Browse > Article
http://dx.doi.org/10.12674/ptk.2018.25.1.039

Comparison of the Berg Balance and Fullerton Advanced Balance Scale for Predicting Falls in Patients With Chronic Stroke  

Kim, In-seop (Dept. of Physical Therapy, Daejeon Health Institute of Technology)
Nam, Taek-gil (Dept. of Physical Therapy, Daejeon Health Institute of Technology)
Kim, Gyoung-mo (Dept. of Physical Therapy, Daejeon Health Institute of Technology)
Kim, Jun-seop (Dept. of Physical Therapy, Daejeon Health Institute of Technology)
Kim, So-jeong (Dept. of Physical Therapy, Daejeon Health Institute of Technology)
Kang, Jeong-ha (Dept. of Physical Therapy, Daejeon Health Institute of Technology)
Publication Information
Physical Therapy Korea / v.25, no.1, 2018 , pp. 39-46 More about this Journal
Abstract
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.
Keywords
Berg balance scale; Fullerton advanced balance scale; Stroke; Receiver operating characteristics;
Citations & Related Records
Times Cited By KSCI : 4  (Citation Analysis)
연도 인용수 순위
1 Andersson AG, Kamwendo K, Appelros P. Fear of falling in stroke patients: Relationship with previous falls and functional characteristics. Int J Rehabil Res. 2008;31(3):261-264. https://doi.org/10.1097/MRR.0b013e3282fba390   DOI
2 Belgen B, Beninato M, Sullivan PE, et al. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil. 2006;87(4):554-561.   DOI
3 Berg K, Wood-Dauphinee S, Williams JI, et al. Measuring balance in the elderly: Preliminary development of an instrument. Physiother Can. 1989;41(6):304-311. https://doi.org/10.3138/ptc.41.6.304   DOI
4 Berg KO, Maki BE, Williams JI, et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992;73(11):1073-1080.
5 Bogle Thorbahn LD, Newton RA. Use of the Berg balance test to predict falls in elderly persons. Phys Ther. 1996;76(6):576-585.   DOI
6 Bonan IV, Colle FM, Guichard JP, et al. Reliance on visual information after stroke. Prt I: balance on dynamic posturography. Arch Phys Med Rehabil 2004;85(2):268-273.   DOI
7 Boulgarides LK, McGinty SM, Willett JA, et al. Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Phys Ther. 2003;83(4):328-339.
8 Brauer SG, Burns YR, Galley P. A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci. 2000;55(8):M469-M476.   DOI
9 Cheng PT, Liaw MY, Wong MK, et al. The sit-to-stand movement in stroke patients and its correlation with falling. Arch Phys Med Rehabil 1998;79(9):1043-1046.   DOI
10 Eng J. Receiver operating characteristic analysis: A primer. Acad Radiol. 2005;12(7):909-916.   DOI
11 Fortinsky RH, Baker D, Gottschalk M, et al. Extent of implementation of evidence-based fall prevention practices for older patients in home health care. J Am Geriatr Soc. 2008;56(4):737-743. https://doi.org/10.1111/j.1532-5415.2007.01630   DOI
12 Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: A modified version of the Berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther. 2003;15(2):114-128.   DOI
13 Friedman SM, Munoz B, West SK, et al. Falls and fear of falling: Which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002;50(8):1329-1335.   DOI
14 Geurts AC, de Haart M, van Nes IJ, et al. A review of standing balance recovery from stroke. Gait Posture. 2005;22(3):267-281. https://doi.org/10.1016/j.gaitpost.2004.10.002   DOI
15 Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med. 2000;45(1-2):23-41.   DOI
16 Hajian-Tilaki K. Receiver Operating Characteristic (ROC) curve analysis for medical diagnostic test evaluation. Caspian J Intern Med. 2013;4(2):627-635.
17 Jung HY, Park JH, Shim JJ, et al. Reliability test of Korean version of Berg balance scale. J Korean Acad Rehabil Med. 2006;30(6):611-618.
18 Hernandez D, Rose DJ. Predicting which older adults will or will not fall using the Fullerton advanced balance scale. Arch Phys Med Rehabil. 2008;89(12):2309-2315. https://doi.org/10.1016/j.apmr.2008.05.020   DOI
19 Hochstenbach J, Donders R, Mulder T, et al. Long-term outcome after stroke: A disabilityorientated approach. Int J Rehabil Res 1996;19(3):189-200.   DOI
20 Jeon YJ, Kim GM. Comparison of the berg balance scale and fullerton advanced balance scale to predict falls in community-dwelling adults. J Phys Ther Sci. 2017;29(2):232-234. https://doi.org/10.1589/jpts.29.232   DOI
21 Kim GM. Comparison of the pediatric balance scale and Fullerton advanced balance scale for predicting falls in children with cerebral palsy. Phy Ther Korea. 2016;23(4):63-70. https://doi.org/10.12674/ptk.2016.23.4.063   DOI
22 Kim GM. Content validity of a Korean-translated version of a Fullerton advanced balance scale: A pliot study. Phys Ther Korea. 2015;22(4):51-61. https://doi.org/10.12674/ptk.2015.22.4.051   DOI
23 Kim GM. Reliability and validity study on the korean version of the fullerton advanced balance scale. Phys Ther Korea. 2016;23(1):31-37. https://doi.org/10.12674/ptk.2016.23.1.031   DOI
24 Legters K. Fear of falling. Phys Ther. 2002;82(3):264-272.
25 Li F, Harmer P, Fitzgerald K, et al. Tai chi and postural stability in patients with Parkinson's disease. N Engl J Med. 2012;366(6):511-519. https://doi.org/10.1056/NEJMoa1107911   DOI
26 Liston RA, Brouwer BJ. Reliability and validity of measures obtained from stroke patients using the balance master. Arch Phys Med Rehabil. 1996;77(5):425-430.   DOI
27 Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83(3):237-252.
28 Schlenstedt C, Brombacher S, Hartwigsen G, et al. Comparison of the Fullerton advanced balance scale, mini-BESTest, and Berg balance scale to predict falls in Parkinson disease. Phys Ther. 2016;96(4):494-501.   DOI
29 Pang MY, Eng JJ. Fall-related self-efficacy, not balance and mobility performance, is related to accidental falls in chronic stroke survivors with low bone mineral density. Osteoporos Int. 2008;19(7):919-927   DOI
30 Rose DJ, Lucchese N, Wiersma LD. Development of a multidimensional balance scale for use with functionally independent older adults. Arch Phys Med Rehabil. 2006;87(11):1478-1485.   DOI
31 Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up &go test. Phys Ther. 2000;80(9):896-903.
32 Smania N, Corato E, Tinazzi M, et al. Effect of balance training on postural instability in patients with idiopathic Parkinson's disease. Neurorehabil Neural Repair. 2010;24(9):826-834.   DOI
33 Smith MT, Baer GD. Achievement of simple mobility milestones after stroke. Arch Phys Med Rehabil. 1999;80(4):442-447.   DOI
34 Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240(4857):1285-1293.   DOI
35 Swets JA. ROC analysis applied to the evaluation of medical imaging techniques. Invest Radiol. 1979;14(2):109-121.   DOI
36 Sze KH, Wong E, Leung HY, et al. Falls among chinese stroke patients during rehabilitation. Arch Phys Med Rehabil. 2001;82(9):1219-1225.   DOI
37 Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;331(13):821-827.   DOI
38 Whitney S, Wrisley D, Furman J. Concurrent validity of the berg balance scale and the dynamic gait index in people with vestibular dysfunction. Physiother Res Int. 2003;8(4):178-186.   DOI
39 van de Port IG, Kwakkel G, Schepers VP, et al. Predicting mobility outcome one year after stroke: A prospective cohort study. J Rehabil Med. 2006;38(4):218-223.   DOI
40 Weerdesteyn V, de Niet M, van Duijnhoven HJ, et al. Falls in individuals with stroke. J Rehabil Res Dev. 2008;45(8):1195-1213.   DOI
41 Won JI. A Comparison of assessment tools for prediction of falls in patients with stroke. Phys Ther Korea. 2014;21(2):37-47.   DOI
42 Yates JS, Lai SM, Duncan PW, et al. Falls in community-dwelling stroke survivors: An accumulated impairments model. J Rehabil Res Dev. 2002;39(3):385-394.