Measuring Balance and Mobility after Traumatic Brain Injury: Validation of the Community Balance and Mobility Scale (CB&amp;M)

Inness, Elizabeth L.; Howe, Jo-Anne; Niechwiej-Szwedo, Ewa; Jaglal, Susan; McIlroy, William E.; Verrier, Molly C.

doi:10.3138/ptc.2009-45

Cited by 59 publications

(59 citation statements)

References 21 publications

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“…For example, the mean BBS scores were less than six points from the maximum score of 56, suggesting a possible ceiling effect for many individuals; therefore, the BBS may be a tool more suitable for individuals in the acute and sub-acute stages of stroke. This problem may be addressed by incorporating a balance measure that is less susceptible to ceiling effects, such as the Community Balance and Mobility Scale; 46 however, this measure was not conducted as part of the primary study, and was therefore not available for secondary analysis. Similarly, the average gait speed for both non-fallers and fallers was considered to be in the community ambulation range (greater than 0.8 m/s), 28 and participants enrolled in this study were independently walking at the time of discharge.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation

Wong

Brooks

Inness

et al. 2016

Journal of Stroke and Cerebrovascular Diseases

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Section: Discussionmentioning

confidence: 99%

The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation

Wong

Brooks

Inness

et al. 2016

Journal of Stroke and Cerebrovascular Diseases

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“…The majority of the studies were rated as "good" (score 6-8), and 1 study was rated as "fair quality" (score [4][5]. The most frequent methodological limitations were a lack of blinding of subjects or study personnel, as well as unconcealed group allocation.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Limited balance ability can have considerable consequences on physical functioning in everyday life and constitutes a leading risk factor for falls [3] . Balance and gait training are together considered to be an important aspect of fall prevention [4] . Several studies have demonstrated the positive effects of conventional exercise training for gait and balance [5] .…”

Section: Introductionmentioning

confidence: 99%

Effects of Wearable Sensor-Based Balance and Gait Training on Balance, Gait, and Functional Performance in Healthy and Patient Populations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2017

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n = 1, type 3: n = 3) or combined different types of training paradigms within their intervention (type 1 and 2: n = 2; all types: n = 2). The meta-analyses revealed significant overall effects of WS training on static steady-state balance outcomes including mediolateral (eyes open: Hedges' g = 0.82, CI: 0.43-1.21; eyes closed: g = 0.57, CI: 0.14-0.99) and anterior-posterior sway (eyes open: g = 0.55, CI: 0.01-1.10; eyes closed: g = 0.44, CI: 0.02-0.86). No effects on habitual gait speed were found in the meta-analysis ( g = -0.19, CI: -0.68 to 0.29). Two RCTs reported significant improvements for selected gait variables including single support time, and fast gait speed. One study identified effects on proactive balance (Alternate Step Test), but no effects were found for the Timed Up and Go test and the Berg Balance Scale. Two studies reported positive results on feasibility and usability. Only one study was performed in an unsupervised setting. Conclusion: This review provides evidence for a positive effect of WS training on static steady-state balance in studies with usual care controls and studies with conventional balance training controls. Specific gait parameters and proactive balance measures may also be improved by WS training, yet limited evidence is available. Heterogeneous training paradigms, small sample sizes, and short intervention durations limit the validity of our findings. Larger studies are required for estimating the true potential of WS technology. © 2017 S. Karger AG, Basel KeywordsInertial measurement unit · Force sensor · Postural balance · Gait · Biofeedback · Exergame · Systematic review Abstract Background: Wearable sensors (WS) can accurately measure body motion and provide interactive feedback for supporting motor learning. Objective: This review aims to summarize current evidence for the effectiveness of WS training for improving balance, gait and functional performance. Methods: A systematic literature search was performed in PubMed, Cochrane, Web of Science, and CINAHL. Randomized controlled trials (RCTs) using a WS exercise program were included. Study quality was examined by the PEDro scale. Metaanalyses were conducted to estimate the effects of WS balance training on the most frequently reported outcome parameters. Results: Eight RCTs were included (Parkinson n = 2, stroke n = 1, Parkinson/stroke n = 1, peripheral neuropathy n = 2, frail older adults n = 1, healthy older adults n = 1). The sample size ranged from n = 20 to 40. Three types of training paradigms were used: (1) static steady-state balance training, (2) dynamic steady-state balance training, which includes gait training, and (3) proactive balance training. RCTs either used one type of training paradigm (type 2:

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“…High-level balance skills are defined as static and dynamic balance and mobility skills that require precision, speed, timing, sequencing of movements, and the ability to multitask (Inness et al, 2011). The CB&M is a 13-item measure that includes tasks that are representative of the motor skills thought to be necessary for everyday functioning in community settings, many of which have a higher degree of complexity than some pediatric outcome measures.…”

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confidence: 99%

“…Construct validity was established by clinicians and patients with traumatic brain injury (TBI), and discriminant validity was demonstrated by the scale's ability to differentiate patients along a continuum of care, from acute care to community settings (Inness et al, 2011). The CB&M demonstrates intra-rater reliability (ICC = 0.98), inter-rater reliability (ICC = 0.98), test-retest reliability (ICC = 0.98), and internal consistency (alpha coefficient = 0.96) in adults (Howe et al, 2006).…”

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confidence: 99%

Performance of Children on the Community Balance and Mobility Scale

Wright

Bos

2012

Physical & Occupational Therapy In Pediatrics

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This study describes the performance of children 8-11 years of age on the Community Balance and Mobility Scale (CB&M) and associations between performance and age, body mass index (BMI), and sex. A convenience sample of 84 was recruited. The CB&M was administered using instructions we developed for children. Mean CB&M total scores (95% confidence intervals) for age groups were 8: 70.1 (64.2, 76.1); 9: 72.8 (68.7, 76.8); 10: 79.2 (76.6, 81.7); and 11: 82.9 (79.2, 86.5). None of the children achieved the maximum score. Scores increased with age, and overweight/obese children had relatively lower scores. There were no significant differences between males and females. A regression analysis found 28.1% of the variation in the CB&M total scores was explained by age (p < .001), BMI (p < .01), and sex (p = .25) suggesting that other factors contribute to variation in balance and mobility proficiency. The modified instructions and scoring patterns from this study can assist in using the CB&M in children of ages 8-11 years.

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Measuring Balance and Mobility after Traumatic Brain Injury: Validation of the Community Balance and Mobility Scale (CB&M)

Abstract: In patients with TBI, the CB&M is less susceptible to a ceiling effect than the BBS. The construct validity of the CB&M was supported, demonstrating associations with laboratory measures of dynamic stability, measures of community integration, and balance confidence.

Cited by 59 publications

References 21 publications

The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation

The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation

Effects of Wearable Sensor-Based Balance and Gait Training on Balance, Gait, and Functional Performance in Healthy and Patient Populations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Performance of Children on the Community Balance and Mobility Scale

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