Predicting fallers in a community-based sample of people with Parkinson’s disease.
The raters observed one individual without PD perform the tests prior to participant testing without discussing the rating scales so they would be familiar with the flow of testing.
This lack of ability to identify early balance impairments in individuals with PD may prevent important early intervention measures.
Once contacted, the inclusion and exclusion criteria were re-verified. Another limitation is that the balance tests were not randomized. A perfect score is Check if you have access through your login credentials or your institution.
Interrater and test-retest funnctional were calculated using ICC 2,1 because raters tested participants using information that any physical therapist or physical therapist student would have available. All participants met the following inclusion criteria: Although the BESTest allows for either random number generation or counting backward by 3s in the timed get-up-and-go dual-task item, random number generation was used for all evaluations.
Reference Group Data for the Functional Gait Assessment | Marion L Walker – testkey
Of the 82 individuals who agreed to participate in the study, 2 were eliminated based on exclusion criteria and an unrelated illness, respectively.
Both disease severity and fear of falling are highly associated with postural instability and falls. The BBS was administered as described in the original article, 32 with one modification. Citing articles via Web of Science After signing the approved consent forms, participants completed demographic information, reported number of falls in the prior 6 months, and took the ABC with the assistance of a caregiver as needed.
The BBS, however, has been shown to have a ceiling effect in individuals with PD, as well as other populations. There was a larger discrepancy between the test-retest scores for the FGA, with the physical therapist having excellent reliability, but funcrional physical therapist student having only moderately good reliability.
The first method maximizes both sensitivity and specificity, assessment both false-positive and false-negative identifications of fallers. Dibble et al 21 proposed the use of multiple tests to increase the posttest probability of accurately assessing who was at risk for falling.
Early interventions may prevent or decrease the negative effects of postural instability. This design might allow the identification of fallers, as well as help determine the main contributor to the underlying balance deficit. Our study included participants from the community who were not actively seeking treatment and, theoretically, less impaired. Intraclass correlation coefficients 2,1 were used to calculate reliability, and Spearman correlation coefficients were used to assess validity.
Participants also were allowed to rest as often as they wanted to prevent any fatigue. ICC intraclass correlation coefficient. Any test item that was duplicated between the tests was performed only once and then scored using criteria from each test. xssessment
We also hypothesized that the FGA and BESTest would be able to differentiate between individuals who fall and individuals who do not fall. Despite its complexity dwonload greater number of items, the BESTest can be used successfully and consistently with available training tools. The responsiveness of these balance tests to assess change in a single individual over time ie, clinically significant differences in scores also is important to explore functkonal better clinical discrimination of effectiveness of different balance interventions.
Understanding diagnostic tests 2: It has been shown to correlate with postural instability and is predictive of falls in individuals with PD. Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Furthermore, we hypothesized that the BESTest would be more sensitive and specific in determining fallers versus nonfallers because it is a more comprehensive test than either the FGA or the BBS.
The first cutoff value indicated by asterisk was chosen to maximize both sensitivity and specificity. Participants were instructed to take their medication according to their normal regimen and were tested while on medication. Although the Berg Balance Scale BBS can be considered the reference standard for the determination of fall risk, it has a noted ceiling effect.
The video training for the BESTest was used and is available for purchase online. Conclusions Almost perfect intrarater and interrater reliability for total FGA scores and good concurrent validity were shown in this study. Based on these cutoff points, similar specificity was found for all 3 tests, with sensitivity being highest for the BESTest.
Receive exclusive offers and updates from Oxford Academic. It is important to understand that the purpose of cutoff scores is to help identify those who are at greater risk clinically for falling.
Recommended articles Citing articles 0. We present cutoff scores for making distinctions between fallers and nonfallers using 2 methods. Individuals in the St Louis community who heard of the study from other participants or the Volunteers for Health database were allowed to participate as well.
Once the reliability for all tests was determined to be good using the initial subset of participants, the remaining balance evaluations for assessing validity, sensitivity, and specificity for detecting fallers versus nonfallers were performed by the physical therapist student.
At the present time, however, the best predictor of falling is a history of prior falls. No participants indicated any wearing off of medication during the balance testing. However, there is a trade-off between sensitivity and specificity, as shown by the large decrease in specificity when the second method was used.
According to Steffen and Seney, 12 the BBS score must change at least 5 points to show a true change in balance. To maintain an alpha level of.
Reliability and validity of the Functional Gait Assessment German version in subacute axsessment patients. Postural instability in idiopathic Parkinson’s disease: Reliability and validity of the dynamic gait index in persons with chronic stroke.
Cutoff points, sensitivity, and specificity were based on receiver operating characteristic plots. The study was approved by the Human Research Protection Office. Tests and Measurements All Journals search input.