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Elliot J Roth - One of the best experts on this subject based on the ideXlab platform.

  • validity and reliability of the Berg Balance Scale for community dwelling persons with lower limb amputation
    Archives of Physical Medicine and Rehabilitation, 2013
    Co-Authors: Matthew J Major, Stefania Fatone, Elliot J Roth
    Abstract:

    Abstract Objective To evaluate the validity and reliability of the Berg Balance Scale (BBS) for use in people with lower-limb amputation. Design Cross-sectional study. Setting Research laboratory. Participants Individuals (N=30; age, 54±12y; 20 men) with unilateral transtibial (n=13), unilateral transfemoral (n=14), or bilateral (n=3) lower-limb amputation of dysvascular (n=7), traumatic (n=14), infectious (n=6), or congenital (n=3) origin. Interventions Not applicable. Main Outcome Measures BBS, 2-minute walk test, L test, Prosthesis Evaluation Questionnaire-Mobility SubScale, Activities-specific Balance Confidence Scale, and Frenchay Activities Index; self-reported descriptors were also collected, including frequency of prosthesis use, number of falls in 12 months before the visit, fear of falling, and daily mobility aid use. Results The BBS had high interrater reliability (intraclass correlation coefficient=.945) and internal consistency (α=.827). Relations between the BBS scores and those of other outcome measures were all statistically significant ( P ≤.001). Significant group differences in BBS scores were observed for fear of falling ( P =.008) and mobility aid use ( P P =.381). BBS items involving reaching forward, turning 360°, tandem standing, and standing on 1 leg had relatively greater frequencies of lower scores across participants. Conclusions The BBS appears to be a valid and reliable clinical instrument for assessing Balance in individuals with lower-limb amputation, but it may not be able to discriminate between individuals with greater or lesser fall risk. Limitations in prosthetic motion and control may be responsible for the challenges experienced on items of lower performance. Future studies would be useful to assess the responsiveness of the BBS to interventions aimed at improving Balance in individuals with lower-limb amputation.

Monica Rodrigues Perracini - One of the best experts on this subject based on the ideXlab platform.

  • the Berg Balance Scale as a clinical screening tool to predict fall risk in older adults a systematic review
    Physiotherapy, 2018
    Co-Authors: Camila Astolphi Lima, Monica Rodrigues Perracini, Natalia Aquaroni Ricci, E C Nogueira
    Abstract:

    Abstract Background The Berg Balance Scale (BBS) is often used in clinical practice to predict falls in the older adults. However, there is no consensus in research regarding its ability to predict falls. Objective To verify whether the BBS can predict falls risk in older adults. Data source Manual and electronic searches (Medline, EMBASE, CINAHL, Ageline, Lilacs, Web of Science, Cochrane Library and PEDro) were conducted using blocks of words (older adults, falls, BBS, study design) and their synonyms, with no language restrictions and published since 1989. Study selection criteria Prognostic studies or clinical trials were used to assess the BBS and falls history. Data extraction and data synthesis In this narrative synthesis, two independent assessors extracted data from articles and a third reviewer provided consensus, in case of disagreement. The methodological quality was assessed using the Quality In Prognosis Studies tool. Results 1047 studies were found and 8 studies were included in this review. The mean BBS score was high, regardless of the history of falls. Three studies presented cut-off scores for BBS, ranging from 45 to 51 points. Two studies reported a difference in the BBS score between fallers and non-fallers. Studies presented low to moderate risk of bias. Limitations Unfeasible to conduct a meta-analysis due the heterogeneity of included studies. Conclusion The evidence to support the use of BBS to predict falls is insufficient, and should not be used alone to determine the risk of falling in older adults. Systematic review registration number PROSPERO CRD42016032309.

  • validation of the brazilian version of the Berg Balance Scale for patients with parkinson s disease
    Arquivos De Neuro-psiquiatria, 2009
    Co-Authors: Paula Luciana Scalzo, Isabella C Nova, Monica Rodrigues Perracini, Daniel R Sacramento, Francisco Cardoso, Henrique Ballalai Ferraz
    Abstract:

    Abstract – Background: Changes in Balance occur with the progression of Parkinson’s disease (PD). Objective: To validate the Brazilian version of the Berg Balance Scale (BBS) for PD patients, determining its reliability and internal consistency and correlating it with PD-specific instruments. Method: We evaluated 53 patients (M/F 37/16, mean age±SD, 62±7.9 years) with PD (mean±SD, 7.8±4.4 years). Unified Parkinson’s Disease Rating Scale (UPDRS), Schwab and England Scale (S&E), Hoehn and Yahr Staging Scale (HY) and BBS were used to assess patients. Statistical analyses for inter-rater reliability, internal consistency and correlations among BBS, UPDRS, S&E and HY were performed. Results: The mean scores±SD on UPDRS and BBS were, respectively, 41.6±17.8 and 47.2±8.2. The median on S&E and HY Scales were 80% and 2.5, respectively. The BBS presented a high intra-class correlation coefficient (ICC=0.84) and internal consistency (Cronbrach’s α=0.92). There was a statistically significant correlation between BBS and disease duration (r

Susan J Harkema - One of the best experts on this subject based on the ideXlab platform.

  • dynamic longitudinal evaluation of the utility of the Berg Balance Scale in individuals with motor incomplete spinal cord injury
    Archives of Physical Medicine and Rehabilitation, 2012
    Co-Authors: Somnath Datta, Douglas J Lorenz, Susan J Harkema
    Abstract:

    Abstract Datta S, Lorenz DJ, Harkema SJ. Dynamic longitudinal evaluation of the utility of the Berg Balance Scale in individuals with motor incomplete spinal cord injury. Objectives To examine the utility of the Berg Balance Scale among patients with motor incomplete spinal cord injuries (SCIs), to determine how the utility of the Berg Balance Scale changes over time with activity-based therapy, and to identify differences in Scale utility across patient groups defined by status of recovery. Design Prospective observational cohort. Setting The NeuroRecovery Network (NRN), a network of clinical centers for patients with motor incomplete SCI. Participants Patients with motor incomplete SCI (n=124) with American Spinal Injury Association Impairment Scale grade C or D, who were enrolled in the NRN between February 2008 and June 2009. Intervention Standardized locomotor training. Main Outcome Measure The Berg Balance Scale items were examined with longitudinal principal components analyses. Patients were categorized by phase using the Neuromuscular Recovery Scale. Results In the full sample, the first principal component explained a large percentage of overall Scale variance (77%), items were loaded homogeneously on the first principal component, and item scores were well correlated with first principal component scores. In subgroups of low and high functioning of patients, first principal component variance accounting was reduced (49%) and only a few of the simplest and most difficult items substantially loaded onto the first principal component. Item loading coefficients evolved over time as patients recovered, with simpler items becoming less important to the full Scale and difficult items more important. Conclusions The utility of the Berg Balance Scale in patients with motor incomplete SCI in early and advanced phases of recovery is limited. Specific item utility changes as patients recover. Thus, a more comprehensive and dynamic instrument is necessary to adequately measure Balance across the spectrum of patients with motor incomplete SCI.

  • a multivariate examination of temporal changes in Berg Balance Scale items for patients with asia impairment Scale c and d spinal cord injuries
    Archives of Physical Medicine and Rehabilitation, 2009
    Co-Authors: Somnath Datta, Douglas J Lorenz, Susan J Harkema, Sarah A Morrison, Elizabeth Ardolino
    Abstract:

    Abstract Datta S, Lorenz DJ, Morrison S, Ardolino E, Harkema SJ. A multivariate examination of temporal changes in Berg Balance Scale items for patients with ASIA Impairment Scale C and D spinal cord injuries. Objective To provide a multivariate examination of the Berg Balance Scale (BBS) in patients with spinal cord injury (SCI) as a first step in developing a Balance tool for the SCI population. Design Observational cohort. Setting The NeuroRecovery Network (NRN), a specialized network of treatment centers providing standardized, activity-based therapy for patients with SCI. Participants Patients (N=97) with American Spinal Injury Association Impairment Scale C or D SCI who were enrolled in the NRN between March 1, 2005, and June 12, 2007. Interventions All enrolled patients received 3 to 5 locomotor training sessions a week, according to NRN protocol, and were periodically evaluated for progress on functional outcome measurements. Main Outcome Measures Scores on the items of the BBS, six-minute walk test distances, ten-meter walk test speeds, and scores on the SCI Functional Ambulation Index. Temporal rates of change of the BBS items were examined with a principal components and correlation analysis. Results The first principal component accounted for nearly half of the overall variability in the BBS, correlated well with rates of change in functional mobility measures, and had good stability in its composition as verified by a resampling analysis. Further analysis showed that the composition of the first principal component varied with the patient's level of recovery. Conclusions The BBS captures a significant amount of information about Balance recovery in persons with SCI and may be a good foundation for a Balance tool. However, the utility of BBS items may be dependent on a patient's level of recovery. A dynamic Balance instrument for the SCI population may be needed.

Pauline Chiarelli - One of the best experts on this subject based on the ideXlab platform.

  • normative scores on the Berg Balance Scale decline after age 70 years in healthy community dwelling people a systematic review
    Journal of Physiotherapy, 2014
    Co-Authors: Stephen Downs, Jodie Marquez, Pauline Chiarelli
    Abstract:

    Abstract Questions: What is the mean Berg Balance Scale score of healthy elderly people living in the community and how does it vary with age? How much variability in Berg Balance Scale scores is present in groups of healthy elderly people and how does this vary with age? Design: Systematic review with meta-analysis. Participants: Any group of healthy community-dwelling people with a mean age of 70 years or greater that has undergone assessment using the Berg Balance Scale. Outcome measurement: Mean and standard deviations of Berg Balance Scale scores within cohorts of elderly people of known mean age. Results: The search yielded 17 relevant studies contributing data from a total of 1363 participants. The mean Berg Balance Scale scores ranged from 37 to 55 out of a possible maximum score of 56. The standard deviation of Berg Balance Scale scores varied from 1.0 to 9.2. Although participants aged around 70 years had very close to normal Berg Balance Scale scores, there was a significant decline in Balance with age at a rate of 0.7 points on the 56-point Berg Balance Scale per year. There was also a strong association between increasing age and increasing variability in Balance ( R 2 = 0.56, p Conclusion: Healthy community-dwelling elderly people have modest Balance deficits, as measured by the Berg Balance Scale, although Balance scores deteriorate and become more variable with age. [Downs S, Marquez J, Chiarelli P (2014) Normative scores on the Berg Balance Scale decline after age 70 years in healthy community-dwelling people: a systematic review. Journal of Physiotherapy 60: 85–89]

  • the Berg Balance Scale has high intra and inter rater reliability but absolute reliability varies across the Scale a systematic review
    Journal of Physiotherapy, 2013
    Co-Authors: Stephen Downs, Jodie Marquez, Pauline Chiarelli
    Abstract:

    Questions What is the intra-rater and inter-rater relative reliability of the Berg Balance Scale? What is the absolute reliability of the Berg Balance Scale? Does the absolute reliability of the Berg Balance Scale vary across the Scale? Design Systematic review with meta-analysis of reliability studies. Participants Any clinical population that has undergone assessment with the Berg Balance Scale. Outcome measures Relative intra-rater reliability, relative inter-rater reliability, and absolute reliability. Results Eleven studies involving 668 participants were included in the review. The relative intrarater reliability of the Berg Balance Scale was high, with a pooled estimate of 0.98 (95% CI 0.97 to 0.99). Relative inter-rater reliability was also high, with a pooled estimate of 0.97 (95% CI 0.96 to 0.98). A ceiling effect of the Berg Balance Scale was evident for some participants. In the analysis of absolute reliability, all of the relevant studies had an average score of 20 or above on the 0 to 56 point Berg Balance Scale. The absolute reliability across this part of the Scale, as measured by the minimal detectable change with 95% confidence, varied between 2.8 points and 6.6 points. The Berg Balance Scale has a higher absolute reliability when close to 56 points due to the ceiling effect. We identified no data that estimated the absolute reliability of the Berg Balance Scale among participants with a mean score below 20 out of 56. Conclusion The Berg Balance Scale has acceptable reliability, although it might not detect modest, clinically important changes in Balance in individual subjects. The review was only able to comment on the absolute reliability of the Berg Balance Scale among people with moderately poor to normal Balance. [Downs S, Marquez J, Chiarelli P (2013) The Berg Balance Scale has high intra- and inter-rater reliability but absolute reliability varies across the Scale: a systematic review. Journal of Physiotherapy 59: 93–99]

Christopher Kevin Wong - One of the best experts on this subject based on the ideXlab platform.

  • Balance ability measured with the Berg Balance Scale a determinant of fall history in community dwelling adults with leg amputation
    Journal of Rehabilitation Medicine, 2015
    Co-Authors: Christopher Kevin Wong, Christine C Chen, Wren M Blackwell, Rana T Rahal, Stephany A Benoy
    Abstract:

    Objective: Falls are common among adults with leg amputations and associated with Balance confidence. But subjective confidence is not equivalent with physical ability. This multivariate analyses of community-dwelling adults with leg amputations examined relationships among individual characteristics, falls, Balance ability and Balance confidence. Design: Cross-sectional study. Subjects/Patients: Community-dwelling adults with leg amputations recruited from a support group and prosthetic clinic. Methods: Subjects provided self-reported medical/fall history, prosthetic functional use, and Activities-specific Balance Confidence (ABC) questionnaire data. Balance ability was assessed with the Berg Balance Scale (BBS). Fall incidence was categorized as any fall (one or more) and recurrent falls (more than one). Multivariate logistic regression analyzed relationships within the two fall categories. Cross tabulations and ANOVA analyzed differences among subcategories. Results: Fifty-four subjects (mean age 56.8) with various etiologies, amputation levels, and Balance abilities participated. 53.7% had any fall; 25.9% had recurrent falls. Models for both fall categories correctly classified fall history in > 70% of subjects with combinations of the variables ABC, BBS, body-mass-index, and amputation level. Conclusion: Falls occurred regardless of clinical characteristics. Total BBS and select item scores were independent determinants of fall history. Unlike other Balance-impaired populations, adults with leg amputation and better Balance ability had greater odds of falling.

  • interrater reliability of the Berg Balance Scale when used by clinicians of various experience levels to assess people with lower limb amputations
    Physical Therapy, 2014
    Co-Authors: Christopher Kevin Wong
    Abstract:

    Background People with lower limb amputations frequently have impaired Balance ability. The Berg Balance Scale (BBS) has excellent psychometric properties for people with neurologic disorders and elderly people dwelling in the community. A Rasch analysis demonstrated the validity of the BBS for people with lower limb amputations of all ability strata, but rater reliability has not been tested. Objective The study objective was to determine the interrater reliability and intrarater reliability of BBS scores and the differences in scores assigned by testers with various levels of experience when assessing people with lower limb amputations. Design This reliability study of video-recorded single-session BBS assessments had a cross-sectional design. Methods From a larger study of people with lower limb amputations, 5 consecutively recruited participants using prostheses were video recorded during an in-person BBS assessment. Sixteen testers independently rated the video-recorded assessments. Testers were 3 physical therapists, 1 occupational therapist, 3 third-year and 4 second-year doctor of physical therapy (DPT) students, and 5 first-year DPT students without clinical training. Rater reliability was calculated using intraclass correlation coefficients (ICC [2,k]). Differences in scores assigned by testers with various levels of experience were determined by use of an analysis of variance with Tukey post hoc tests. Results The average age of the participants was 53.0 years (SD=15.7). Amputations had occurred at the ankle disarticulation, transtibial, and transfemoral levels because of vascular, trauma, and medical etiologies an average of 8.2 years earlier (SD=7.9). Berg Balance Scale scores spanned all ability strata. Interrater reliability (ICC [2,k]=.99) and intrarater reliability of scores determined in person and through video-recorded assessments by the same testers (ICC [2,k]=.99) were excellent. For participants with the lowest levels of ability, licensed professionals assigned lower scores than did DPT students without clinical training. Limitations Intrarater reliability calculations were based on 2 testers. Conclusions Berg Balance Scale scores assigned to people using prostheses by testers with various levels of clinical experience had excellent interrater reliability and intrarater reliability.