Objectives: To compare the validity of three widely-used fall risk assessment tools—Berg Balance Scale (BBS), Time Up and Go (TUG), and Five times Sit to Stand (5xSTS)—in predicting falls in community-dwelling elderly individuals in Saudi Arabia. Moreover, the cut-off point, sensitivity, specificity, and post-test accuracy percentage for each of the three physical performance measures were determined.
Design: Prospective study.
Setting: Two physical therapy department.
Participants: We recruited 114 ambulatory community-dwelling individuals aged ≥ 65 years. The exclusion criteria included balance-disturbing neurologic or orthopedic disorders, uncontrolled hypertension, cardiovascular disease, or inability to walk and communicate independently.
Primary and secondary outcome measures: The cut-off point, sensitivity, specificity, and post-test accuracy percentage for each of the three physical performance measures were determined.
Results: The BBS was sensitive to group differences between fallers and non-fallers (P=0.0001). Results from the receiver operating characteristic curve analyses showed that the accuracies of the BBS and TUG at classifying participants with and without a fall history were high-to-moderate (area under the curve [AUC], 0.73 and 0.71, respectively). In contrast, the accuracy of the 5xSTS for the same was low (AUC, 0.67). The cut-off points for the BBS, TUG, and 5xSTS were 42, 20, and 34 seconds, respectively. The highest post-test accuracy was of the BBS at 84.39%, followed by that of the TUG at 68.05%, and 5xSTS had the lowest accuracy at 25.29%.
Conclusions: Among the three assessment tools, the BBS was the most useful, followed by the TUG. On the other hand, the 5xSTS test revealed significant inadequacies, as it failed to distinguish between fallers and non-fallers, lacked discriminative power, and had poor post-test accuracy. Identifying elderly people at risk of falling using BBS, or TUG for time efficiency, would be most helpful to prevent falls and related injuries.