Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg Balance Scale, and the Activities-Specific Balance Confidence (ABC) scale for comparing fallers and non-fallers

School of Human Kinetics, University of Ottawa, 125 University St, Ottawa, Ont., Canada K1N6N5.
Archives of Gerontology and Geriatrics (Impact Factor: 1.85). 01/2004; 38(1):11-26. DOI: 10.1016/S0167-4943(03)00082-7
Source: PubMed


Simple reaction time, the Berg balance scale, the Activities-specific Balance Confidence (ABC) scale and postural sway were studied in order to determine cut-off scores as well as develop a model used in the prevention of fallers within the elderly community. One hundred and twenty-five subjects, 45 fallers and 80 non-fallers were evaluated throughout the study and results indicated that non-fallers have significantly faster reaction times, have higher scores on the Berg balance scale and the ABC scale as well as sway at slower frequencies when compared to fallers. Furthermore, all risk factors were subsequently entered into a logistic regression analysis and results showed that reaction time, the total Berg score and the total ABC score contributed significantly to the prediction of falls with 89% sensitivity and 96% specificity. A second logistic regression was carried out with the same previous variables as well as all questions of the Berg and ABC scales. Results from the logistic analysis revealed that three variables were associated with fall status with 91% sensitivity and 97% specificity. Results from the following study would seem rather valuable as an assessment tool for health care professionals in the identification and monitoring of potential fallers within nursing homes and throughout the community.

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Article: Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg Balance Scale, and the Activities-Specific Balance Confidence (ABC) scale for comparing fallers and non-fallers

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    • "The percentage assigned for each task is summed and divided by 16 in order to obtain the overall score. The ABC scale has good test–retest reliability, convergent and criterion validity [13] and the ability to discriminate between fallers and non-fallers in community-dwelling elderly (cut-off score 67%) [15] "
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    ABSTRACT: The Balance Evaluation Systems Test (BESTest) and its two abbreviated versions (mini-BESTest and briefBESTest) are functional balance tools that have yet to be validated in middle aged and elderly people living in the community. Determine the construct validity of the three BESTest versions by comparing them with commonly-used measures of balance, balance confidence and physical activity, and examining their ability to discriminate between groups with respect to falls and fall risk. This was a secondary analysis of data from 79 adults (mean age 68.7±10.57 years). Pearson correlation coefficients were used to examine the relationships between each BESTest measure and the Activities-Specific Balance Confidence (ABC) scale, the Physical Activity Scale for the Elderly (PASE), the Timed Up and Go (TUG) and the Single Leg Stance (SLS) test. Independent t-tests were used to examine differences in balance between fallers (≥1 fall in previous year) and non-fallers and individuals classified at low versus high fall risk using the Elderly Falls Screening Test (EFST). The BESTest measures showed moderate associations with the ABC scale and TUG (r=0.62-0.67 and -0.60 to -0.68 respectively), fair associations (r=0.33-0.40) with the PASE and moderate to high associations (r=0.67-0.77) with the SLS. Fallers showed a trend (p=0.054) for lower scores on the original BESTest, and people at high risk for falls had significantly lower scores on all BESTest versions. These findings support the construct validity of the BESTest, mini-BESTest and briefBESTest in adults over 50 years old. Copyright © 2015. Published by Elsevier B.V.
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    • "For familiarization with the reaction time test, participants were given 2 practice trials. Reaction time is an established predictor of falls risk and functional declines (Lajoie and Gallagher 2004). For adaptive gait tests, participants were assessed and videotaped while walking barefoot at a self-selected comfortable pace within a narrow, 6.1-m-long path, both without (single task) and with a concurrent cognitive task (dual task; see Executive function section below), as described previously (Kelly et al. 2008; Schrager et al. 2008). "
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    ABSTRACT: Limited functional mobility in older adults has been associated with declines in tests of motor, psychomotor, and executive function. Animal studies have demonstrated reversals in indices of motor and psychomotor function via supplementation with polyphenolic-rich foods such as blueberries. The purpose of this study was to examine whether 6 weeks of daily consumption of 2 cups of frozen blueberries affects functional mobility in older adults. Pre- and post-intervention assessments of grip strength, simple reaction time, adaptive gait, and executive function were completed for older adults (age >60 years) partially randomly assigned to a blueberry (BB) supplementation or a carrot juice drink control (CAR) group. Paired t tests were used to assess within-group effects for outcome variables in each supplementation group, and a mixed-model analysis of covariance (ANCOVA) was used to determine group (CAR vs. BB) differences. Mixed-model analysis indicated that the BB group demonstrated significant improvements relative to the CAR group in performance (i.e., number of step errors) of a challenging dual-task adaptive gait test that were independent of differences in gait speed. Within only the BB group, significant improvements were also seen in 3 other measures (i.e., usual gait speed; number of step errors during single-task adaptive gait; and gait speed during dual-task adaptive gait). These preliminary findings support the hypothesis that blueberry supplementation may provide an effective countermeasure to age-related declines in functional mobility and serve as justification for an expansion to larger trials to more fully assess this nonpharmacologic approach to maintaining optimal mobility and independence.
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    • "Although a direct objective predictor of fall risk has not been discovered yet, several studies have determined a strong association between poor postural balance and increased risk of falling. Abnormal postural sway measured by the range of sway, for example, has been introduced as a significant independent predictor of recurrent falls (Maki et al., 1994; Thapa et al., 1996), or as a distinguishable factor among fallers and non-fallers (Lajoie and Gallagher, 2004; Maki et al., 1994). Therefore if an AFO were able to improve postural stability while avoiding limiting the ankle range of motion, it may subsequently reduce fall risk in the general older adult population. "

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