Background and Purpose:
Hip fracture is a common injury in older adults, with a high proportion of hip fractures affecting women. After a hip fracture, the recovery of the patient's walking speed is very important; one of the key determinants of walking speed is balance. The Balance Evaluation Systems Test (BESTest), a clinical balance measure, categorizes balance into 6 postural control systems. However, the relationship between the walking speed level and the sections of the BESTest has not been explored for older women with hip fracture. Our objective was to establish section scores for the BESTest cutoff values for walking speed in older women with hip fracture.
Methods:
This was an observational study involving 46 older women 65 years or older with hip fracture. The BESTest was administered to all participants upon their discharge from the hospital. Participants were divided into groups on the basis of their walking speed levels, and receiver operating characteristic curves were determined for each section of the BESTest. We calculated the cutoff value, area under the curve (AUC), sensitivity, and specificity of each.
Results:
Section IV-Stability in Gait showed the highest AUC (0.92) compared with the other sections, and the cutoff value determined for the fast and slow walker groups was 64.3% (sensitivity = 0.82, specificity = 0.83). The sections with moderate AUC (0.7-0.9) were I-Biomechanical Constraints (cutoff = 70.0%), III-Anticipatory Postural Adjustments (cutoff = 66.5%), IV-Postural Responses (cutoff = 69.4%), and V-Sensory Orientation (cutoff = 83.4%). The sections with the highest sensitivity (0.82) were I-Biomechanical Constraints and VI-Stability in Gait, and that with the highest specificity (0.88) was II-Stability Limits and Verticality.
Conclusions:
Five of the BESTest sections (I-Biomechanical Constraints, III-Anticipatory Postural Adjustments, IV-Postural Responses, V-Sensory Orientation, and IV-Stability in Gait) were able to differentiate between fast and slow walkers among older women with hip fracture. Balance during gait and anticipatory postural adjustments were shown to be important components of balance, and their cutoff values were indicators of the balance required to reach fast walking levels.
[Purpose] The purpose of this study was to clarify the relationships between falls and
sections of the Balance Evaluation Systems Test (BESTest) in patients with stroke or those
with a history of fracture. [Subjects and Methods] This longitudinal study included 51
self-ambulatory inpatients. Balance was assessed 1 week prior to discharge using the
BESTest, and the incidence of falls within 6 months after discharge was investigated.
Relationships between falling and balance components were analyzed using the
t-test or the Mann-Whitney U test and receiver operating characteristic
(ROC) curve analysis. [Results] Five subjects were dropped out before follow-up at 6
months. Falls were reported by 10 of the remaining 46 participants. Scores for two
sections (Anticipatory Postural Adjustments and Sensory Orientation) were significantly
lower in fallers than in non-fallers with stroke. Four of the six sections (Biomechanical
Constraints, Anticipatory Postural Adjustments, Sensory Orientation, and Stability in
Gait) showed areas under the ROC curves >0.8 (0.82, 0.83, 0.84, and 0.81,
respectively). In patients with a history of fractures, all sections were not
significantly different between fallers and non-fallers. [Conclusion] Anticipatory
Postural Adjustments and Sensory Orientation sections of the BESTest were related to
future occurrence of fall after discharge in self-ambulatory stroke patients.
[Purpose] Afferent input caused by electrical stimulation of a peripheral nerve or a
muscle modulates corticospinal excitability. However, a long duration of stimulation is
required to induce these effects. The purpose of this study was to investigate the effect
of short-duration high-frequency electrical muscle stimulation (EMS) on corticospinal
excitability through the measurement of motor evoked potentials (MEP) in young healthy
subjects. [Subjects] Eleven healthy right-handed subjects participated in this study.
[Methods] EMS was applied to the abductor pollicis brevis (APB) muscle at 100 Hz with a
pulse width of 100 μs for 120 s. The intensity of stimulation was just below the motor
threshold. Transcranial magnetic stimulation was applied over the motor cortex, and MEP
were recorded from the APB before, and immediately, 10, and 20 min after EMS. [Results] In
the APB muscle, the MEP amplitude significantly decreased after EMS, and this effect
lasted for 20 min. [Conclusion] The excitability of the corticospinal tract decreased
after short-duration high-frequency EMS, and the effect lasted for 20 min. These results
suggest that even short duration EMS can change the excitability of the corticospinal
tract.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.