Predicting the Probability for Fall Incidence in Stroke Patients Using the Berg Balance Scale

Maeda, Noriaki; Kato, Jun; Shimada, Tomoaki

doi:10.1177/147323000903700313

Cited by 92 publications

(66 citation statements)

References 21 publications

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“…22 Matching was necessary because, on average, fallers and non-fallers tend to differ on measures of function and impairment on admission that are predictive of the current study's primary outcomes. 5,23 The sample of non-fallers was matched to fallers by stratified random sampling according to the Rehabilitation Patient Group and age. The Rehabilitation Patient Group algorithm was developed to provide a case-mix classification system to estimate in-patient rehabilitation costs, and is often used to determine length of stay (LOS) (i.e., one of the primary outcomes).…”

Section: Participantsmentioning

confidence: 99%

Do Falls Experienced During Inpatient Stroke Rehabilitation Affect Length of Stay, Functional Status, and Discharge Destination?

Wong

Brooks

Mansfield

2016

Archives of Physical Medicine and Rehabilitation

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Objective-To compare length of stay, functional status, and discharge destination between individuals who fell during in-patient stroke rehabilitation and those who did not fall. Design-Retrospective cohort study. Setting-Rehabilitation hospital.Participants-Individuals who fell during in-patient stroke rehabilitation (n=106; fallers group; mean age=67.8 years, SD=12.9; mean time post-stroke=26.4 days, SD=28.3) were matched to individuals who did not fall (n=106; non-fallers group; mean age=67.3 years, SD=13.6; mean time post-stroke=21.9 days, SD=28.8) on age and functional status (N=212). Interventions-Not applicable.Main outcome measures-Total length of stay, Functional Independence Measure (FIM) assessed at discharge, and discharge destination.Results-The mean length of stay for fallers was 11 days longer than non-fallers (p=0.0017). Non-fallers and fallers did not differ on discharge total FIM scores (p=0.19), and both groups were discharged home after in-patient rehabilitation (non-fallers: 77%; fallers: 74%; p=0.52).Conclusions-This study suggests that falls experienced during in-patient stroke rehabilitation may have contributed to a longer length of stay; however, falls did not impact discharge functional status or discharge destination. In-patient rehabilitation is a health care setting where patients are focused on improving function and maximizing their abilities. It is typically delivered during the sub-acute stage of stroke recovery (i.e. less than three months post-stroke) when patients are likely to receive the most benefit from intensive therapy. 17,18 Unfortunately, there is limited available evidence for the effectiveness of falls prevention interventions after stroke across acute care, rehabilitation, community, and institutional care settings. 19,20 Thus, the incidence of falls will remain of concern, as it may not be possible to prevent every fall. KeywordsLittle evidence exists on the impact of falls on rehabilitation outcomes; therefore, it is important to understand the effect that falls have on the course of patient recovery and delivery of care during the critical sub-acute phase of stroke. The primary objective of this study was to compare length of stay, functional status, and discharge destination between individuals who fell during in-patient stroke rehabilitation and those who did not fall. It was hypothesized that patients who fell would have poorer recovery compared to those who did not fall. This would be demonstrated by a longer length of stay, worse functional outcomes at discharge, and less likely to be discharged home following the rehabilitation stay among individuals who fell. METHODS Study designA retrospective cohort study involving a chart review was conducted. The chart review involved consecutive admissions to the specialized stroke unit at the Toronto Rehabilitation Institute from October 1, 2009 to September 30, 2012. The Toronto Rehabilitation Institute Research Ethics Board approved this study, and a waiver of patient consent for the purpose of this review...

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Section: Participantsmentioning

confidence: 99%

Do Falls Experienced During Inpatient Stroke Rehabilitation Affect Length of Stay, Functional Status, and Discharge Destination?

Wong

Brooks

Mansfield

2016

Archives of Physical Medicine and Rehabilitation

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“…A score of Յ46 identifies an individual at risk for falls after stroke. 29 The 16-item Activities-specific Balance Confidence Scale was used to measure balance self-efficacy. The Activities-specific Balance Confidence Scale is a self-report of a participant's self-efficacy in maintaining static and dynamic balance control during functional tasks.…”

Section: Outcome Assessmentsmentioning

confidence: 99%

Poststroke Balance Improves With Yoga

Schmid¹,

Puymbroeck

Altenburger

et al. 2012

Stroke

113

106

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Background and Purpose— Balance impairment is common after stroke; modified yoga may be able to improve balance and other important poststroke variables. Scientific-evidence is needed to support such treatment interventions. The purpose of this study was to assess the impact of a yoga-based rehabilitation intervention on balance, balance self-efficacy, fear of falling (FoF), and quality of life after stroke. Methods— This was a prospective, randomized, pilot study of yoga-based rehabilitation for people with chronic stroke. All yoga sessions were taught by a registered yoga therapist, occurred twice per week for 8 weeks and included seated, standing, and floor postures with relaxation and meditation. Balance was assessed with the Berg Balance Scale, balance self-efficacy with the Activities-specific Balance Confidence Scale, FoF with a dichotomous yes/no question, and quality of life with the Stroke Specific Quality of Life scale. Results— There were no significant differences between wait-list control (n=10) and yoga (n=37) groups in baseline or follow-up scores. However, using within-group comparisons, yoga group data demonstrated significant improvement in balance (Berg Balance Scale, 41.3±11.7 vs 46.3±9.1; P <0.001) and FoF (51% vs 46% with FoF; P <0.001). Conclusions— A group yoga-based rehabilitation intervention for people with chronic stroke has potential in improving multiple poststroke variables. Group yoga may be complementary to rehabilitation, may be possible in medical-based and community-based settings, and may be cost-effective. Further testing of group yoga-based rehabilitation interventions is warranted. Clinical Trial Registration— URL: http://clinicaltrials.gov . Unique Identifier: NCT01109602.

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“…Psychometric properties f BBS have been studied in details [8,[13][14][15]. This important property of the scale would be affected if two different examiners perform the test on two different occasions not aware of the side of the patient that was used every time.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have used BBS to predict the fall in patients with stroke and found it to be a good predictor of fall [8,16,17]. Also BBS is used to differentiate between fallers and non-fallers [18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is Scoring on Berg Balance Scale Affected By Items Being Performed By Sound Side or An Affected Side?

Ganvir¹,

Harishch²

2017

Physiother Rehabil

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Predicting the Probability for Fall Incidence in Stroke Patients Using the Berg Balance Scale

Cited by 92 publications

References 21 publications

Do Falls Experienced During Inpatient Stroke Rehabilitation Affect Length of Stay, Functional Status, and Discharge Destination?

Do Falls Experienced During Inpatient Stroke Rehabilitation Affect Length of Stay, Functional Status, and Discharge Destination?

Poststroke Balance Improves With Yoga

Is Scoring on Berg Balance Scale Affected By Items Being Performed By Sound Side or An Affected Side?

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