Journal of International Medical
The online version of this article can be found at:
2009 37: 697Journal of International Medical Research
N Maeda, J Kato and T Shimada
Predicting the Probability for Fall Incidence in Stroke Patients Using the Berg
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Journal of International Medical Research
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The Journal of International Medical Research
2009; 37: 697 – 704
Predicting the Probability for Fall
Incidence in Stroke Patients Using the
Berg Balance Scale
N MAEDA1,3, J KATO2AND T SHIMADA3
1Department of Physical Therapy, Hyogo Rehabilitation Centre at Nishiharima, Tatsuno City,
Japan;2Department of Internal Medicine, Hyogo Rehabilitation Centre Hospital, and3Faculty
of Health Science, Kobe University Graduate School of Health Sciences, Kobe City, Japan.
This observational study investigated the
relationship between balance, mobility
inpatients, with the aim of developing a
model for predicting fall risk. Fall history
was recorded by interview, balance was
assessed using the Berg Balance Scale
(BBS) and activities of daily living were
Independence Measure (FIM). Variables
differing between fallers and non-fallers
were identified, and a stepwise regression
analysis was performed to identify a
combination of variables that effectively
predicted fall status. Fallers (occasional
and repeat; n = 27) had a shorter time
from stroke onset, lower FIM scores on
admission and discharge, lower BBS and
Mini-Mental State Examination scores, a
greater age and longer length of hospital
differences were significant). A logistic
model for predicting falls showed that BBS
at admission was significantly related to
falls, with fallers having lower BBS scores
at admission (cut-off ≤ 29; sensitivity 80%;
specificity 78%). These data suggest BBS is
a sensitive and specific measure for
identifying stroke patients at risk of
KEY WORDS: HEMIPLEGIA; STROKE; FALLS; ACTIVITIES OF DAILY LIVING; BERG BALANCE SCALE;
FUNCTIONAL INDEPENDENCE MEASURE; MINI-MENTAL STATE EXAMINATION
A high risk of falling after stroke has been
reported, both during hospital stay and after
patients have been discharged.1,2Incidence
for falls in stroke inpatients has been
reported to range from 14% to as high as
65%.3,4The prevention of falls should be an
important goal of acute, rehabilitative and
chronic stroke care. Risk factors for falls in
stroke patients in the acute to sub-acute
stage, have been reported to include reduced
motor function, and impaired balance and
cognitive function.5 – 8Hyndman et al.9
important factor to predict falls in stroke
patients living in the community. Teasell et
al.10reported that significant differences
between fallers and non-fallers were the
presence or absence of apraxia and defective
cognitive function, and that directionality to
ensure safety in both walking and the
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the course ofacute
Author’s address for correspondence
Dr Junichi Kato
Department of Internal Medicine, Hyogo Rehabilitation Centre Hospital, Akebono-Cho 1070,
Nishi-Ku, Kobe City 651-2181, Japan.
N Maeda, J Kato, T Shimada
Predicting fall incidence in stroke patients