Mini-Balance Evaluation Systems Test Research Articles

Effects of Progressive Gaze Stability Exercises on Balance and Gait in Vestibular Neuritis Patients: A Quasi-experimental Study

Introduction: Gaze stability exercises are the exercises that are used effectively to improve gaze stability during head movement in various vestibular disorders patients, and to improve balance in in static and dynamic movements the same. Aim: To compare the effectiveness of progressive gaze stability exercises to improve balance and gait in patients with vestibular neuritis. Materials and Methods: This quasi-experimental study was conducted at Outpatient Department of SGT hospital, Gurugram, Haryana, India, from November 2018 to March 2019. A total of 26 subjects were randomly assigned into two groups, Group A received progressive gaze stability exercises with conventional therapy (n=13) and Group B received conventional therapy (n=13). Group A received Vestibular Rehabilitation Therapy (VRT) for 25 minutes a day 5 times a week for 4 weeks. Group B conventional training which consisted of balance exercises. Participants were assessed with Mini Balance Evaluation Systems Test (Mini-BESTest) and dizziness handicap inventory to access the performance of balance and functional limitation, respectively. Data was analysed by using the Statistical Package for the Social Sciences (SPSS) version 20.0 for statistical analysis. A level of significance was set at p-value <0.05. Results: The finding of the study showed no significant change for baseline parameters between the experimental and conventional groups with respect to age (p-value=0.097), gender (p-value=0.573), height (p-value=0.682), weight (p-value=0.945), duration of illness (p-value=0.579). Both the groups showed significant improvement with in group, when measured using dependent t-test for Mini-BESTest and Wisconsin Gait Scale. The comparison of postintervention scores of Mini-BESTest and WGS between Group A and Group B showed significant difference (p-value=0.001) and (p-value=0.002) respectively. Conclusion: The present study has provided preliminary evidence that progressive gaze stability exercises when coupled with conventional balance exercises may improve gait and balance in patients with vestibular neuritis.

Validation of Mini–Balance Evaluation Systems Test for short–term intensive rehabilitation of patients with spinocerebellar degeneration

Validation of Mini–Balance Evaluation Systems Test for short–term intensive rehabilitation of patients with spinocerebellar degeneration

Rasch Validation and Comparison of the Mini-BESTest and S-BESTest in Individuals With Stroke.

The purpose of this study was to compare the psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) and S-BESTest and to evaluate which is more suitable for use in clinical settings for individuals with stroke. This multicenter retrospective cross-sectional study investigated 115 individuals with stroke (mean age, 70.8 y [SD = 11.2 y]) who were able to stand without physical assistance. All individuals were examined with the BESTest and with the Mini-BESTest and S-BESTest scored based on the BESTest results. The data were analyzed using a Rasch analysis (partial credit model). The Mini-BESTest results revealed a correctly functioning rating scale, good fit of the data to the model (apart from 1 overfit item), good reliability for both persons and items (6 statistically detectable levels of balance ability), local dependence between 1 item pair, and essential unidimensionality. The S-BESTest results demonstrated disordered rating scale thresholds (1 response option required collapsing), good fit of the data to the model (apart from 1 underfit item), good reliability for both persons and items (5 statistically detectable levels of balance ability), local dependence between 2 item pairs, and essential unidimensionality. The analyses confirmed that the reliability of the S-BESTest was good and unidimensional and that the test provides several improved points, such as item redundancy and local independence of items. Nevertheless, the Mini-BESTest results supported previous findings as a whole and were better than those from the S-BESTest. Rasch analysis demonstrated that the Mini-BESTest was a better balance assessment scale than the S-BESTest for individuals with stroke based on its psychometric properties. The Mini-BESTest may serve as a useful scale for assessing balance in individuals with stroke, and a keyform plot and strata may help clinical decision-making in terms of interpreting scores and goal setting.

Balance, movement confidence, and cognition: Exploring the impacts of a group motion‐based technology intervention for people with dementia and mild cognitive impairment

AbstractBackgroundExercise can impact balance, movement confidence, and cognition among people with dementia and mild cognitive impairment (MCI). However, engaging and accessible ways for this population to exercise are lacking. Motion‐based technology, which people with dementia and MCI can learn to use and enjoy using, could be a potential solution. The purpose of this study was to examine the impacts of a group motion‐based technology intervention on balance, movement confidence, and cognition among people with dementia and MCI.MethodParticipants with dementia and MCI (n=28; 53.6% female) were recruited from four community‐based adult day programs and invited to partake in a 10‐week Xbox Kinect bowling intervention. Before and after the intervention, participants completed the Montreal Cognitive Assessment (MoCA) and the Mini Balance Evaluation Systems Test (Mini‐BEST) to measure cognition and balance, respectively. Video recordings were taken during the first, middle, and final week of the intervention and coded using video analysis software, to measure movement confidence. Quantitative data from the MoCA, Mini‐BEST, and coded video recordings were compared using a series of related‐samples Wilcoxon signed rank tests.ResultAt baseline, participants with dementia and MCI were substantially impaired with regards to balance (mean Mini‐BEST: 14.58/28), cognition (mean MoCA: 12.86/30), and mobility (57.1% mobility device users). Among the participants who completed the study, there was no significant decline in balance (Z‐score=‐1.276, p=0.202), movement confidence (Z‐score=‐0.359, p=0.719), or cognition (Z‐score=‐0.060, p=0.952), suggesting a potential maintenance effect of the intervention.ConclusionFirstly, the findings highlight the prevalence of mobility and balance impairments among people with dementia and MCI, in addition to confirming their cognitive impairment. Secondly, this study also highlights the potential of using motion‐based technology to support the function and well‐being of people with dementia and MCI. That is, the finding of no significant decline in function among the participants can be considered a positive finding, given the generally progressive nature and trajectory of dementia.

Not just cognitive impairment: Using motion‐based technology to examine mobility, balance, and cognition in dementia and MCI

AbstractBackgroundDementia and Mild Cognitive Impairment (MCI) are both characterized by impaired cognition, with dementia a more significant impairment that interferes with functioning in daily life. Both groups are also at high risk of falls and reduced physical activity. Yet, little is known about the characterization of this population with regards to balance, mobility, and their relationship to cognition.MethodParticipants with dementia and MCI (n=28; 53.6% female) were recruited from four community‐based adult day programs and invited to participate in a 10‐week motion‐based technology intervention (i.e., Xbox Kinect bowling) to see whether the intervention impacted their balance, movement confidence, and cognition. As part of the data collection procedures, participants completed a demographic survey, as well as the Montreal Cognitive Assessment (MoCA), and the Mini Balance Evaluation Systems Test (Mini‐BEST) at the start of the study. These baseline data were analyzed using descriptive statistics.ResultIn addition to confirming participants’ cognitive impairment (mean MoCA: 12.86/30; range: 2‐25), participants reported a high instance of mobility impairment (16/28 = 57.1%), with many participants using either walkers (12/16 = 75.0%) or canes (4/16 = 25.0%). The entire sample demonstrated significant balance impairments according to the Mini‐BEST (mean: 14.58/28 [<19‐point cut‐off]; range: 6‐21), but only one of 28 participants (3.6%) reported ever receiving treatment (e.g., physiotherapy) for a balance problem.ConclusionPeople with dementia and MCI have a high prevalence of balance and mobility impairments, in addition to their cognitive impairment. Furthermore, there are few instances in which rehabilitation for these physical issues are offered to this population. This may reflect the primary focus on their cognitive impairment but also misconceptions about the capabilities of people with dementia and MCI to engage in rehabilitation. The findings highlight a need for more physical rehabilitation and/or exercise programs for people with dementia and MCI that target balance and mobility, in addition in taking participants’ cognitive impairment into account.

Responses to balance challenges in persons with panic disorder: A pilot study of computerized static and dynamic balance measurements

IntroductionSeveral studies have shown an association between panic disorder (PD) and reduced balance abilities, mainly based on functional balance scales.This pilot study aims to demonstrate the feasibility of studying balance abilities of persons with PD (PwPD) using computerized static and, for the first time, dynamic balance measurements in order to characterize balance control strategies employed by PwPD.MethodsTwelve PwPD and 11 healthy controls were recruited. PD diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV), and the severity of symptoms was evaluated using the Hamilton Anxiety Scale (HAM‐A), PD Severity Scales (PDSS), and Panic and Agoraphobia Scale (PAS). Balance was clinically assessed using the Activities‐Specific Balance Confidence (ABC) scale and physically by the Mini‐Balance Evaluation Systems Test (Mini‐BESTest). Dizziness was evaluated using the Dizziness Handicap Inventory (DHI) scale. Postural control was evaluated statically by measuring body sway and dynamically by measuring body responses to rapid unexpected physical perturbations.ResultsPwPD had higher scores on the HAM‐A (17.6 ± 10.3 vs. 3.0 ± 2.9; p < .001), PDSS (11.3 ± 5.1 vs. 0; p < .001), and PAS (20.3 ± 8.7 vs. 0; p < .001) questionnaires and lower scores on the balance scales compared to the controls (ABC scale: 156.2 ± 5.9 vs. 160 ± 0.0, p = .016; Mini‐BESTest: 29.4 ± 2.1 vs. 31.4 ± 0.9, p = .014; DHI: 5.3 ± 4.4 vs. 0.09 ± 0.3, p < .001). In the static balance tests, PwPD showed a not‐significantly smaller ellipse area of center of pressure trajectory (p = .36) and higher body sway velocity (p = .46), whereas in the dynamic balance tests, PwPD had shorter recovery time from physical perturbations in comparison to controls (2.1 ± 1.2s vs. 1.6 ± 0.9 s, p = .018).ConclusionThe computerized balance tests results point to an adoption of a ‘‘postural rigidity’’ strategy by the PwPD, that is, reduced dynamic adaptations in the face of postural challenges. This may reflect a nonsecure compensatory behavior. Further research is needed to delineate this strategy.

Effect of Walking Training with Textured Insole Socks in Older Adults

Aims To evaluate the effects of textured insole socks on balance, gait parameters, and fall risk in older adults at risk of falling. Methods Thirty older adults at risk of falls participated and were randomly allocated equally to the intervention (texture insole socks) or control (unmodified socks) groups. Both groups were asked to walk on a 10-meter walkway for 2000 steps/day, 3 days/week for 4 weeks. Outcomes were measured using the Mini-Balance Evaluation Systems test, the modified 30-second chair stand test, and Gait Analyzer application. Results Textured insole socks increased balance and decreased the risk of falls in older adults to the same extent as unmodified socks. The beneficial effect on balance lasted at least for 2 weeks. No significant changes were observed in gait parameters for either group. Conclusions These interventions may be viewed as low-cost instruments for improving balance and lowering the risk of falls in older adults.

To What Extent is Walking Ability Associated with Participation in People after Stroke?

ObjectivesThis study aims to 1) identify the relation between walking ability and participation after stroke and 2) explore whether change in walking ability is associated with change in participation over time in community living-people after stroke. Materials and MethodsFifty-two people after stroke were assessed at baseline and after a 6-week gait training intervention. People were included between two weeks and six months after stroke. The Utrecht Scale for Evaluation of Rehabilitation-Participation was used to measure participation. Assessment of walking ability included the six-minute walking test for walking endurance, Timed-up & Go test for functional mobility, Mini Balance Evaluation Systems Test for dynamic balance, and total duration of walking activity per day to measure walking activity. ResultsAt baseline, six-minute walking test, Timed-up & Go test, and Mini Balance Evaluation Systems Test were univariately associated with participation (P < 0.001). Backward multiple regression analysis showed that the Mini Balance Evaluation Systems Test independently explained 55.7% of the variance in participation at baseline. Over time, only change in the six-minute walking test was positively associated with change in participation (R2 = 0.087, P = 0.040). ConclusionsCross-sectional associations showed that walking ability, and especially dynamic balance, contributes to participation after stroke. Dynamic balance, as underlying variable for walking, was an important independently related factor to participation after stroke which needs attention during rehabilitation. Longitudinally, improvement in walking endurance was significantly associated with improvement in participation, which indicates the relevance of training walking endurance to improve participation after stroke.

Impact of social and mobility restrictions in Parkinson\u2019s disease during COVID-19 lockdown

BackgroundThe consequences of strict COVID-19 mobility restrictions on motor/non-motor features in Parkinson’s disease (PD) have not been systematically studied but worse mobility and quality of life have been reported. To elucidate this question, 12 mild to moderate PD patients were assessed in March 2020 before and after two months of isolation as part of a clinical study that had to be interrupted due to the pandemic and the implementation of COVID19 mobility restrictions.MethodsTwelve patients were systematically evaluated before and after the lockdown period as part of a larger cohort that previously underwent thermal water rehabilitation. Clinical outcomes were the Body Mass index, the Mini-Balance Evaluation Systems Test, the MDS-Unified Parkinson’s Disease Rating Scale part III, the 6 Minute Walking Test and the New Freezing of Gait Questionnaire. Global cognition was evaluated with the Montreal Cognitive Assessment scale. The impact of COVID-19 restrictions on quality of life and functional independence was evaluated with The Parkinson’s disease Quality of life (PDQ-39), the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living questionnaires (IADL) and the Parkinson’s disease cognitive functional rating scales (PD-CFRS).ResultsAfter two months of isolation the Mini-BESTest score worsened (p=0.005), and four patients reported one or more falls during the lockdown. BMI increased (p=0.031) while the remaining clinical variables including quality of life did not change.ConclusionWe observed moderate worsening at Mini-BESTest, greater risk of falls and increased body weight as consequence of prolonged immobility. We believe negative effects were partially softened since patients were in contact with our multidisciplinary team during the lockdown and had previously received training to respond to the needs of this emergency isolation. These findings highligh the importnace of patient-centered interventions in PD management.

Insights Into the Mini-BESTest Scoring System: Comparison of 6 Different Structural Models.

The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a balance scale common to clinical practice, but different scoring has been proposed, that is, total score and/or subsections. This study aimed to investigate Mini-BESTest validity by comparing 6 structural models and to establish the best model for discriminating fallers from nonfallers, that is, those who did or did not report at least 2 falls in the 6 months before evaluation. In this cross-sectional validation study, data from 709 individuals with idiopathic Parkinson disease (Hoehn and Yahr stages 1-3) were analyzed. Individuals were evaluated with the Mini-BESTest, and fall history was recorded. Construct, convergent, and discriminant validity and reliability of the 6 models were analyzed. The ability of the models to adequately identify individuals with or without a history of falls was tested with receiving operating characteristic curves. Confirmatory factor analysis showed that the unidimensional models and the 4-factor solutions showed the best fit indexes. Conversely, second-order models, which allowed reporting of both total and subsections, did not converge. Most models and factors showed a low convergent validity (average variance extracted values <0.5). Correlations among the anticipatory postural adjustments factor with both the sensory orientation and the dynamic gait factors of multidimensional models were high (r ≥ 0.85). Unidimensional model reliability was good, whereas low values were found in one-half of the subsections. Finally, both unidimensional models showed a large area under the receiving operating characteristic curve (0.81). The original unidimensional Mini-BESTest model-with a total score of 28-showed the highest validity and reliability and was best at discriminating fallers from nonfallers. Conversely, its 4 subsections should not be reported separately, because they were highly correlated and had low reliability; therefore, they are not actually capable of measuring different aspects of balance. This study shows that the Mini-BESTest should be used only with the original unidimensional scoring system in people with Parkinson disease.

Effects of lower extremity constraint-induced movement therapy on gait and balance of chronic hemiparetic patients after stroke: description of a study protocol for a randomized controlled clinical trial

BackgroundProtocols involving intensive practice have shown positive outcomes. Constraint induced movement therapy (CIT) appears to be one of the best options for better outcomes in upper limb rehabilitation, but we still have little data about lower extremity constraint-induced movement therapy (LE-CIT) and its effects on gait and balance.ObjectiveTo evaluate the effects of an LE-CIT protocol on gait functionality and balance in chronic hemiparetic patients following a stroke.MethodsThe study adopts a randomized, controlled, single-blinded study design. Forty-two patients, who suffered a stroke, who were in the chronic phase of recovery (>6 months), with gait disability (no community gait), and who were able to walk at least 10 m with or without the advice or support of 1 person, will be randomly allocated to 2 groups: the LE-CIT group or the control group (intensive conventional therapy). People will be excluded if they have speech deficits that render them unable to understand and/or answer properly to evaluation scales and exercises selected for the protocol and/or if they have suffered any clinical event between the screening and the beginning of the protocol. Outcome will be assessed at baseline (T0), immediately after the intervention (T1), and after 6 months (T2). The outcome measures chosen for this trial are as follows: 6-min walk test (6minWT), 10-m walk test (10mWT), timed up and go (TUG), 3-D gait analysis (3DGA), Mini Balance Evaluation Systems Test (Mini-BESTest), and as a secondary measure, Lower Extremity Motor Activity Log will be evaluated (LE-MAL). The participants in both groups will receive 15 consecutive days of daily exercise. The participants in the LE-CIT group will be submitted to this protocol 2.5 h/day for 15 consecutive days. It will include (1) intensive supervised training, (2) use of shaping as strategy for motor training, and (3) application of a transfer package (plus 30 min). The control group will receive conventional physiotherapy for 2.5 h/day over 15 consecutive days (the same period as the CIT intervention). Repeated measures analyses will be made to compare differences and define clinically relevant changes between groups.ResultsData collection is currently on-going and results are expected in 2021.DiscussionLE-CIT seems to be a good protocol for inclusion into stroke survivors’ rehabilitation as it has all the components needed for positive results, as well as intensity and transference of gains to daily life activities.Trial registrationwww.ensaiosclinicos.gov.brRBR-467cv6. Registered on 10 October 2017. “Effects of Lower Extremities - Constraint Induced Therapy on gait and balance function in chronic hemipretic post-stroke patients”.

SY2.5. Balance and gait assessment

Postural instability and walking difficulties are the most disabling symptoms in Parkinson disease (PD), leading to falls, physical injuries, functional decline and early institutionalization. Medical, surgical and rehabilitation are the mainstay of management for balance and gait disorders. Evaluation of balance and gait disorders is crucial to determine the problems of the patients so that targeted treatment can be given. Postural instability manifests as reductions in limits of stability, postural adjustment, and postural responses. Gait disorders comprise reduced gait speed, short stride length, freezing of gait, and dual-task deficits. Postural instability and gait disorders can be evaluated using reliable and validated clinical tests, measurement scales, questionnaires and technological equipment. Objective clinical tests and measurement scales require simple equipment and needs a short time to complete the tests. Questionnaires are useful to reflect patients’ perceived balance and gait ability. Technological equipment can be costly but they can increase the measurement sensitivity. The clinical tests used to evaluate postural instability include retropulsion tests, Functional reach test, and one-leg-stance test, whilst those for gait disorders include single or dual-task walk test, timed-up-and-go-test, and 6-minute walk test. Measurement scales including Berg’s balance scale, mini-Balance evaluation system test and Tinetti mobility test, are used to assess overall balance and gait limitations. Most of the measurement scales have cut-off scores for predicting fall risk. Validated questionnaires such as Activities-specific balance confidence scale and Fall efficacy scale evaluate one’s perceived level of balance confidence. Freezing-of-gait questionnaire subjectively assess the severity of freezing of gait. Most of the technological equipment are bulky, laboratory-based and may require a long time to complete the test and/or to analysis the data. Nowadays, body worn sensors is getting more popular because they allow measurement to be taken anywhere including patients’ home and in the community. Algorithm has been built in some systems to shorten the data analyzing time. There are many choices of outcome measures and clinicians/researchers can choose the evaluation methods that is best for their measurement purposes.

O-TS003. The combined effect of Repetitive Transcranial Magnetic Stimulation (RTMS) and treadmill training on walking endurance and balance in people with Parkinson’s Disease (PD) – A randomised PLACEBO-CONTROLLED trial

Introduction. Reduced walking endurance and balance is common among patients with PD. Treadmill training and rTMS have been shown to be effective in improving walking performance in patients with PD, but effects were modest and short-lived. Long-term effect of combined rTMS and treadmill training on walking endurance and balance performance in patients with PD is not known. Methods. 34 participants with PD were randomised into 2 groups. Participants received 12 sessions of either 25 Hz rTMS and treadmill training (25 Hz-TT) or sham rTMS and treadmill training (1 Hz-TT) conducted over 3 weeks. For 25 Hz-TT group, 600 TMS stimuli at 80% resting motor threshold were delivered to leg area of motor cortex of each hemisphere. Two- minute walk test (2MWT) and mini-Balance Evaluation System Test (mini-BEST) were used to evaluate the efficacy of interventions on walking tolerance and balance performance. Participants were tested before, after, 1 month and 3 months after intervention ended. Two- way repeated measure ANOVA was used to evaluate the outcome data. SPSS 23.0 was used for all statistical analysis. Results. Significant interaction effect was found in mini-BEST (F (3,32) = 3.247, p = 0.041). Post-hoc analysis shows that only 25-Hz group improved mini-BEST at Post (p = 0.001), 1-month (p = 0.006) and 3-month post intervention (p = 0.036). Between-group analysis of change from baseline showed that 25 Hz-TT had a greater change than sham-TT (by 1.96, p = 0.01) in improving mini-BEST. Both 25 Hz-TT and sham-TT groups improved 2MWT at all measurement time points (p < 0.001). Conclusion. Our results showed that combining 25-Hz rTMS with treadmill training improved walking endurance and balance performance in people with PD in both short-and long-term.

Diagnostic tests to assess balance in patients with spinal cord injury: a systematic review of their validity and reliability.

Sophisticated biomechanical instruments can assess balance in patients with spinal cord injury (SCI) with accuracy and precision; however, they are costly and time consuming to use. Clinical diagnostic tests to assess balance in patients with SCI are less costly and easier to use, but there is limited literature available regarding their reliability and validity. To review systematically articles reporting the validity and reliability of diagnostic tests used to assess balance function in patients with SCI. We searched for articles in the English language from the earliest record to December 15, 2020, which reported validity or reliability of any clinical instrument or diagnostic test used to assess balance in patients with SCI. Articles assessing balance in paraplegic patients with causes other than SCI were excluded. Databases included MEDLINE, AMED, EMBASE, HMIC, PsycINFO, CINAHL, Scopus, and Google Scholar. The COSMIN Risk of Bias checklist was used to assess the studies included and PRISMA-DTA guidelines were applied. We included 16 articles that assessed the validity or reliability of 10 diagnostic tests. The Functional Reach Test (FRT), Berg Balance Scale (BBS), and Mini-Balance Evaluation Systems Test (Mini-BESTest) were assessed by more than 1 study, while the remaining 7 diagnostic tests including the Function in Sitting Test, T-Shirt Test, Motor Assessment Scale item 3, Sitting Balance Score, 5 Times Sit-to-Stand Test, Tinetti scale, and Sitting Balance Measure were assessed by 1 study each. The FRT has good-to-excellent test-retest reliability, excellent inter-rater reliability, and good construct, concurrent, and convergent validity. The BBS has excellent inter-rater and intra-rater reliability, high internal consistency, and good concurrent and construct validity. The Mini-BESTest has excellent test-retest reliability, excellent inter-rater reliability, high internal consistency, and good concurrent, convergent, and construct validity. The FRT, BBS, and Mini-BESTest appear to be valid and reliable clinical instruments to assess balance function in patients with SCI.

Revascularization for asymptomatic carotid artery stenosis improves balance and mobility

ObjectiveBalance and mobility function worsen with age, more so for those with underlying chronic diseases. We recently found that asymptomatic carotid artery stenosis (ACAS) restricts blood flow to the brain and might also contribute to balance and mobility impairment. In the present study, we tested the hypothesis that ACAS is a modifiable risk factor for balance and mobility impairment. Our goal was to assess the effect of restoring blood flow to the brain by carotid revascularization on the balance and mobility of patients with high-grade ACAS (≥70% diameter-reducing stenosis). MethodsTwenty adults (age, 67.0 ± 9.4 years) undergoing carotid endarterectomy for high-grade stenosis were enrolled. Balance and mobility assessments were performed before and 6 weeks after revascularization. These included the Short Physical Performance Battery, the Berg Balance Scale, the Four Square Step Test, the Dynamic Gait Index (DGI), the Timed Up and Go test, gait speed, the Mini-Balance Evaluation Systems Test (Mini-BESTest), and the Walking While Talking complex test. ResultsConsistent with our previous findings, patients demonstrated reduced scores on the Short Physical Performance Battery, Berg Balance Scale, DGI, and Timed Up and Go test and in gait speed. Depending on the outcome measure, 25% to 90% of the patients had scored in the impaired range at baseline. After surgery, significant improvements were observed in the outcome measures that combined walking with dynamic movements, including the DGI (P = .02) and Mini-BESTest (P = .002). The proportion of patients with Mini-BESTest scores indicating a high fall risk had decreased significantly from 90% (n = 18) at baseline to 40% (n = 8) after surgery (P = .02). We used Pearson's correlations to examine the relationship between balance and mobility before surgery and the change after surgery. Patients with lower baseline DGI and Mini-BESTest scores demonstrated the most improvement after surgery (r = −0.59, P = .006; and r = −0.70, P = .001, respectively). ConclusionsCarotid revascularization improved patients' balance and mobility, especially for measures that combine walking and dynamic movements. The greatest improvements were observed for the patients who had been most impaired at baseline.

Factors associated with fear of falling in hemodialysis patients.

Fear of falling (FOF) has important clinical and psychological consequences. This study evaluated the factors associated with FOF in hemodialysis patients and compared with the FOF reported by age-gender matched individuals without chronic kidney disease. This cross sectional study included hemodialysis group (n = 60, 55.4 ± 7.6years, 55.0% male) and control group (n = 40, 55.1 ± 7.5years, 52.5% male). FOF was assessed by the Falls Efficacy Scale International (FES-I). Physical function was evaluated using the Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go test, 4-m gait speed, isometric handgrip force and 10-repetition sit-to-stand test. The physical and mental components of quality of life was evaluated by 36-Item Short Form Health Survey. The FES-I score was higher in the hemodialysis group compared to the control group (28.2 ± 9.7 vs. 23.3 ± 5.1, p = 0.020). In addition, the prevalence of individuals with a higher concern about falling was greater in the hemodialysis group (41.7 vs. 17.5%, p = 0.033). Multiple linear regression showed that the FES-I score was associated with the Mini-BESTest score and the physical component summary of quality of life (coefficient of determination of 0.51 and an adjusted coefficient of determination of 0.46). FOF was associated with poor postural balance and reduced physical component of quality of life in patients on hemodialysis and these patients showed higher FOF compared to individuals without chronic kidney disease.

Validation of an Adapted Questionnaire for Outdoor Walking Among Older Adults: The CHAMPS-OUTDOORS

The aim of this study was to examine the construct and known-groups validity of the total score of five items adapted from the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure outdoor walking (CHAMPS-OUTDOORS) in older adults. Data from the baseline assessment of the Getting Older Adult OUTdoors (GO-OUT) trial were used. Construct validity of the CHAMPS-OUTDOORS used objective measures of outdoor walking (accelerometry-GPS), Ambulatory Self-Confidence Questionnaire, RAND-36, 6-min walk test, 10-m walk test, and Mini-Balance Evaluation System Test. For known-groups validity, we compared the CHAMPS-OUTDOORS of those who walked < or ≥1.2m/s. Sixty-five participants had an average age of 76.5 ± 7.8years. The CHAMPS-OUTDOORS was moderately correlated with total outdoor walking time (r = .33) and outdoor steps (r = .33) per week measured by accelerometry-GPS, and weakly correlated with Mini-Balance Evaluation System Test score (r = .27). The CHAMPS-OUTDOORS did not distinguish known groups based on crosswalk speed (p = .33). The CHAMPS-OUTDOORS may be used to assess outdoor walking in the absence of accelerometry GPS. Further research examining reliability is needed.

Baduanjin Qigong Improves Balance, Leg Strength, and Mobility in Individuals With Chronic Stroke: A Randomized Controlled Study

Background Effective and sustainable exercise training methods for improving balance poststroke are needed. Objective To evaluate the effect of Baduanjin Qigong for improving balance after stroke. Methods This was a single-blinded randomized controlled study in which only the assessor was blinded. Fifty-eight people with chronic stroke (mean age: 62.5 ± 11.8 years) were randomly assigned to the experimental (n = 29) or control group (n = 29). The experimental group underwent 8 weeks of supervised Baduanjin training (3 sessions per week). This was followed by home-based practice of the same exercises 3 days a week for another 8 weeks. The control group underwent 2 sessions of supervised conventional fitness training in the first week, followed by home-based exercise practice 3 days a week until the end of week 16. All outcomes were measured at baseline, week 8, and week 16. Results Significantly greater improvements in the Mini-Balance Evaluation Systems Test (Mini-BESTest), composite equilibrium score (Sensory Organization Test), 5 Times Sit to Stand, and Timed Up and Go test were detected at week 8 in the experimental group than in the control group (P < .017). Further improvement in the Mini-BESTest was observed from week 8 to 16 in the experimental group (P < .001). Other outcomes (Limit of Stability, Fall-Efficacy Scale, Modified Barthel Index, Stroke-Specific Quality of Life) showed no significant results. Conclusion Baduanjin is effective in improving balance, leg strength, and mobility and is a safe and sustainable form of home-based exercise for people with chronic stroke.

Influence of age and lymphedema on the postural balance of women undergoing breast cancer treatment

IntroductionBreast cancer affects women of different ages, and comorbidities resulting from treatment can affect postural stability. The study aimed to evaluate the influence of age and lymphedema on the postural balance of women undergoing breast cancer treatment. MethodsThe study included 77 women undergoing breast cancer treatment, divided into different groups: 37 young adult women divided into 17 with lymphedema (GYL) and 20 young adults without lymphedema (GY); 40 elderly women, 20 elderly women with lymphedema (GEL) and 20 elderly women without lymphedema (GE). Mini Balance Evaluation Systems Test (Mini BESTest) and Falls Efficacy Scale - International (FES-I) were used. ResultsMini BESTest and FES-I between the groups showed that GE and GEL had a significant difference to GY. Mini BESTest Total and Time Up and Go TUG-Double Task showed that GE has a significant difference to GYL, with GE and GEL having lower scores. Moderate negative correlation in the GEL between FES-I and Mini BESTest. In the age correlation between the Mini BESTest, FES-I, TUG, and double task TUG, a moderate positive correlation was observed for TUG. GEL showed a moderate positive correlation for FES-I and double-task TUG, strong for TUG, and moderate negative correlation with Mini BESTest. Correlation of the volume difference between the limb affected and not affected by lymphedema and the FES-I, Mini BESTest, TUG, and TUG double task, GYL showed moderate negative correlation for TUG. ConclusionAge and lymphedema influenced the dynamic postural balance of women undergoing breast cancer treatment.

Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson’s disease: A systematic review and meta-analysis

Objective: To conduct a systematic review evaluating the effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life among individuals with Parkinson’s disease. Data sources: A systematic search of PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Physiotherapy Evidence Database was carried out to identify eligible papers published up to December 10, 2020. Review methods: Literature selection, data extraction, and methodological quality assessment were independently performed by two investigators. Publication bias was determined by funnel plot and Egger’s regression test. “Trim and fill” analysis was performed to adjust any potential publication bias. Results: Seventeen studies involving 598 participants were included in this meta-analysis. Music-based movement therapy significantly improved motor function (Unified Parkinson’s Disease Rating Scale motor subscale, MD = −5.44, P = 0.002; Timed Up and Go Test, MD = −1.02, P = 0.001), balance (Berg Balance Scale, MD = 2.02, P < 0.001; Mini-Balance Evaluation Systems Test, MD = 2.95, P = 0.001), freezing of gait (MD = −2.35, P = 0.039), walking velocity (MD = 0.18, P < 0.001), and mental health (SMD = −0.38, P = 0.003). However, no significant effects were observed on gait cadence, stride length, and quality of life. Conclusion: The findings of this study show that music-based movement therapy is an effective treatment approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson’s disease.