People with chronic obstructive pulmonary disease (COPD) have balance impairments and an increased risk of falls. The psychometric properties of short balance tests to inform fall risk assessment in COPD are unknown. Our objective was to determine the validity (concurrent, convergent, and known-groups) of short balance and mobility tests for fall risk screening. Participants with COPD aged ≥ 60 years attended a single assessment. Correlation coefficients described the relationships between the Brief Balance Evaluation Systems Test (Brief BESTest), Single-Leg Stance (SLS), Timed Up and Go (TUG), and Timed Up and Go Dual-Task (TUG-DT) tests, with the comprehensive Berg Balance Scale (BBS), chair-stand test, and measures of exercise tolerance, functional limitation, disability, and prognosis. Independent t-tests or Mann–Whitney U tests were used to examine differences between groups with respect to fall risk. Receiver operating characteristic curves examined the ability of the screening tests to identify individuals with previous falls. A total of 86 patients with COPD completed the study (72.9 ± 6.8 years; forced expiratory volume in 1 second: 47.3 ± 20.3% predicted). The Brief BESTest identified individuals who reported a previous fall (area under the curve (AUC) = 0.715, p = 0.001), and the SLS showed borderline acceptable accuracy in identifying individuals with a fall history (AUC = 0.684, p = 0.004). The strongest correlations were found for the Brief BESTest and SLS with the BBS ( r = 0.80 and r = 0.72, respectively) and between the TUG and TUG-DT with the chair-stands test ( r = 0.73 and r = 0.70, respectively). The Brief BESTest and SLS show the most promise as balance screening tools for fall risk assessment in older adults with COPD. These tests should be further evaluated prospectively.

Purpose: To analyze weekend physiotherapy services in acute-care community hospitals across Canada. Method: Questionnaires were mailed to acutecare community hospitals (institutions with >100 inpatient beds, excluding psychiatric, mental health, paediatric, rehabilitation, tertiary, and long-term care facilities) across Canada from January to April 2010. The questionnaire collected information on patient referral criteria, staffing, workload, and compensation for weekend physiotherapy services and on the availability of other rehabilitation health professionals. Results: Of 146 community hospitals deemed eligible, 104 (71%) responded. Weekend physiotherapy was offered at 69% of hospitals across Canada, but this rate varied: b75% in all regions except Quebec (30%). Hospitals with a high proportion of acute-care beds were more likely to offer weekend physiotherapy services (logistic regression, p ¼ 0.021). Services differed among Saturdays, Sundays, and holidays in terms of the numbers of both physiotherapists and physiotherapy assistants working (Kruskal-Wallis, p < 0.02 for each). Physiotherapists were predominantly compensated via time off in lieu. Of hospitals not offering weekend physiotherapy, 53% reported that it would benefit patients; most perceived staffing and financial barriers. Social-work services were offered on the weekend at 24% of hospitals and occupational therapy at 16%. Conclusions: Substantial regional variation exists in access to weekend physiotherapy services in acute-care community hospitals. To address the importance of this variation, research on the efficacy and cost-effectiveness of such services is required.Key Words: rehabilitation; hospitals, community; delivery of health care; health services research. RÉ SUMÉObjectif : Analyser les services de physiothé rapie offerts durant les fins de semaine dans les hô pitaux communautaires de soins de courte duré e d'un bout à l'autre du Canada. Mé thode : De janvier à avril 2010, des questionnaires ont é té posté s aux hô pitaux communautaires de soins de courte duré e (é tablissements comptant plus de 100 lits pour hospitalisation, excluant les lits en psychiatrie, en santé mentale, en pé diatrie, en ré adaptation, les soins tertiaires et les é tablissements de soins prolongé s) partout au Canada. Le questionnaire visait à recueillir de l'information sur les critè res justifiant le renvoi en consultation, le personnel, la charge de travail et la ré muné ration pour des services de physiothé rapie offerts les fins de semaine, et sur la disponibilité d'autres professionnels de la santé oeuvrant en ré adaptation. Ré sultats : Des 146 hô pitaux communautaires admissibles, 104 (71 %) ont ré pondu. Des services de physiothé rapie é taient offerts les fins de semaine dans 69 % des hô pitaux au Canada, mais cette proportion varie : b75 % dans toutes les ré gions, sauf au Qué bec (30 %). Il é tait plus probable que des services de physiothé rapie soient offerts les fins de semaine dans les hô pitaux qui disposent d'une forte proportion de li...

Physiotherapists' participation in physiotherapy students' clinical education varied widely among Ontario regions. Future research could explore whether regional differences are persistent, why they occur, and whether they should be reduced.