Accuracy of Berg balance scale to predict falls among community elderly dwellers
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.
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.
Files | ||
Issue | Vol 2 No 1 (2015): Winter | |
Section | Original Article(s) | |
Keywords | ||
accuracy elderly community berg balance scale likelihood ratio |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |