Development of Cut-off Values on the Berg Balance Scale for Predicting Walking Independence in Older Adults with Hip Fracture

Abstract

Objectives: The aim of the current study was to identify a cut-off value for predicting walking independence at discharge in older adults with hip fracture based on their Berg Balance Scale (BBS) score at admission to a convalescent rehabilitation ward. Methods: This was a retrospective, multicenter, observational study of 187 older adults with hip fractures (mean age 83.7, range 66–97 years). Data was collected on the patients’ age, sex, treatment, and physical function evaluation. An ordinal logistic regression analysis was used to identify predictors associated with the degree of independence in walking at discharge. Receiver operating characteristic curves were used to estimate cut-off values to predict independent and supervised walking at discharge based on the BBS score at admission. The accuracy of the classification was assessed using the area under the curve (AUC). Results: The BBS score at admission was a significant factor predicting the degree of walking independence at discharge (odds ratio = 1.09, 95%CI: 1.06–1.11). The cut-off values of the BBS score at admission for predicting independent walking and supervised walking at discharge were 28 points (AUC = 0.76, 95%CI: 0.69–0.83) and 21 points (AUC = 0.84, 95%CI: 0.77–0.91), respectively. Conclusions: The BBS scores of older adults with hip fracture on admission to a rehabilitation ward are useful for predicting the degree of independence in walking at discharge and can help to structure therapy according to the predicted degree of independence.

Usefulness of the Kansas University Standing Balance Scale in inpatient rehabilitation: a retrospective validation study

“…Considering the simplicity and ease of conducting the KUSBS, the KUSBS can replace the BBS to evaluate the standing balance of patients in inpatient rehabilitation facilities when the BBS is inadequate. Cohort studies conducted in inpatient rehabilitation settings [9][10][11][12][13]30,31] reported that the BBS at admission could predict walking ability at the time of discharge of patients with stroke [9][10][11]13,30,32] and hip fractures [12]. The hospital stays for patients with stroke in two previous studies was similar to those in our study, and the BBS cutoff values were 20 and 29 points [9,11].…”

“…In another study, the cutoff value for patients with hip fractures was 28 [12] while the mean participant age and duration of hospital stay were 84 years and 50 days, respectively. In our study, the cutoff values for patients with stroke were similar to those of young-old and old-old patients but different from those of oldestold patients.…”

“…It includes 14 items that measure sitting, standing, and dynamic balance, making it the gold standard for assessing balance [6][7][8]. BBS scores of 13-29 are reported to predict independent walking after inpatient rehabilitation interventions [9][10][11][12][13] with cutoff scores varying by the length of stay.…”

Assessment indicators for determining walking independence

“…Assessment Indicators for Determining Walking Independence DOI: http://dx.doi.org/10.5772/intechopen.1003255 to rehabilitation wards is 18 points [10]. The BBS score of hip fracture patients admitted to rehabilitation wards helps to predict walking independence at discharge and determine treatment according to the predicted level of independence [14]. The reported cut-off value for the 10MWT, a walking indicator, for walking independence in patients in recovery wards is 0.8 m/s, indoor walking independence in older adults living in the community is 0.5 m/s, and outdoor walking independence is 1 m/s [11,12].…”

Instrumental and Non-Instrumental Measurements in Patients with Peripheral Vestibular Dysfunctions

“…The effectiveness of rehabilitation can be assessed with clinical tests, the most popular of which are the Timed “Up and Go” test (TUG), the Dynamic Gait Index (DGI), the Berg Balance Scale (BBS), the Tinetti test (TT), and the Functional Reach test (FR) [ 9 , 10 , 11 , 12 ]. Clinical balance tests usually consist of static and dynamic tasks, while some even attempt to estimate the risk of falls.…”