Functional Balance Scale Research Articles

Investigation of the Effects of Remote Online Exercise Training in Individuals Self-Isolating at Home Due to COVID-19 Disease: A Randomized Controlled Study

Objective: Effectiveness of a 4-week telerehabilitation program including thoracic expansion exercises (TEE), non-specific general body exercises (NSGBE), and physical activity recommendations (PAR) which started at quarantine in individuals with acute mild-COVID-19 was investigated in current study. Methods: This is a randomized controlled study which was performed between May 2021 and February 2022. Adult individuals with acute mild-COVID-19 were randomly grouped as training (TG) (telerehabilitation program under supervision for 3 days/week) and control (CG) (home program including TEE and PAR). Dyspnea (Modified Borg Scale and Modified Medical Research Council Dyspnea Scale), chronic fatigue (Checklist Individual Strength Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), balance (Berg Functional Balance Scale) and lower body strength (a 30-s chair stand test) were evaluated remotely in the individuals before and after a 4-week follow-up. Results: Baseline characteristics and balance scores were similar between groups (p>0.05). After 4-week from baseline, there were no significant differences in dyspnea, chronic fatigue, anxiety, depression, balance, and lower body strength between the groups (p>0.05). However, as dyspnea, chronic fatigue, anxiety, and depression scores decreased, lower body strength increased significantly within TG after follow-up (p<0.05). Dyspnea, chronic fatigue, and anxiety scores decreased while lower body strength increased significantly within CG after follow-up (p<0.05). Conclusion: Dyspnea, severe fatigue, anxiety, and depression are commonly observed in individuals with mild-COVID-19 in the acute period. In these individuals, dyspnea perception, chronic fatigue, anxiety, depression, and functional performance improve after a 4-week light-intensity online tele-program applied either supervised or unsupervised. Mild exercises and PAR are safe and effective in these individuals.

Relationship between toe grip strength and dynamic balance in older adult patients with femoral neck fracture.

[Purpose] Femoral neck fractures are a common problem resulting from balance impairment. Toe grip strength is related to balance function. This study aimed to confirm the type of balance function that is highly related to toe grip strength. [Participants and Methods] The participants included 15 patients who were examined for differences in toe grip strength between the affected and nonaffected side. The relationship between toe grip strength and functional balance scale (FBS) and index of postural stability (IPS) was analyzed. [Results] The result showed no significant difference between the nonaffected and affected sides. A correlation exists between toe grip strength and FBS and IPS. In addition, the data from the center-of-gravity sway meter showed a correlation only between the toe grip strength and anteroposterior diameter of the stable area but not between the right and left diameters of the stable area and anterior and posterior trajectory lengths. [Conclusion] No significant difference was found between the affected and nonaffected sides. The results suggest that toe grip strength is related to the ability to move the center of gravity forward and backward rather than to sustain the center of gravity.

Is Swiss-ball-based exercise superior to plinth-based exercise in improving trunk motor control and balance in subjects with sub-acute stroke? A pilot randomized control trial

IntroductionStroke is the most common cause of neurological dysfunction, associated with high mortality and morbidity. Early stroke rehabilitation is essential for optional functional recovery, particularly motor control of the trunk muscles and balance. The study investigated the effects of Swiss-ball-based and plinth-based trunk exercises for improving trunk control and functional balance in subjects with sub-acute stroke.MethodsOverall, 20 sub-acute stroke patients aged 40–60 years were recruited and divided into the experimental group (Swiss ball exercise) and the control group (plinth exercise). Upper and lower trunk exercises were performed by the patients sitting on a Swiss ball or a plinth. The 45-minute sessions were applied for 5 days a week for a total of 4 weeks. Trunk Impairment Scale, Modified Functional Reach Test, and Functional Balance Scale evaluations were performed at baseline and at the end of the 4 weeks.ResultsThe differences between the baseline characteristics of participants in both groups were not significant. After the intervention, there were significant (<i>p</i> > 0.01) changes in the Trunk Impairment Scale total, static, dynamic, and coordination scores, mental status, Modified Functional Reach Test results, and functional balance scores, with high effect sizes in the Swiss ball exercise group.ConclusionsIn patients with sub-acute stroke, trunk exercises performed on a Swiss ball were found to be more effective than those performed on a plinth to improve trunk control, forward and lateral reach, and functional balance.

The Effect of an Interactive Tele Rehabilitation Program on Balance in Older Individuals

Objective: To investigate the effect of a home-based interactive telerehabilitation program on balance performance in older people, and to compare the results with a nonsupervised home exercise (NHE) program. Subjects and Methods: A total of 50 participants (35 females), aged 65–90 years, were included in the study. The subjects were randomly assigned to one of three groups as the interactive telerehabilitation home exercise group (ITHE), NHE group or control group. The ITHE and NHE groups exercised three times per week for 8 weeks. The outcome measures were the Berg Functional Balance Scale (BBS), Timed Up and Go Test (TUG), Sway Balance Mobile Application, Trait Anxiety Inventory (TAI), and the World Health Organization Quality of Life Instrument-Older Adults Module (WHL). Results: In the control group, no difference was observed in the TUG and BBS scores, at the end of the 8 weeks compared with preexercise (pre-ex), whereas these scores increased significantly in the NHE (TUG: P < 0.001, BBS: P < 0.001) and ITHE groups (TUG: P < 0.001, BBS: P = 0.003). The WHL scores increased significantly in all three groups, and no difference was observed in the TAI scores. There was a significant difference in SWAY score only in the telerehabilitation group compared with pre-ex (P < 0.001). Conclusions: Although NHE and ITHE were effective on the improvement of balance, mobility and reduction of fall risk in older individuals, this effect was found to be greater in the ITHE group. Quality of life increased in all groups, but no change in anxiety level was observed.

Dynamic balance assessment using an unstable board in community-dwelling elderly people

[Purpose] A new method for measuring dynamic balance was developed. The aim of this study was to describe the use of a novel “unstable board” to evaluate the balance ability of community-dwelling elderly individuals. [Participants and Methods] The following balance outcomes were evaluated in 59 community-dwelling elderly people: anteroposterior and mediolateral stability indexes on the unstable board, Mini-Balance Evaluation Systems Test score, the Functional Reach Test score, Timed Up-and-Go time, and the Figure-8 Walk Test time. [Results] With respect to the relationship between the stability indexes and functional balance scales, the anteroposterior stability index significantly correlated with the anticipatory postural adjustment component (r=−0.422), stability in the gait component (r=−0.274), and total score of the Mini-Balance Evaluation Systems Test (r=−0.316); timed up-and-go time (r=0.320); and figure-8 walk test time (r=0.340). No correlation was found between the mediolateral stability index and the functional balance scale scores. [Conclusion] The anteroposterior stability index correlated with the declines in postural adjustments and performance in the dynamic balance assessments. Therefore, the anteroposterior stability index, evaluated on an unstable board, could provide an efficient tool for predicting changes in dynamic balance capacity, which could not be identified using the most commonly used balance assessment tools.

Reliability and validity of standing balance assessment index using a hand-held dynamometer in stroke patients.

[Purpose] This study aimed to determine the reliability and validity of our standing balance assessment index using a hand-held dynamometer (the hand-held dynamometer assessment index) in stroke patients. [Subjects and Methods] The participants were 60 stroke patients with impaired standing balance. Intrarater and interrater reliabilities were evaluated employing the intraclass correlation coefficient. Criterion-related validity was evaluated by Spearman’s rank correlation coefficient between the HHD assessment index and the functional balance scale. [Results] The intraclass correlation coefficient values obtained ranged from 0.91 to 0.98, and the correlation coefficient with the FBS was 0.83. [Conclusion] Our findings confirmed the reliability and validity of the hand-held dynamometer assessment index in stroke patients.

Collegial mentoring through routine patient consultation—a new learning strategy in outpatient physical therapy settings

(geriatric depression scale: GDS), balance (functional balance scale: FBS), and urinary incontinence were evaluated. Results: Among the 130 elderly people with disuse syndrome (mean± standard deviation age, 78.3± 10.5), 71 people were classified in the independent group and 59 in the dependent group. The mean duration of hospitalization was 21.3± 15.1 days. According to the univariate analysis, the number of days from onset to the start of rehabilitation, consciousness, transportation, grip strength, range of motion (extension of hip joint), and MMSE, GDS, and FBS scores was significantly different between the two groups. According to the multivariate logistic regression analysis, MMSE [odds ratio (OR), 1.31; 95% confidence interval (CI), 1.13–1.53; p= 0.001] and GDS (OR, 0.80; 95% CI, 0.66–0.97; p= 0.03) were factors associated with the FIM score at discharge. Conclusion(s): Our study results suggested that cognitive levels and depressive state at the start of rehabilitation were associated with the ability of elderly people with disuse syndrome to recover independent ADL. Implications: The results of this study can be used to predict the prognosis of people who are hospitalized for internal disease. In addition, an early examination of mental function may be important for elderly people who undergo rehabilitation.

Physiotherapy intervention in Alzheimer's disease: systematic review and meta-analysis.

Many studies reported that physiotherapy interventions are available to treat Alzheimer's disease (AD), but the efficacy remains uncertain. To evaluate the effectiveness of physiotherapy intervention on AD. The data sources were searched from literature databases, journals, and reference lists from 1 January 1990 to the end of 1 April 2014. Randomized and non-randomized controlled trials with physiotherapy intervention were included in our meta-analysis. Jadad score and Newcastle-Ottawa scale were used to assess the quality of included trials. Outcome measures were cognition function, physical function, activity of daily life (ADL) and neuropsychiatric inventory (NPI). 23 trials met the inclusion standard finally. Significant changes were seen in cognitive function: Mini-Mental State Examination score (weighted mean difference (WMD): 1.84, 95% confidence interval (CI): [0.76, to, 2.93], p < 0.0001), and verbal fluency (standard mean difference (SMD): 0.34, 95% CI: [0.01 to 0.66], p = 0.04). Other outcomes are also significant, they were timed up and go test (SMD: 0.56, 95% CI: [0.30 to 0.83], p < 0.0001), berg functional balance scale (SMD: 1.11, 95% CI: [0.37 to 1.84], p = 0.003), 6-min walk distance test (SMD: 141.45, 95% CI: [11.72 to 271.18], p = 0.03), ADL (SMD: 0.78, 95% CI: [0.33 to 1.23], p = 0.0007) and NPI (SMD: -0.69, 95% CI: [-1.31 to -0.07], p = 0.03). The available data indicate that physiotherapy intervention may have benefits in AD. However, current data are not definitive; more carefully designed and conducted observational studies are needed to definitively establish that whether physiotherapy intervention can effectively alleviate symptoms of AD.

Factors Associated with Recovery of Activities of Daily Living in Elderly Pneumonia Patients

Background: The current study aimed to investigate factors associated with the prognosis of activities of daily living (ADL) in elderly patients with pneumonia who had undergone rehabilitation during their hospitalization. Methods: The study included patients of age ≥65 years who were hospitalized due to pneumonia and had undergone rehabilitation for disuse syndrome at Tsukuba Memorial Hospital. The main outcome was measured using the functional independence measure (FIM) scores to assess ADL. The participants were divided into a high-recovery group (≥80%) and a low-recovery group (<80%) based on the FIM recovery rate score. Further, factors associated with the prognosis of ADL were evaluated using multivariate logistic regression analysis. Basic characteristics, consciousness, usual mode of transportation, FIM score, grip strength, range of motion, orthostatic hypotension, exercise tolerance (6-minutes walking distance), respiratory disorder (Hugh–Jones classification), constipation, malnutrition (mini-nutritional assessment), cognitive (mini-mental state examination), depression (geriatric depression scale), balance (functional balance scale), urinary incontinence, and pressure ulcers were included as the evaluation items. Results: Among the 51 elderly patients with pneumonia (average age ± SD; 82.0 ± 11.3), 34 patients were classified in the high-recovery group and 17 in the low-recovery group. In multivariate logistic regression analysis, it was revealed that the number of days from the onset until the initiation of rehabilitation (days of inactivity) and nutritional status were factors associated with a high-recovery FIM score. Conclusions: The study results suggest that days of inactivity and early management of nutritional status after hospitalization are important for elderly patients with pneumonia to return to their ADL.

Examination of the Structural Elements of the Functional Balance Scale Using Hemiplegic Cerebrovascular Disease Patients

Examination of the Structural Elements of the Functional Balance Scale Using Hemiplegic Cerebrovascular Disease Patients

Functional dependence and caregiver burden in Alzheimer's disease: a controlled trial on the benefits of motor intervention

Cognitive decline has a negative impact on functional activities in Alzheimer's disease. Investigating the effects of motor intervention with the intent to reduce the decline in functionality is an expected target for patients and caregivers. The aim of this study was to verify if a 6-month motor intervention programme promoted functionality in Alzheimer's patients and attenuated caregivers' burden. The sample comprised 32 community patients with Alzheimer's disease and their 32 respective caregivers. Patients were divided into two groups: 16 participated in the motor intervention programme and 16 controls. Subjects performed 60 minutes of exercises, three times per week during the 6-month period, to improve flexibility, strength, agility and balance. Caregivers followed the procedures with their patients during this period. Functionality was evaluated by the Berg Functional Balance Scale and the Functional Independence Measure. Caregivers completed the Neuropsychiatric Inventory Caregiver Distress Scale and the Zarit Carer Burden Scale. Two-way ANOVA was used to verify the interaction between time (pre- and post-intervention) and the motor intervention program. While patients in the motor programme preserved their functionality, as assessed by the Functional Independence Measure, the controls suffered a relative decline (motor intervention group: from 109.6 to 108.4 vs controls: from 99.5 to 71.6; P= 0.01). Patients from motor intervention also had better scores than the controls on functional balance assessed by Berg scale (F: 22.2; P= 0.001). As assessed by the Neuropsychiatric Inventory and Zarit scale, burden was reduced among caregivers whose patients participated in the motor intervention programme compared with caregivers whose patients did not participate in this programme (Neuropsychiatric Inventory, caregiver's part: F: 9.37; P= 0.01; Zarit: F: 11.28; P= 0.01). Patients from the motor intervention group showed reduced functional decline compared to the controls, and there was an associated decrease in caregivers' burden.

Feasibility of virtual therapy in rehabilitation of Parkinson's disease patients: pilot study

INTRODUCTION: Among Parkinson's disease (PD) motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. OBJECTIVE: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. MATERIAL AND METHODS: Six volunteers, diagnosed to be in Stages II and III of PD (Hoehn and Yahr Scale), were recruited for this study. Patients (65 ± 13 years old) participated in activities involving Wii Fit, for a total of twelve interventions, twice per week. Clinical and qualitative methods were used for the data collection for the initial and final evaluations: Borg's Scale, Berg Functional Balance Scale, Time Up and Go, anterior and lateral functional reach and Nottingham's Scale were performed during the study. Penguin Slide, Ski Slalom, Soccer Heading and Table Tilt were the Wii games selected as a form of virtual therapy. RESULTS: The collected data were analyzed using the Wilcoxon test. Motor skill, functional capacities and quality of life were analyzed as variables of the patients' balance. Statistically significant differences were found in the following tests: Borg's Scale (p = 0.0464), Berg Functional Balance Scale (p = 0.0277), lateral functional reach to the right (p = 0.0431*) and lateral functional reach to the left (p = 0.0277). CONCLUSION: It is believed that exercises with virtual reality therapy can be a useful tool to improve the balance in PD patients.

엉덩관절의 근력, 감각과 경직이 만성 뇌졸중 환자의 균형에 미치는 영향

이 연구는 뇌졸중 환자를 대상으로 임상척도를 이용하여 엉덩관절의 근력, 감각과 경직이 균형능력에 미치는 영향을 알아보기 위해 실시되었다. 32명의 뇌졸중 환자를 대상으로 도수근력검사를 사용하여 환측 다리의 가벼운 접촉감각과 엉덩관절굽힘근, 폄근, 모음근, 그리고 벌림근의 근력을 측정하였고, 수정 Ashworth 척도를 이용하여 넙다리근의 경직을 측정하였으며, 기능적 균형 척도를 이용하여 정적 및 동적균형능력을 측정하였다. 수집된 자료는 다중회귀분석을 이용하여 분석하였다. 연구결과 정적균형에 유의한 영향을 미치는 요인은 엉덩관절벌림근력, 넙다리 경직, 가벼운 접촉감각인 것으로 나타났으며(p 【The purpose of this study was to identify the effect of muscular strength, sensation, and spasticity of the hip joint on balance using clinical tools in chronic stroke patients. Thirty-two subjects participated. It were measured muscular strength of the hip flexor, extensor, abductor, and adductor using manual muscle testing, light touch sensibility, and spasticity of the quadriceps using the modified Ashworth scale in the paretic lower extremity. Also, static and dynamic balance were measured by the functional balance scale. Collected data was analyzed by stepwise multiple regression. Muscular strength of the hip abductor, light touch sensibility, and spasticity were associated with static balance(p】

15.19 Responsiveness ofBerg's functional balance scale to disease severity in patients with Parkinson's disease

15.19 Responsiveness ofBerg's functional balance scale to disease severity in patients with Parkinson's disease

Levodopa effect upon functional balance of Parkinson's disease patients

Objective. The aim of this study was to evaluate functional balance in PD patients taking levodopa during their ‘on’ and ‘off’ phases. Design. We evaluated 23 PD patients who were manifesting fluctuations of levodopa effect. All patients were assessed by Hoehn–Yahr, UPDRS-III and Schwab–England rating scales and by the Berg functional balance scale during a practically defined ‘off’ (at least after 12 h the last levodopa intake) and ‘on’ (the mobile state induced by the drug) phases. Results. Mean scores obtained for all scales showed improvements during the ‘on’ phase of levodopa and all of the comparisons were statistically significant. Mean scores of Berg scale moved from 31.7 during the ‘off’ phase to 42.7 during the ‘on’ phase. Mean UPDRS ‘off’ and ‘on’ scores were 50.6 and 32.0, respectively. Conclusion. We conclude that Berg functional balance scale is able to detect changes in balance and that levodopa can modify the postural instability of PD patients.

Examination and Comparison of the Relationships Between Strength, Balance, Fall History, and Ambulatory Function in Older Adults

Purpose: This study assessed the relationships between strength and ambulatory function, and balance and ambulatory function in community-dwelling older adults. Subjects: One hundred adults over the age of 65, with or without a history of 2 or more falls in the previous year, participated. Method: Measurements from hand-held dynamometry of ankle dorsiflexion strength, the Berg Functional Balance Scale, and the Timed Up and Go (ambulatory function) were collected. Data Analysis: Pearson correlations were used to analyze the data. Results: The correlation between balance and ambulatory function was moderate for the nonfaller (r = −0.574, p < 0.001) and faller (r = −0.611, p < 0.001) groups. A t-test between the r-coefficients revealed no significant difference in this relationship between the 2 groups. In both groups, the correlations between ankle strength and ambulatory function were weak. Conclusion: The moderate relationship found between balance and ambulatory function in older adults with or without a fall history suggests that assessment of balance may be a more predictive tool for screening fall risk and functional decline than ankle strength measurement.

Construct Validity of Functional Balance Scale in Stroke Inpatients.

The purpose of this study was to assess the construct validity of the Berg Balance Scale (BBS) in stroke inpatients. We measured the BBS score of 46 stroke patients, and simultaneously assessed the following neurological conditions: attention, mental status, emotion, agnosia, visual perception, sensation and motor status of the affected lower extremity. We also assessed functional independence in the basic activities of daily living using the Barthel Index. Patients’ functional walking abilities were categorized into 4 levels (from with assistance to independent within hospital). The mean BBS scores were associated with attentional deficits, emotional distress, proprioceptive sensation problems and motor status. These neurological conditions explained 43% of the BBS scores. The BBS scores correlated with the Barthel Index and were associated with functional walking ability. The BBS scores and walking ability explained 67% of the Barthel Index. 83% of patients scoring above a score of 40 were independent within hospital in functional walking ability. These results provide information to support construct validity of the BBS in stroke inpatients.