To identify the Berg Balance Scale (BBS) values that can be used to discriminate the use of a walking aid and the BBS sub-items that reveal the differences in the use of walking aids among ...hospitalized older adults with a hip fracture.
The cases of 77 older adults (age 80.8 ± 7.5 years) with a hip fracture who were able to walk independently in the hospital were retrospectively analyzed. A receiver operating characteristic curve (AUC) analysis was used to identify BBS scores that optimized the identification of subjects with different levels of aids. The BBS sub-items identifying differing among the walking aids were identified by a classification and regression tree analysis.
The BBS scores were highest for no aid, a cane, and a walker, in that order. The ability to walk without an aid and the ability to walk without a walker showed moderate AUCs (0.824 and 0.865) with cutoff values of 51.5 and 45.5 points, respectively. The sub-items identified were Turning 360° (4 vs. < 4 points) as the best discriminator for using/not using a cane and Stool Stepping (≥ 2 vs. < 2 points) for using a cane or walker.
The BBS is useful for determining whether to discontinue the use of a walker in individuals with a hip fracture.
Balance disorders are considered to be a serious clinical manifestation after stroke. Therefore, to assess stroke patients' balance performance, use of a quantitative method appears essential. A ...fundamental step would be the approval of the efficiency of the measurement instruments. The current study aimed to investigate correlations between balance assessment as examined by Biodex Stability System (BSS) and the clinical Berg Balance Scale (BBS) in post-stroke hemiparesis.
Twenty-five stroke survivors and 25 healthy age-sex matched subjects were recruited. The subjects were assessed using BSS during 3 days, with a 24-h interval. The high interclass correlation coefficient (ICC) values showed that the system was reliable enough to continue the study. The clinical evaluation was performed by the standard BBS.
There was a significant moderate negative correlation between the Biodex overall indices and BBS scores in the stroke groups (ravg = −0.68) and in the healthy cohort (ravg = -0.55). Also, a significant moderate negative correlation was found between the Biodex antero-posterior stability indices and BBS scores in the stroke groups (ravg = −0.67) and in healthy cohort (ravg = −0.55). The correlation between the Biodex mediolateral stability indices and BBS scores was moderate to low in the stroke and healthy groups (ravg = −0.67 and −0.39 respectively).
Moderate negative correlation between the stability indices of the Biodex Stability System and BBS scores indicates that dynamic balance status of the participants partially reflects their functional balance status.
To investigate the effectiveness of robot-assisted therapy on balance function in stroke survivors.
PubMed, the Cochrane Library, Embase and China National Knowledge Infrastructure databases were ...searched systematically for relevant studies.
Randomized controlled trials reporting robot-assisted therapy on balance function in patients after stroke were included.
Information on study characteristics, demographics, interventions strategies and outcome measures were extracted by 2 reviewers.
A total of 19 randomized trials fulfilled the inclusion criteria and 13 out of 19 were included in the meta-analysis. Analysis revealed that robot-assisted therapy significantly improved balance function assessed by berg balance scale (weighted mean difference (WMD) 3.58, 95% confidence interval (95% CI) 1.89-5.28, p < 0.001) compared with conventional therapy. Secondary analysis indicated that there was a significant difference in balance recovery between the conventional therapy and robot-assisted therapy groups in the acute/subacute stages of stroke (WMD 5.40, 95% CI 3.94-6.86, p < 0.001), while it was not significant in the chronic stages. With exoskeleton devices, the balance recovery in robot-assisted therapy groups was significantly better than in the conventional therapy groups (WMD 3.73, 95% CI 1.83-5.63, p < 0.001). Analysis further revealed that a total training time of more than 10 h can significantly improve balance function (WMD 4.53, 95% CI 2.31-6.75, p < 0.001). No publication bias or small study effects were observed according to the Cochrane Collaboration tool.
These results suggest that robot-assisted therapy is an effective intervention for improving balance function in stroke survivors.
Fall rates are increasing among the aging population and even higher falls rates have been reported in populations with neurological impairments. The Berg Balance Scale is often used to assess ...balance in older adults and has been validated for use in people with stroke, traumatic brain injury, and Parkinson’s disease. While the Berg Balance Scale (BBS) has been found to be predictive of the length of rehabilitation stay following stroke, a recent review concluded the BBS lacked predictive validity for fall risk. Conversely, sophisticated measures assessing center of mass (COM) displacement have shown to be predictive of falls risk. However, calculating COM displacement is difficult to measure outside a laboratory. Accordingly, we sought to validate COM displacement measurements derived from an HTC Vive tracker secured to the pelvis by comparing it to COM derived from ‘gold’ standard laboratory-based full-body motion capture. Results showed that RMS between the COM calculated from HTC Vive tracker and full body motion capture agree with an average error rate of 2.1 ± 2.6 cm. Therefore, we conclude measurement of COM displacement using an HTC Vive tracker placed on the pelvis is reasonably representative of laboratory-based measurement of COM displacement.
The objective of this work is the development of a learning system for the automatic assessment of balance abilities in elderly people. The system is based on estimating the Berg Balance Scale (BBS) ...score from the stream of sensor data gathered by a Wii Balance Board. The scientific challenge tackled by our investigation is to assess the feasibility of exploiting the richness of the temporal signals gathered by the balance board for inferring the complete BBS score based on data from a single BBS exercise.
The relation between the data collected by the balance board and the BBS score is inferred by neural networks for temporal data, modeled in particular as Echo State Networks within the Reservoir Computing (RC) paradigm, as a result of a comprehensive comparison among different learning models. The proposed system results to be able to estimate the complete BBS score directly from temporal data on exercise #10 of the BBS test, with ≈10 s of duration. Experimental results on real-world data show an absolute error below 4 BBS score points (i.e. below the 7% of the whole BBS range), resulting in a favorable trade-off between predictive performance and user’s required time with respect to previous works in literature. Results achieved by RC models compare well also with respect to different related learning models.
Overall, the proposed system puts forward as an effective tool for an accurate automated assessment of balance abilities in the elderly and it is characterized by being unobtrusive, easy to use and suitable for autonomous usage.
•Fullerton advanced scale is valid and reliable in MS.•Fullerton advanced scale can be used by physiotherapists of different experiences.•Fullerton advanced scale is suitable for use in the online ...environment.
This study was conducted to evaluate the reliability and validity of the Fullerton Advanced Balance Scale (FAB) in people with Multiple Sclerosis (PwMS).
A total of 65 people with multiple sclerosis, Expanded Disability Status Scale (EDSS) ranging from 1 to 5.5, were included in the study. Test-retest reliability, intra-rater, inter-rater reliability, and internal consistency (item-total score correlation, Cronbach's alpha coefficient) were investigated to examine the reliability of FAB. In the intra-rater and inter-rater reliability analysis, the FAB application of 34 patients, whose initial evaluation was gathered, was video-recorded and re-watched by two physiotherapists at different times and scored. For the Validity of FAB, concurrent validity with criterion validity; construct validity with hypothesis testing were calculated. Convergent validity was assessed for correlations with EDDS, Dynamic Gait Index (DGI), and Timed Up and Go Test (TUG).
Test-retest reliability of FAB Intraclass Correlation Coefficient (ICC) values was excellent (ICC= 0.994, p < 0.001). While the intra-rater reliability (ICC=0.986, p < 0.001) and inter-rater reliability (ICC=0.985, p < 0.001) of the FAB were calculated at an excellent level. Cronbach's alpha value was determined to perfect correlation. (Cronbach's alpha coefficient: 0.929). FAB had an excellent correlation with BBS (0.919 (p < 0.001). For convergent validity of FAB, EDSS (r=-0.885, p < 0.001), TUG (r=-0.833, p < 0.001), and DGI (r = 0.916, p < 0.001), it was determined that the scale had convergent validity.
The FAB proved to be a reliable and valid in PwMS. The study showed that the FAB could be applied regardless of the physiotherapists' clinical experiences. It has been determined that the scale can be used in PwMS with a wide EDSS score. Considering the inter-rater and intra-rater reliability results, it is thought that the FAB is also suitable for use in the online environment.
Improvement of sensory strategies is a relevant part of balance rehabilitation in multiple sclerosis (MS). This study aimed to Assess the effectiveness of visual-feedback exercises in improving ...balance in MS. We divided 36 patients into Wii and control-treated groups that underwent balance rehabilitation. Outcomes were obtained for Berg Balance Scale (BBS), Modified Fatigue Impact Scale, and sway area under conditions of opened and closed eyes. BBS showed a statistically significant improvement (from 49.6 to 54.6 points, p < 0.05) in the Wii group. Interactive visual-feedback exercises such as Wii could be more effective than the current standard protocol in improving balance disorders in MS.
Deep-vein thrombosis (DVT) is a common complication of acute stroke (AS). Only limited studies have discussed DVT in patients with AS at admission to a rehabilitation unit. The purpose of this study ...is to identify the predictors of DVT in AS patients admitted to a rehabilitation unit in China.
We retrospectively reviewed the medical records of all patients with AS admitted within 14 days of stroke onset between July 2019 and June 2022 at the Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, China. Ultrasonography was used to diagnose DVT in all patients within 3 days after rehabilitation admission. Univariate and binary logistic regression analyses were performed to determine the risk factors for DVT.
Overall, 234 cases were identified and the incidence rate of DVT among AS patients was 13.2% (31/234). The univariate analysis showed that age, drinking, lower limb muscle strength, Brunnstrom Assessment (BRS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), Barthel Index (BI) scale, serum albumin (Alb), and D-dimer were statistically significant factors. Age (OR = 1.037, 95% CI = 1.000-1.075,
< 0.05), BBS (OR = 0.952, 95% CI = 0.913-0.993,
< 0.05), and D-dimer (OR = 1.446, 95% CI = 1.130-1.849,
< 0.05) were demonstrated as independent risk factors for DVT.
Older age, lower BBS, and higher D-dimer levels at rehabilitation admission were independent risk factors for DVT. Therefore, ultrasonography should be performed for those patients with these three significant factors before implementing rehabilitation therapy.
•The FAB-T scale was successfully translated from the original English version (FAB) to Turkish language.•The FAB-T scale has very high inter-rater and intra-rater reliability.•There was a good ...agreement between the FAB-T and Berg Balance Scale (BBS).•The scale has high correlation with the BBS.•The FAB-T has no floor and ceiling effect.
The aim of this study was to evaluate the reliability and validity of the Turkish version of the FAB(FAB-T) scale in the older Turkish adults.
The reliability and validity of the scale was tested on 200 community-dwelling older adults. FAB-T scale was scored by different physiotherapists on different days to evaluate inter-rater and intrarater reliability. The Berg Balance Scale (BBS) was used for the evaluation of convergent validity, and the content validity of the FAB-T scale was investigated.
The FAB-T scale showed very high inter- and intra-rater reliability. For inter-rater agreement, on the individual test items and total score ICC values were 0.92 (95 %CI; 0.90–0.94) and 0.96 (95% CI; 0.95–0.97) respectively. The intra-rater agreement, on the individual test items and total score ICC values were 0.93 (95 %CI; 0.91– 0.95) and 0.96 (95% CI; 0.95– 0.97) respectively. There was a good agreement between the FAB-T and BBS scales. A high correlation was found between the BBS and FAB-T scales rho = 0.70 (%95 CI; 0.62–0.76) indicating good convergent validity. Considering the content validity of the FAB-T scale, no floor (floor score: 0%) or ceiling (ceiling score: 6.5%) effect was detected.
: The FAB-T scale was successfully translated from the original English version (FAB) and demonstrated strong psychometric features. It was found that the FAB-T scale has very high inter-rater and intra-rater reliability. Considering the convergent validity, the scale has high correlation with the BBS. The FAB-T has no floor and ceiling effect.
The problem of decreased balance caused by injury, illness, or aging is becoming increasingly prevalent in society. The traditional functional balance assessment method is highly time-consuming and ...inefficient, as well as being susceptible to measurement errors caused by personal subjective factors. This study proposes a system that can rapidly, conveniently, and accurately predict a participant's Berg balance scale (BBS) score without professional supervision. The proposed system uses a wearable inertial sensing device combined with machine learning to predict the BBS score of a test participant. In the beginning, the participants were asked to wear inertial sensing devices on seven parts of the body and perform 17 test tasks. The wearable device locations and the test tasks were ranked by importance and further reduced wearable devices and the test tasks. Eventually, the participant is only required to wear an inertial sensing device on their left thigh and perform two simple test tasks, namely "placing an alternate foot on a stool" and "standing on one foot (right foot)," to obtain their BBS score. In this study, the proposed system has a high level of accuracy for predicting BBS scores. The experimental results indicate that the mean absolute error (MAE) of the proposed system was 1.274. Moreover, this study provided some important information as a reference for future research on functional balance, including feature sets selection, regression model selection, wearable device locations ranking, and test tasks ranking. The researchers can use that information to design their experiment.
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