The Value of the Barrow Neurological Institute Balance Scale in Predicting Falls (P06.043)

Abstract

Objective: A novel Barrow Neurological Institute (BNI) balance scale has been developed and its effectiveness in identifying falls examined. Background In Parkinson disease (PD), balance difficulty has been shown to correlate with falls. The revised Unified Parkinson Disease Rating Scale (UPDRS), however, is not focused to identify people with falls. Consequently, we developed the BNI balance scale as a complement to the UPDRS. Design/Methods: We compared the BNI scale with the Tinetti scale, a widely used scale for assessing fall risks, in 53 PD patients, 9 of whom fell ≥ 3 times per month (fallers). The BNI scale consists of evaluating balance during standing on one foot, turning, and tandem walking. All patients were also examined utilizing the motor part of the UPDRS during medication-on state. A t-test was used to compare continuous variables, a chi- square test to compare categorical variables, and a logistic regression model was constructed to predict sensitivities and specificities. Results: The fallers had a longer PD duration, a higher UPDRS score, a higher (worse) BNI balance score and a lower (worse) Tinetti score than non-fallers. All differences were significant. Fallers were more significantly impaired than non-fallers on the UPDRS postural stability and on the BNI subtests of standing on one foot, turning, and tandem walking. The BNI scale, score ≥ 10, had a sensitivity of 100 % and a specificity of 88.6% in predicting falls. The Tinetti scale, score Conclusions: The BNI balance scale is more sensitive and as specific in predicting falls than the Tinetti. The BNI balance scale takes less than one third of the time to perform than the Tinetti and is a necessary complement to the UPDRS for predicting falls. Disclosure: Dr. Husain has nothing to disclose. Dr. Krishnamurthi has nothing to disclose. Dr. Santiago has nothing to disclose. Dr. Dhall has received personal compensation for activities with Teva Pharmacuticals as a speaker. Dr. Moguel-Cobos has nothing to disclose. Dr. Sadreddin has nothing to disclose. Dr. Salins has nothing to disclose. Dr. Pan has nothing to disclose. Dr. Lieberman has nothing to disclose. Dr. Dhanani has nothing to disclose.