Nursing Practice Today 2015. 2(1):34-40.

Accuracy of Berg balance scale to predict falls among community elderly dwellers
Ali Dadgari, Tengku Aizan Hamid, Mohammad Nazrul Hakim, Reza Chaman, Seyed Abbas Mousavi, Lim Poh Hin, Leila Dadvar

Abstract


Background & Aim: Berg balance scale (BBS) is one of the most applied tests to identify high-risk elderly people for fall. Fall is a common health problem among community senior citizens. A diag- nostic test to identify high-risk elderly people can prevent or alleviate falls. The purpose of this study was to determine the accuracy of BBS to predict falls among elderly community dwellers.
Methods  &  Materials:  This  cross-sectional  study  was  conducted  among  elderly  community dwellers in Shahroud, Semnan Providence, Iran. In this study, 1312 elderly individuals were regis- tered for the study, 455 of them were randomly selected as qualified participants. This study is a validity investigation on BBS among elderly community dwellers. To validate the BBS, research- ers assessed validity, specificity, positive and negative predictive values, positive likelihood ratio (LR+) and negative LR (LR−).
Results: The findings of this study showed that 243 subjects were male, and 212 subjects were female. The mean age of subjects were 71.45 ± 9.25 years. This study showed sensitivity  and specificity of 0.63 and 0.97, respectively. According to the findings of the study, LR+ and LR− were calculated as 9.57 and 0.39, respectively.
Conclusion: The results of the study are in harmony with the hypothesis to design the test, i.e. BBS have the acceptable accuracy to identify high-risk community elderly people for falls. How- ever, other influential factors such as personal and environmental variables are necessary to con- sider for prediction of falls.


Keywords


accuracy; elderly; community; berg balance scale; likelihood ratio

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References


Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas 2013; 75(1): 51- 61.

Tinetti ME, Kumar C. The patient who falls: "It's always a trade-off". JAMA 2010; 303(3): 258-66.

Srinivas-Shankar U, Roberts SA, Connolly MJ, O'Connell MD, Adams JE, Oldham JA, et al. Effects of testosterone on muscle strength, physical function, body composi- tion, and quality of life in intermediate-frail and frail elderly men: a randomized, double- blind, placebo-controlled study. J Clin En- docrinol Metab 2010; 95(2): 639-50.

Close JC, Lord SR, Antonova EJ, Martin M, Lensberg B, Taylor M, et al. Older people presenting to the emergency department af- ter a fall: a population with substantial re- current healthcare use. Emerg Med J 2012; 29(9): 742-7.

Kwan MM, Close JC, Wong AK, Lord SR. Falls incidence, risk factors, and conse- quences in Chinese older people: a systemat- ic review. J Am Geriatr Soc 2011; 59(3): 536-43.

Deandrea S, Lucenteforte E, Bravi F, Foschi R, La VC, Negri E. Risk factors for falls in community-dwelling older people: a sys- tematic review and meta-analysis. Epidemi- ology 2010; 21(5): 658-68.

Lee HC, Chang KC, Tsauo JY, Hung JW, Huang YC, Lin SI. Effects of a multifactori- al fall prevention program on fall incidence and physical function in community- dwelling older adults with risk of falls. Arch Phys Med Rehabil 2013; 94(4): 606-15, 615.

Marks R. Falls among the Elderly: Multi- factorial community-based falls-prevention programs. Aging Sci 2014; 2: e109.

Bogle Thorbahn LD, Newton RA. Use of the Berg Balance Test to predict falls in elderly persons. Phys Ther 1996; 76(6): 576-83.

Dahl AK, Reynolds CA, Fall T, Magnusson PK, Pedersen NL. Multifactorial analysis of changes in body mass index across the adult life course: a study with 65 years of follow- up. Int J Obes (Lond) 2014; 38(8): 1133-41.

de Amorim Bizerra CD, Gonçalves RF, de Figueirôa Silva Carmo A, Moura LA, Nona- to Coelho Mendes R. Falls in elderly: identi- fication of extrinsic risk factors at home. Journal of Research: Fundamental Care Online 2014; 6(1): 203-12.

Bergland A. Fall risk factors in community- dwelling elderly people. Norsk Epidemiolo- gi 2012; 22(2): 151-64.

Alamgir H, Muazzam S, Nasrullah M. Unin- tentional falls mortality among elderly in the United States: time for action. Injury 2012; 43(12): 2065-71.

Raji P. Functional balance tests. Audiol 2012; 21(4): 1-9. [In Persian].

Saunders N. Reliability and validity of an accelerometer-based balance assessment for fall risk screening [Thesis]. Columbus, OH: Ohio State University, EDU Physical Activi- ty and Educational Services; 2013.

Smith PS, Hembree JA, Thompson ME. Berg Balance Scale and Functional Reach: determining the best clinical tool for indi- vidual post- acute stroke. Clin Rehabil 2004; 18(7): 811-8.

Oppewal A, Hilgenkamp TI, van Wijck R, Evenhuis HM. Feasibility and outcomes of the Berg Balance Scale in older adults with intellectual disabilities. Res Dev Disabil 2013; 34(9): 2743-52.

Lindemann U, Moe-Nilssen R, Nicolai SE, Becker C, Chiari L. Assessment of balance in unsupported standing with elderly inpa- tients by force plate and accelerometers. Ag- ing Clin Exp Res 2012; 24(1): 37-41.

Berg K, Wood-Dauphinee SL, Williams JI, Gayton D. Measuring balance in the elderly; preliminary development of an instrument. Physiotherapy Canada 1989; 41: 304-11.

Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elder- ly: validation of an instrument. Can J Public Health 1992; 83(Suppl 2): S7-S11.

Bogaerts A, Delecluse C, Boonen S, Claessens AL, Milisen K, Verschueren SM. Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial. Gait Posture 2011; 33(3): 466-72.

Park MK, Lim HW, Cho JG, Choi CJ, Hwang SJ, Chae SW. A head shake sensory organization test to improve the sensitivity of the sensory organization test in the elder- ly. Otol Neurotol 2012; 33(1): 67-71.

Chen EW, Fu AS, Chan KM, Tsang WW. Balance control in very old adults with and without visual impairment. Eur J Appl Phys- iol 2012; 112(5): 1631-6.

Azadi F, Salavati M, Kazemi B, Akbari Kamrani AA. Prediction of risk of falling among institutionalized elderly people in Iran. J Rehab 2003; 4(2): 45-51. [In Persian].

Miyamoto ST, Lombardi J, I, Berg KO, Ramos LR, Natour J. Brazilian version of the Berg balance scale. Braz J Med Biol Res 2004; 37(9): 1411-21.

Muir SW, Berg K, Chesworth B, Speechley M. Use of the Berg Balance Scale for pre- dicting multiple falls in community-dwelling elderly people: a prospective study. Phys Ther 2008; 88(4): 449-59.

Godi M, Franchignoni F, Caligari M, Giordano A, Turcato AM, Nardone A. Comparison of reliability, validity, and re- sponsiveness of the mini-BESTest and Berg Balance Scale in patients with balance dis- orders. Phys Ther 2013; 93(2): 158-67.

Stevenson TJ. Detecting change in patients with stroke using the Berg Balance Scale. Aust J Physiother 2001; 47(1): 29-38.

Azad A, Taghizadeh G, Khaneghini A. As- sessments of the reliability of the Iranian version of the Berg Balance Scale in patients with multiple sclerosis. Acta Neurol Taiwan 2011; 20(1): 22-8.

Riddle DL, Stratford PW. Interpreting valid- ity indexes for diagnostic tests: an illustra- tion using the Berg balance test. Phys Ther 1999; 79(10): 939-48.

Salavati M, Negahban H, Mazaheri M, So- leimanifar M, Hadadi M, Sefiddashti L, et al. The Persian version of the Berg Balance Scale: inter and intra-rater reliability and construct validity in elderly adults. Disabil Rehabil 2012; 34(20): 1695-8.

Deeks JJ, Altman DG. Diagnostic tests 4: likelihood ratios. BMJ 2004; 329(7458): 168-9.

Dibble LE, Lopez-Lennon C, Lake W, Hoffmeister C, Gappmaier E. Utility of dis- ease-specific measures and clinical balance tests in prediction of falls in persons with multiple sclerosis. J Neurol Phys Ther 2013; 37(3): 99-104.

Berg K, Wood-Dauphinee S, Williams JI. The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995; 27(1): 27-36.

Fathi Rezaei Z, Aslankhani MA, Farsi AR, Abdoli B, Zamani Sani SH. A comparison of three functional tests of balance in identi- fying fallers from non-fallers in elderly peo- ple. Knowledge Health 2010; 4(4): 21-6. [In Persian].

Qutubuddin AA, Pegg PO, Cifu DX, Brown R, McNamee S, Carne W. Validating the Berg Balance Scale for patients with Parkin- son's disease: a key to rehabilitation evalua- tion. Arch Phys Med Rehabil 2005; 86(4): 789-92.

Conradsson M, Lundin-Olsson L, Lindelof N, Littbrand H, Malmqvist L, Gustafson Y, et al. Berg balance scale: intrarater test- retest reliability among older people de- pendent in activities of daily living and liv- ing in residential care facilities. Phys Ther 2007; 87(9): 1155-63.


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