Introduction
The purpose of this study was to evaluate balance function before and after total knee arthroplasty (TKA) using Berg balance scale (BBS). The study also aimed to identify factors ...associated with balance impairment.
Materials and methods
Ninety-three knees in 90 patients were prospectively evaluated using their BBS scores, passive knee extension/flexion angles, Visual analogue scale for pain scores, hip–knee–ankle angles, and knee extensor/flexor muscle strengths before and after TKA. A total BBS score of less than 45 indicates an enhanced risk of multiple falls. Multivariate logistic regression models were performed to elucidate factors associated with post-operative BBS score.
Results
A significant difference in mean pre- and post-operative BBS scores were noted (49.3 ± 6.4 vs. 52.2 ± 4.7) (
p
< 0.05). The percentage of pre- and post-operative BBS scores less than 45 were 20% and 10% (
p
< 0.05). Rheumatoid Arthritis (RA), lower pre-operative BBS score, and larger post-operative knee flexion contracture were significantly associated with lower post-operative BBS score (
p
< 0.01). The post-operative knee flexion contracture greater than 10° was significantly associated with substantially high odds of post-operative BBS scores less than 45 (Odds ratio 7.6; 95% confidential interval 1.69–34.17).
Conclusions
While TKA significantly improved BBS scores, 10% of the patients remained at a risk for multiple falls. RA, lower pre-operative BBS score, and post-operative knee flexion contracture greater than 10° retained balance impairment even after TKA.
INTRODUCTIONInspiratory muscle training (IMT) has been widely used in both healthy and diseased populations especially in older adults, and its effects have been proven not only on inspiratory muscle ...strength but also on dyspnea, exercise capacity, quality of life, and other health parameters. AIMThis study aims to review the effects of IMT on balance and functional ability of healthy and diseased populations. METHODSA systematic literature search was conducted on MEDLINE, EMBASE, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized control trials having participants > 18 years of age and having balance and functional mobility as primary or secondary outcomes were included. Two independent reviewers screened studies against the eligibility criteria, extracted the data, and assessed the quality of evidence. The protocol was prospectively registered on PROSPERO: CRD42021261652. RESULTSTen studies were included in the review out of which eight had balance and six had functional mobility as an outcome measure. There was a significant improvement in balance of the participants after treatment with IMT, however the effect on functional mobility was inconclusive. CONCLUSIONThe review provided evidence of improvement in balance and functional mobility following inspiratory muscle training in both healthy and diseased adults. Future studies should be conducted to determine the optimal protocol and dosage of treatment.
Automating fall risk assessment, in an efficient, non-invasive manner, specifically in the elderly population, serves as an efficient means for implementing wide screening of individuals for fall ...risk and determining their need for participation in fall prevention programs. We present an automated and efficient system for fall risk assessment based on a multi-depth camera human motion tracking system, which captures patients performing the well-known and validated Berg Balance Scale (BBS). Trained machine learning classifiers predict the patient's 14 scores of the BBS by extracting spatio-temporal features from the captured human motion records. Additionally, we used machine learning tools to develop fall risk predictors that enable reducing the number of BBS tasks required to assess fall risk, from 14 to 4-6 tasks, without compromising the quality and accuracy of the BBS assessment. The reduced battery, termed Efficient-BBS (E-BBS), can be performed by physiotherapists in a traditional setting or deployed using our automated system, allowing an efficient and effective BBS evaluation. We report on a pilot study, run in a major hospital, including accuracy and statistical evaluations. We show the accuracy and confidence levels of the E-BBS, as well as the average number of BBS tasks required to reach the accuracy thresholds. The trained E-BBS system was shown to reduce the number of tasks in the BBS test by approximately 50% while maintaining 97% accuracy. The presented approach enables a wide screening of individuals for fall risk in a manner that does not require significant time or resources from the medical community. Furthermore, the technology and machine learning algorithms can be implemented on other batteries of medical tests and evaluations.
Introduction
The Berg Balance Scale, possibly the most widely used balance-related measure, has gained popularity in clinical trials. It provides information about patients’ balance-related abilities ...and can be used to assess improvement or worsening after rehabilitation. The aim of this study is to determine the cut-off value of the Berg Balance Scale for the fall risk in patients with multiple sclerosis (MS).
Methods
This study was designed as a prospective descriptive trial, and 186 patients with MS were included. Fall history was recorded by interview; balance was assessed using the Berg Balance Scale (BBS).
Results
The mean ages of 96 patients with a fall history within the previous month and 90 patients without a fall history were 35.98 ± 8.58 and 35.71 ± 9.33 years, respectively. The mean value of the BBS score of the faller group was 49.44 ± 5.43 while 52.36 ± 3.53 in non-faller group. The cut-off value of the BBS for fall risk in patients with MS was determined as 50.50 points.
Conclusions
For patient safety and the success of rehabilitation, it is crucial to evaluate the risk of falling in patients with MS, one of the neurological patient groups where complaints about falling are most prevalent. The results showed that BBS is a sensitive and specific measure for identifying in patients with MS at risk of falling.
Stroke survivors need continuing exercise intervention to maintain functional status. This study assessed the feasibility and efficacy of an interactive telerehabilitation exergaming system to ...improve balance in individuals with chronic stroke, compared to conventional one-on-one rehabilitation.
In this prospective case-control pilot study, 30 Taiwanese individuals with chronic stroke were enrolled and randomly allocated to an experimental group and a control group. All participants received intervention 3 times per week for 4 weeks in the study hospital. The experiment group underwent telerehabilitation using a Kinect camera-based interactive telerehabilitation system in an independent room to simulate home environment. In contrast, the control group received conventional one-on-one physiotherapy in a dedicated rehabilitation area. The effectiveness of interactive telerehabilitation in improving balance in stroke survivors was evaluated by comparing outcomes between the two groups. The primary outcome was Berg Balance Scale (BBS) scores. Secondary outcomes were performance of the Timed Up and Go (TUG) test, Modified Falls Efficacy Scale, Motricity Index, and Functional Ambulation Category.
Comparison of outcomes between experimental and control groups revealed no significant differences between groups at baseline and post-intervention for all outcome measures. However, BBS scores improved significantly in both groups (control group: p = 0.01, effect size = 0.49; experimental group: p = 0.01, effect size = 0.70). Completion times of TUG tests also improved significantly in the experimental group (p = 0.005, effect size = 0.70).
The Kinect camera-based interactive telerehabilitation system demonstrates superior or equal efficacy compared to conventional one-on-one physiotherapy for improving balance in individuals with chronic stroke. Trial registration ClinicalTrials.gov. NCT03698357. Registered October 4, 2018, retrospectively registered.
Introduction: One of the most common manifestations of diabetic peripheral neuropathy is postural impairment and proprioception deficits. Whole Body Vibration (WBV) is a relatively new somatosensory ...stimulation, the effects of which on balance and proprioception in patients with diabetic neuropathy have not been adequately studied. This study aimed to investigate the effects of WBV on balance and proprioception of the ankle joint in patients with diabetic neuropathy. Materials and Methods: This clinical trial study was conducted on 30 patients with diabetic neuropathy who were enrolled based on inclusion and exclusion criteria. The patients were randomly assigned to the intervention and control groups (15 patients in each group). The WBV group was subjected to WBV with a frequency of 30 Hz and an amplitude of 2 mm for 6 weeks and twice a week. Postural stability, balance indices, and ankle proprioception were measured before and after the intervention with the Biodex Balance System, Berg Balance Scale (BBS), and Biodex Isokinetic Dynamometer, respectively. Results: The results of this study showed that the static and dynamic postural stability indices in different axes with eyes open showed a significant improvement in the intervention group (except for the dynamic stability index of the mediolateral axis). The repositioning error angle also showed a significant decrease in the maximum inversion minus 5 °. But the BBS and repositioning error angle at 15 ° inversion did not change significantly after 6 weeks of intervention. Conclusion: WBV can improve postural stability and ankle position sense in people with diabetic neuropathy. Clinical improvements in functional balance were also observed in these patients. WBV may be suggested to prevent progressive balance changes in diabetic patients.
만성 뇌졸중 환자의 낙상 예측을 위한 버그균형 척도와 플러턴 어드밴스드 균형 척도의 비교 김인섭; In-seop Kim; 남택길 ...
Han'guk Chŏnmun Mulli Ch'iryo Hakhoe chi = Journal of the Korean Academy of University Trained Physical Therapists,
02/2018, Volume:
25, Issue:
1
Journal Article
Open access
Background: The Berg Balance Scale (BBS) and the Fullerton Advanced Balance (FAB) scale have been used to assess balance function in patients with chronic stroke. These clinical balance scales ...provide information about potential risk factors for falls.
Objects: The purpose of this study was to investigate the incidence of and risk factors of falls and compare the predictive values of the BBS and FAB scale relative to fall risk in patients with stroke through receiver operating characteristic analysis.
Methods: Sixty-three patients with stroke (faller=34, non-faller=29) who could walk independently for 10 meters participated in this study. The BBS and FAB scale were administered. Then, we verified the cut-off score, sensitivity, specificity, and the area of under the curve.
Results: In this study, the BBS and FAB scale did not predict fall risk in patients with stroke in the receiver operator characteristic curve analysis. A cut-off score of 37.5 points provided sensitivity of .47 and specificity of .35 on the BBS, and a cut-off score of 20.5 points provided sensitivity of .44 and specificity of .45 on the FAB scale.
Conclusion: The BBS and FAB scale were not useful screening tools for predicting fall risk in patients with stroke in this study, but those who scored 37.5 or lower on the BBS and 20.5 or lower on the FAB scale had a high risk for falls.
To determine the main factor that predicts balance impairment in patients with chronic stroke.
Cross-sectional study.
Inpatient rehabilitation hospital and research laboratory.
A total of 57 patients ...(42 men, 15 women; mean age 55.7±12.2 years) with chronic symptoms after stroke.
Not applicable.
Primary outcomes were ankle functions, including strength, range of motion, and proprioception, and balance, including Berg Balance Scale score and Timed Up and Go test values. Secondary outcomes included gait kinematics, Fugl-Meyer Scale score, and Fall Efficacy Scale score.
According to the cutoff score <46 on the Berg Balance Scale and the Timed Up and Go test ≥13.5 seconds, 21 patients were classified as having a balance impairment (36.8%). Multivariable logistic regressions showed that ankle proprioception (odds ratio = 3.49; 95% confidence interval, 1.17-10.42) was a significant predictor when coupled with step length (odds ratio = 0.00; 95% confidence interval, 0.00-0.22). A cutoff score of 2.59 for the ankle proprioception value predicts balance impairment in patients with stroke (area under the curve 0.784).
Ankle proprioception can be used to predict balance impairment in patients with stroke.
Introduction: The basic functional assessment, on the basis of which rehabilitation programming is carried out in a patient after a stroke, consists in examining the efficiency of the upper and lower ...limbs, balance and i.a. muscle tension. Therefore, it is important to identify and understand the relationships between these basic data in order to make conclusions easier and to set good goals in rehabilitation.
Objective: The aim of the study was to investigate the relation between the assessment of the motor efficiency of the lower limb, measured Fugl-Meyer Assessment Scale (FMA) and the balance, measured Berg Balance Scale (BBS) and between the FMA and the assessment of muscle tone, measured modified Ashworth scale in chronic-phase patients after an ischemic stroke before and after a 6-week rehabilitation process.
Material and methods: The study group consisted of 37 patients after stroke (post-stroke duration > 1 year). All patients were subjected to a double functional assessment. Main measures: motor function in the lower limb, balance and spasticity in the lower limb. Spearman correlation coefficients was used to identify and analyze the relationship between the FMA and BBS as an assessment of the increased muscle tone.
Results: There was a highly significant p <0.0001 positive correlation between the FMA and BBS tests: first period r = 0.6120, second period r = 0.6604. There was a highly significant (p <0.0001) negative correlation between the assessment of FMA test and the muscle tone: first period r = -0.6814, second period r = -0.6532.
Conclusions: People in chronic phase after an ischemic stroke have a high positive correlation between the motor efficiency of the lower limb and balance. This study shows also a high, negative correlation between the motor efficiency of the lower limb, and the muscle tone of this limb. Both before and after rehabilitation process.
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