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Abstract
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OBJECTIVE: To examine whether the Berg Balance Scale (BBS) on admission and changes in it after one month predict the Functional Independence Measure (FIM) walking level 6 or 7 (modified independent and independent gait respectively) after 3 months and to determine the optimal BBS cut-off score for predicting independent gait among inpatients with first stroke in a rehabilitation facility.
DESIGN: Retrospective cohort study. SETTING: Inpatient rehabilitation facility (Kaifukuki). PARTICIPANTS: Two hundred and fifty-one consecutive patients with first stroke and non-independent gait on admission. OUTCOME MEASURES: BBS on admission and after 1 month and Functional Independent Measure on admission and after 3 months.
RESULTS: Area under the receiver operating characteristic (ROC) curves for predicting independent gait after 3 months was 0.81 (95% confidence interval [CI], 0.75¬-0.88) for BBS score on admission; the optimal cut-off score being ≥13 (63% sensitivity; 90% specificity). Achieving higher than this cut off score on admission was significantly associated with subsequent independent gait (odds ratio [OR] 9.7; 95% CI, 4.38-21.36; P <.001). Sub-analysis of patients with poor balance on admission (BBS score <13; n = 191) showed area under the ROC curves for predicting independent gait after 3 months of 0.88 (95% CI, 0.80-0.95) for BBS scores 1 month after admission. In this subgroup, BBS scores at 1 month of ≥27 were significantly associated with subsequent independent gait (OR = 21.6, 95% CI, 6.40¬-73.20; P <.001).
CONCLUSIONS: Admission BBS scores predicted FIM walking level 6 or 7, which denotes modified independent or independent gait, after 3 months, the optimal cut-off for BBS scores being ≥13 among inpatients with first stroke in a rehabilitation facility. Patients with poor balance on admission whose BBS scores had improved to ≥27 at 1 month after admission were likely to achieve modified independent or independent gait within 3 months after admission.
Language: en |