moderate strength training successfully prevented a strength loss in the IG that was remarkable in the CG (− 1.60 vs. 0.60,
p
= 0.029). Concerning the psychological parameters assessed via EORTC- and MFI-questionnaires, no significant improvements were found.
Conclusion
Future studies should focus on the correlation of clinical and posturometry findings and subjective QOL such as the long-term-development of CIPN.
To compare the effects of balance training with and without Gaze Stabilization exercises on clinical outcomes in elderly patient with chronic dizziness.
Total 64 participants after referral from ...neurologist at Lahore General Hospital were recruited in this study. These participants were randomly assigned into two groups i.e. Group A (Gaze group) and Group B (control group) with 32 participants in each group by sealed envelope method. Gaze group performed balance exercises with gaze stability exercise whereas, group B performed balance exercises with saccade eye exercises. Berg Balance Scale, Disability Handicapped Inventory, and Activity Specific Balance Confidence Scale were used to measure outcome variables.
Demographic variables were represented by mean, standard deviation and frequency distribution. Results showed that there was no baseline difference between gaze and control group (p > 0.05). Both groups showed improved results with the gaze group showing significantly more improvement as compare to the control group on balance (p < 0.05, Mean Group A = 44.1, Mean group B = 40.91), perceived disability (p < 0.05, Mean Group A = 52.84, Group B = 56.09), and risk of fall (p < 0.05, Mean Group A = 53.84, Mean Group B = 50.72) respectively.
This study concluded that gaze stability exercises with balance training are effective in improving balance, level of perceived disability, and risk of fall prevention among elderly patients with chronic dizziness.
Background:
Evidence-based complementary treatment options for multiple sclerosis (MS) are limited.
Objective:
To investigate the effect of hippotherapy plus standard care versus standard care alone ...in MS patients.
Methods:
A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity.
Results:
Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03–4.63, p = 0.047) between intervention (n = 32) and control (n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (−6.8, p = 0.02) and spasticity (−0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p < 0.001) in physical health score and 14.4 (p < 0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54).
Conclusion:
Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.
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