Hyuma Makizako1, Norihito Kabe2, Asami Takano3, Kanako Isobe4. 1. Department of Functional Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-machi, Obu, Aichi 474-8511, Japan∗. Electronic address: makizako@ncgg.go.jp. 2. National Center for Geriatrics and Gerontology, Aichi, Japan; and Department of Physical Therapy, Funabashi Municipal Rehabilitation Hospital, Chiba, Japan(†). 3. Department of Speech Therapy, Funabashi Municipal Rehabilitation Hospital, Chiba, Japan(‡). 4. Department of Nursing and Care Work, Funabashi Municipal Rehabilitation Hospital, Chiba, Japan(§).
Abstract
OBJECTIVE: To examine whether the Berg Balance Scale (BBS) score on admission and after 1 month can be used to predict the Functional Independence Measure (FIM) walking level 6 or 7 (modified independent and independent gait respectively) after 3 months and to determine the optimal BBS cut-off score for predicting independent gait among inpatients with first stroke in a rehabilitation facility. DESIGN: Retrospective cohort study. SETTING: Inpatient rehabilitation facility (Kaifukuki). PARTICIPANTS: Two hundred fifty-one consecutive patients with first stroke and nonindependent gait on admission. OUTCOME MEASURES: BBS on admission and after 1 month and FIM on admission and after 3 months. RESULTS: Area under the receiver operating characteristic curves for predicting independent gait after 3 months were 0.81 (95% confidence interval [CI], 0.75-0.88) for BBS score on admission; the optimal cut-off score being ≥13 (63% sensitivity; 90% specificity). Achieving greater cut-off score on admission was significantly associated with subsequent independent gait (odds ratio, 9.7; 95% CI, 4.38-21.36; P < .001). A subanalysis of patients with poor balance on admission (BBS score <13; n = 191) showed area under the receiver operating characteristic curves for predicting independent gait after 3 months of 0.88 (95% CI, 0.80-0.95) for BBS scores 1 month after admission. In this subgroup, BBS scores at 1 month of ≥27 were significantly associated with subsequent independent gait (odds ratio, 21.6, 95% CI, 6.40-73.20; P < .001). CONCLUSIONS: Admission BBS scores predicted FIM walking level 6 or 7, which denotes modified independent or independent gait, after 3 months, the optimal cut-off for BBS scores being ≥13 among inpatients with first stroke in a rehabilitation facility. Patients with poor balance on admission whose BBS scores had improved to ≥27 at 1 month after admission were likely to achieve modified independent or independent gait within 3 months after admission.
OBJECTIVE: To examine whether the Berg Balance Scale (BBS) score on admission and after 1 month can be used to predict the Functional Independence Measure (FIM) walking level 6 or 7 (modified independent and independent gait respectively) after 3 months and to determine the optimal BBS cut-off score for predicting independent gait among inpatients with first stroke in a rehabilitation facility. DESIGN: Retrospective cohort study. SETTING: Inpatient rehabilitation facility (Kaifukuki). PARTICIPANTS: Two hundred fifty-one consecutive patients with first stroke and nonindependent gait on admission. OUTCOME MEASURES: BBS on admission and after 1 month and FIM on admission and after 3 months. RESULTS: Area under the receiver operating characteristic curves for predicting independent gait after 3 months were 0.81 (95% confidence interval [CI], 0.75-0.88) for BBS score on admission; the optimal cut-off score being ≥13 (63% sensitivity; 90% specificity). Achieving greater cut-off score on admission was significantly associated with subsequent independent gait (odds ratio, 9.7; 95% CI, 4.38-21.36; P < .001). A subanalysis of patients with poor balance on admission (BBS score <13; n = 191) showed area under the receiver operating characteristic curves for predicting independent gait after 3 months of 0.88 (95% CI, 0.80-0.95) for BBS scores 1 month after admission. In this subgroup, BBS scores at 1 month of ≥27 were significantly associated with subsequent independent gait (odds ratio, 21.6, 95% CI, 6.40-73.20; P < .001). CONCLUSIONS: Admission BBS scores predicted FIM walking level 6 or 7, which denotes modified independent or independent gait, after 3 months, the optimal cut-off for BBS scores being ≥13 among inpatients with first stroke in a rehabilitation facility. Patients with poor balance on admission whose BBS scores had improved to ≥27 at 1 month after admission were likely to achieve modified independent or independent gait within 3 months after admission.
Authors: Soo Jeong Kim; Hye Jin Lee; Seung Won Hwang; Hannah Pyo; Sung Phil Yang; Mun-Hee Lim; Gyu Lee Park; Eun Joo Kim Journal: Ann Rehabil Med Date: 2016-04-25
Authors: Marc Bolliger; Andrew R Blight; Edelle C Field-Fote; Kristin Musselman; Serge Rossignol; Dorothy Barthélemy; Laurent Bouyer; Milos R Popovic; Jan M Schwab; Michael L Boninger; Keith E Tansey; Giorgio Scivoletto; Naomi Kleitman; Linda A T Jones; Dany H Gagnon; Sylvie Nadeau; Dirk Haupt; Lea Awai; Chris S Easthope; Björn Zörner; Ruediger Rupp; Dan Lammertse; Armin Curt; John Steeves Journal: Spinal Cord Date: 2018-04-27 Impact factor: 2.772