Preliminary descriptive data suggest that physical therapists should use age-related data when interpreting patient data obtained for the 6MW, BBS, TUG, CGS and FGS. Further data on these clinical tests with larger sample sizes are needed to serve as a reference for patient comparisons.

Background and PurposeDistinguishing between a clinically significant change and change due to measurement error can be difficult. The purpose of this study was to determine test-retest reliability and minimal detectable change for the Berg Balance Scale (BBS), forward and backward functional reach, the Romberg Test and the Sharpened Romberg Test (SRT) with eyes open and closed, the Activities-specific Balance Confidence (ABC) Scale, the Six-Minute Walk Test (6MWT), comfortable and fast gait speed, the Timed “Up & Go” Test (TUG), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Unified Parkinson Disease Rating Scale (UPDRS) in people with parkinsonism.SubjectsThirty-seven community-dwelling adults with parkinsonism (mean age=71 years) participated. The Hoehn and Yahr Scale median score of 2 was on the lower end of the scale; however, the scores ranged from 1 to 4.MethodsSubjects were tested twice by the same raters, with 1 week between tests. Test-retest reliability was calculated using intraclass correlation coefficients (ICCs). Minimal detectable change was calculated using a 95% confidence interval (MDC95).ResultsThe ICCs for test-retest reliability were above .90 for the BBS, ABC Scale, SRT with eyes closed, 6MWT, and comfortable and fast gait speeds. The MDC95 values for those functional tests were: BBS=5/56, ABC Scale=13%, SRT with eyes closed=19 seconds, 6MWT=82 m, comfortable gait speed=0.18 m/s, and fast gait speed=0.25 m/s. The ICCs for test-retest reliability of SF-36 scores were above .80, with the exception of the social functioning subscale. The MDC95 values for the SF-36 ranged between 19% and 45%. The MDC95 values for the UPDRS Activities of Daily Living section, Motor Examination section, and total scores were 4/52, 11/108, and 13/176, respectively.Discussion and ConclusionMinimal detectable change values are useful to therapists in rehabilitation and wellness programs in determining whether change during or after intervention is clinically significant. High test-retest reliability of scores for the BBS, ABC Scale, SRT with eyes closed, 6MWT, and gait speed make them trustworthy functional assessments in people with parkinsonism. The SF-36 and UPDRS provide quality-of-life and disease severity rating values in the ongoing assessment of people with parkinsonism.

Background and Purpose. Although the Unified Parkinson's Disease Rating Scale (UPDRS) is the most common performance measure for people with Parkinson disease (PD), the Berg Balance Scale (BBS), Forward Functional Reach Test (FFR), Backward Functional Reach Test (BFR), Timed “Up & Go” Test (TUG), and gait speed may be used to quantify some aspects of functional performance not measured by the UPDRS. The purpose of this study was to describe the relationship among a set of tests of balance, walking performance, and mobility in people with PD. Subjects. Twenty-five community-dwelling adults (11 female, 14 male) with a diagnosis of PD were recruited from PD support groups in southeastern Wisconsin and consented to participate in the study. The mean age of the participants was 76 years (SD=7). The average Hoehn and Yahr Stage Scale score was 2. Methods. Functional abilities of each subject were assessed with the UPDRS, BBS, FFR, BFR, TUG, and gait speed. Spearman and Pearson correlations were performed. Results. The UPDRS total score was correlated with the BBS (r =−.64, P<.001), FFR (r =−.52, P<.05), and TUG (r =.50, P<.05) measurements. The BBS is the only test of functional performance where scores correlate with all other functional tests and the UPDRS. Discussion and Conclusions. The UPDRS total score may not reflect a comprehensive measure of mobility in people with PD. Because the BBS scores correlate both with UPDRS scores and with scores of all other tests of functional performance, the BBS appears to be a good overall measure of function in this population.

The data confirmed significant positive correlations between degree of KFC and presence of resistance to passive knee motion, cognitive impairment, impaired ambulation, and presence of knee pain. Physical therapy assessment and intervention may be appropriate in nonambulatory nursing home residents with resistance to passive motion, residents with KFC approaching 20 degrees, and ambulatory residents with minimal KFC who develop resistance and begin to regress in ambulation. Several areas for future study are suggested.

To assess for change over time, we found the 30sSTS and the FGA tests can be used reliably in patients with PD. A lower FGA score was associated with a higher chance of falls, and good internal consistency of the FGA was found.