Activities-specific Balance Scale Research Articles

Prosthetic device and service satisfaction, quality of life, and functional performance in lower limb prosthesis clients.

The aim of this study was to characterize the relationship between prosthetic device and service satisfaction, health-related quality of life (HRQOL), and functional movement in a diverse population of lower limb prosthesis users. An online survey was conducted on individuals with lower limb amputation between September and October 2021. Sample validated questionnaires assessing demographic and clinical features, satisfaction, functional outcomes, and quality of life were analyzed using path analysis. Participants were 1736 individuals with lower limb amputation. Overall, 44% of participants reported dissatisfaction with prosthetic device, whereas 37% were dissatisfied with prosthetic service. Low functional mobility was reported by 58% of participants and 61% reported low HRQOL. Lower extremity functional status (β = 0.55), HRQOL (β = 0.08), Activities-specific Balance Scale (β = 0.22), and modified fall efficacy scale (β = -0.07) are significantly associated with prosthetic device satisfaction (P < 0.0005, R2 = 0.47). Satisfaction with provider service was significantly associated with lower extremity functional status (β = 0.44) and balance confidence (β = 0.18) (P < 0.0005, R2 = 0.34). Civilians, veterans, and service members reported low functional mobility, low quality of life, and moderate levels of dissatisfaction with their lower extremity prosthetic device and provider service. Improvements in mobility, balance, quality of life, and fall efficacy may enhance device satisfaction. Functional mobility and balance improvements may increase ratings of provider service. This study provides feedback that may improve clinical decisions on lower limb prosthesis patient care.

Falls efficacy scale international or elderly in Maharashtra: cross cultural adaptation and validation assessment

Background: Aim of the study was to translate falls efficacy scale international (FES-I) in Marathi and to evaluate the translation on the basis of test-retest reliability, internal consistency, concurrent validity for elderly in Maharashtra.Methods: The study was divided in 2 phases. Phase 1: Translation of FES-I following translation back translation method following ProFane guidelines. Phase 2: Psychometric testing of the new version. In phase 1 translation in to Marathi and back. The 507 participants were included for the study. Activity specific balance scale was used to as a gold standard for criterion validity and Berg balance scale was used for construct validity.Results: Study had 53.3% of male and 43.7% of female participant. The validity (Cronbach alpha and ICC) and reliability (Spearman coefficient value) of the scale is excellent.Conclusions: FES-I (M) has excellent reliability and good validity. Hence this scale can be used to assess fear of falls in Maharashtrian elderly.

Revisiting the Concept of Minimal Detectable Change for Patient-Reported Outcome Measures.

Interpreting change is a requisite component of clinical decision making for physical therapists. Physical therapists often interpret change using minimal detectable change (MDC) values. Current MDC formulas are informed by classical test theory and calculated with group-level error data. This approach assumes that measurement error is the same across a measure's scale and confines the MDC value to the sample characteristics of the study. Alternatively, an item response theory (IRT) approach calculates separate estimates of measurement error for different locations on a measure's scale. This generates a conditional measurement error for someone with a low, middle, or high score. Error estimates at the measure-level can then be used to determine a conditional MDC (cMDC) value for individual patients based on their unique pre- and post-score combination. cMDC values can supply clinicians with a means for using individual score data to interpret change scores while providing a personalized approach that should lower the threshold for change compared with the MDC and enhance the precision of care decisions by preventing misclassification of patients. The purpose of this Perspective is to present how IRT can address the limitations of MDCs for informing clinical practice. This Perspective demonstrates how cMDC values can be generated from item-level psychometrics derived from an IRT model using the patient-reported Activities-specific Balance Scale (ABC) commonly used in stroke rehabilitation and also illustrates how the cMDC compares to the MDC when accounting for changes in measurement error across a scale. Theoretical patient examples highlight how reliance on the MDC value can result in misclassification of patient change and how cMDC values can help prevent this from occurring. This personalized approach for interpreting change can be used by physical therapists to enhance the precision of care decisions.

Kadınlarda Hallux Valgus Deformitesine Yönelik Aktivite Odaklı Egzersiz Müdahalesi

Background: The aim of the current study is to investigate the effects of activity-based exercise intervention for hallux valgus deformity. Materials and Methods: Forty women with hallux valgus deformity were included in the study and the participants were divided into two groups as intervention and control (intervention group 37.8 ± 7.20 years, control group 37.3±2.61 years). Before and after the 8-week intervention programme hallux valgus angle, activity-specific balance scale, dynamic gait index and foot function index were measured. Results: According to the results of the study in the intervention group, the hallux valgus angle decreased significantly in both the right and left feet after the treatment, and a significant improvement was obtained in the activity specific balance confidence scale, foot function index, pain, disability, activity limitation, and total score of foot function index (p&amp;lt;0.001). When the intervention and control groups were compared after the intervention, a significant difference was found in favor of the intervention group in the foot function index and pain, disability and total score parameters of the dynamic gait index (p&amp;lt;0.001). Conclusions: The results of our research reveal that the exercise applied for hallux valgus is effective in terms of balance, walking and function. It has been demonstrated that activity-based exercise is a good option in the treatment of hallux valgus, which is a very common deformity that should be taken seriously.

Urdu Translation and Validation of Activities-Specific Balance Confidence (ABC) Scale

Objective: To translate and validate the ABC-Scale in Urdu language to predict risk of fall in older population. Study design: Cross-cultural Translation and validation Place and Duration: Study was conducted in older adult community of Sialkot from March 2020 to December 2020. Methodology: Translation of ABC in Urdu was conducted by using Beaton et al guidelines. Two bilingual translators translated the original version into Urdu language step wise, correction process was followed. Then two backward translations were done by language expert. After all this process, the translated version was reviewed by the professionals and the final version was applied on 15 individuals. Its reliability and validity was tested on 60 older adults. Results: For test re test reliability, intra class correlation coefficient ICC was measured with a value of 0.984 Which shows good test re-test reliability. The internal consistency and reliability of ABC was calculated by Cronbach’s alpha for total score with a value of 0.985. Content validity was good with values of CVI ranging from 0.767 to 0.955. To test the discriminative validity, independent t test was used to show the difference between the healthy and unhealthy adults. Factor analysis of UABC showed total variance 81.277 and cumulative variance was also 81.277. To calculate construct validity of U-ABC Pearson’s correlation coefficient was used and measured as 0.558. Conclusion: It was concluded that Urdu version of UABC is a valid assessment tool for older adults with fear of fall. It has good content validity, construct validity and reliability. Keywords: activities specific balance scale, validation, Urdu translation, reliability, tool translation

The Efficacy of Whole-Body Vibration for Functional Improvement of Stroke Patients: A Meta-Analysis of Randomized Controlled Trials

AbstractThe efficacy of whole-body vibration for functional improvement in stroke patients remains controversial. We conduct a systematic review and meta-analysis to explore the influence of whole-body vibration on functional improvement in stroke patients.We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through June 2018 for randomized controlled trials (RCTs) assessing the effect of whole-body vibration on functional improvement in stroke patients. This meta-analysis is performed using the random-effect model.Eight RCTs are included in the meta-analysis. Overall, compared with control group for stroke patients, whole-body vibration has no positive impact on 6 min walk test (6MWT) distance (standard mean difference (Std. MD)=−0.28; 95% confidence interval (CI)=−0.66 to 0.11; P=0.16), timed-up-and-go (TUG) test (Std. MD=0.15; 95% CI=−0.54 to 0.84; P=0.67), Fugl-Meyer assessment (Std. MD=0.33; 95% CI=−0.23 to 0.89; P=0.25), Berg Balance Scale (Std. MD=0.19; 95% CI=−0.43 to 0.80; P=0.55), and activities specific balance (ABC) scale (Std. MD=−0.22; 95% CI=−0.62 to 0.17; P=0.26).Whole-body vibration shows no notable influence on 6MWT distance, TUG test, Fugl-Meyer assessment, Berg Balance Scale, and ABC scale in stroke patients.

New-generation prosthetic feet: Comparative biomechanical evaluation and functional correlation in transtibial traumatic amputee during standing and walking

Even if properly fitted, the posture and gait of amputee people are disturbed, leading to compensations and over-solicitations of the contralateral limb. The recent commercialization of new generation ankle-foot (NG) prosthesis is not covered by French social security insurance. The evaluation of the service delivered by these medical devices was until now a combination of multidisciplinary evaluations and patient assessments, but needs objective evaluation. Several teams reported a benefit of NG feet, mainly in terms of joint mobility, walking speed and reduction in compensations. But the main subjective improvement is in balance, both in static (more comfortable waiting position) as well as in dynamic (quality and fluidity of walking), which was poorly evaluated in amputees with NG feet. The main objective of this research is to evaluate the relevance of these NG feet in terms of static stability, on both flat and inclined surfaces. Six transtibial subjects were included. Three NG feet (Elan ® , Propriofoot ® , Meridium ® ) and the patient's usual foot were successively tested. For each foot type, after socket and alignment validation by an expert prosthetist, an acclimatization period of 15 days at home was observed. After this period, clinical, instrumental (static acquisitions of 20 s on two force platforms, eyes open and closed, on flat ground and on 12% inclined slope uphill and downhill) and functional evaluations (Berg Balance Scale and Activity Specific Balance Scale) were performed. Participants observed a wash out period of 3 weeks with the usual foot before testing each NG foot. The static parameters collected were: lower limb joint angles, Center of Pressure (COP) variation, ground reaction forces (GRF), and functional scores. In static position, a larger prosthetic ankle dorsiflexion, less compensations of the amputed lower limb, better symmetry of the GRF and increase of CoP parameters (as length of trajectory and range) were found with NG feet, compared to ESR. The absence of postural control leads to asymmetrical posture, leading to osteoarticular complications. Ankle mobility of NG feet may allow a better balance and improve destabilizations adaptations, above all on slope, and may reduce sound limb compensations.

Gait Training in Chronic Stroke Using Walk-Even Feedback Device: A Pilot Study.

Asymmetrical gait and a reduction in weight bearing on the affected side are a common finding in chronic stroke survivors. The purpose of this pilot study was to determine the effectiveness of a shoe insole device that we developed, called Walk-Even, in correcting asymmetric gait in chronic stroke survivors. Six individuals with chronic (>6 months) stroke underwent 8 weeks of intervention with 2 sessions/week, each consisting of 20 minutes of gait training and 20 minutes of lower-extremity strength training. The 2 control participants underwent conventional gait training, while 4 participants underwent gait training using the Walk-Even. Following intervention, all the participants improved on most of the gait measures: peak pressure of the foot, time of transfer of weight from heel-to-forefoot, center of pressure (COP) trajectory, COP velocity, asymmetry ratio of stance, mean-force-heel, mean-force-metatarsals, Timed “Up and Go,” and Activities-specific Balance Scale. The improvement was more pronounced in the 4 participants that underwent training with Walk-Even compared to the control participants. This pilot study suggests that a combination of strength and gait training with real-time feedback may reduce temporal asymmetry and enhance weight-bearing on the affected side in chronic stroke survivors. A large randomized controlled study is needed to confirm its efficacy.

THE EFFECT OF TRANSFEMORAL INTERFACE DESIGN ON GAIT SPEED AND RISK OF FALLS.

Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables). Dependent variables included the Activity-specific Balance Scale (ABC) and the two-minute walk test (2MWT). Complete records were available for 13 patients (n = 13). The age range was 26 to 58 years. Three patients functioned at the K4 activity level, whereas all others functioned at the K3 level. Mean ABC scores were significantly different (p ≤ 0.05) at 77.2 (±16.8; 35.6 to 96.9) for IRC and 90.7 (±5.7; 77.5 to 98.7) for HiFi. The mean distance walked on the 2MWT was 91.8 m (±22.0, 58.3 to 124.7) for IRC compared to 110.4 m (±28.7; 64.7 to 171.1) for the HiFi socket (p ≤ 0.05). Alternative transfemoral interface design, such as the HiFi socket, can improve walking capacity and balance confidence in higher-functioning TFA patients.

Correlation between the dizziness handicap inventory and balance performance during the acute phase of unilateral vestibulopathy

PurposeThe dizziness handicap inventory (DHI) is widely used to evaluate self-perceived handicap due to dizziness, and is known to correlate with vestibular function tests in chronic dizziness. However, whether DHI reflects subjective symptoms during the acute phase has not been studied. This study aims to investigate the correlations of subjective and objective measurements to highlight parameters that reflect the severity of dizziness during the first week of acute unilateral vestibulopathy. Materials and methodsThirty-seven patients with acute unilateral vestibulopathy were examined. Patients’ subjective perceptions of dizziness were measured using the DHI, Vertigo Visual Analog Scale (VVAS), Disability Scale (DS), and Activity-Specific Balance Scale (ABC). Additionally, the oculomotor tests, Romberg and sharpened Romberg tests, functional reach test, and dynamic visual acuity tests were performed. The correlation between the DHI and other tests was evaluated. ResultsDHI-total scores exhibited a moderately positive correlation with VVAS and DS, and a moderately negative correlation with ABC. However, DHI-total score did not correlate with results of the Romberg, sharpened Romberg, or functional reach tests. When compared among four groups divided according to DHI scores, VVAS and DS scores exhibited statistically significant differences, but no significant differences were detected for other test results. ConclusionOur findings revealed that the DHI correlated significantly with self-perceived symptoms measured by VVAS and DS, but not ABC. There was no significant correlation with other balance function tests during the first week of acute vestibulopathy. The results suggest that DHI, VVAS and DS may be more useful to measure the severity of acute dizziness symptoms.

Participating in a virtual reality balance exercise program can reduce risk and fear of falls

ObjectiveThe objective of this study was to quantify the effectiveness of virtual reality balance games (VRBG) to decrease risk and fear of falls among women. MethodsThirty six community dwelling women aged 56 and above were randomly divided into experimental (exercises using VRBG focus on improving balance) and control (conventional balance exercises) groups. Both groups attended a twice 6 weekly exercise session for an hour. Risk and fear of falls were measured with Physiological Profile Approach (PPA) and Activity Specific Balance Scale (ABC-6). Pre and post intervention differences between the groups were examined using two way repeated measures ANOVA. ResultsBoth VRBG and conventional balance exercise groups had significant decrease in PPA (p<0.001) and ABC-6 (p<0.01) after the interventions. However, no significant effects were demonstrated between the groups in PPA (p=0.18) and ABC-6 (p=0.25) post intervention. Time and group interaction effect were not significant for PPA (p=0.18) and ABC-6 (p=0.45). ConclusionsPractising VRBG can increase balance confidence and decrease risk of falls among community dwelling women.

Effects of a Yoga Program on Postural Control, Mobility, and Gait Speed in Community-Living Older Adults

To examine the impact of an 8-week therapeutic yoga program on postural control, mobility, rising from the floor, and gait speed in community-living older adults. Pretest/posttest design with an experimental group and an age-matched control group. Changes over time (pretest to posttest) were evaluated in all outcome measures using paired t tests. The yoga class was performed at a local continuing care retirement community. All testing was performed at the site. Control-subject pretests and posttests were performed at a second continuing care retirement community. Eight research participants, all women, with a mean age of 84 (4.6) years, 8 control participants, 5 women and 3 men, aged 81.3 (4.9) years. Research participants were naive to yoga. An 8-week, 80-minute, biweekly Kripalu yoga class designed specifically for community-dwelling older adults. Postural control (Berg Balance Scale), mobility (time to rise from the floor to standing, Timed Up and Go), gait (usual and fast gait speed), and balance confidence (Activities-Specific Balance Scale). All subjects attended at least 10 of the 16 classes (62% attendance). Posttest differences were found for yoga participants in balance scores (P < .003) and fast walking speed (P < .031). No other significant changes were noted. Improvements in postural control as measured by the Berg Balance Scale and gait as measured by fast gait speed indicate that research subjects benefited from the yoga intervention. The yoga program designed for this study included the activities of standing, sitting, and lying on the floor. Therefore, subjects perform activities during yoga that can improve postural control, mobility, and gait speed.

Determinants of Balance Confidence in Community-Dwelling Elderly People

The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study. The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (mean=81.7, SD=6.7). Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up Go Test. The Activities-specific Balance Scale was used to assess balance confidence. Data were analyzed using Pearson correlation, multiple regression analysis, and t tests. Fifty-seven percent of the variance in balance confidence could be explained by balance performance. Functional mobility and subject characteristics examined in this study did not contribute to balance confidence. Balance performance alone is a strong determinant of balance confidence in community-dwelling elderly people.