Balance ability measured with the Berg Balance Scale: A determinant of fall history in community-dwelling adults with leg amputation

Abstract

Objective: Falls are common among adults with leg amputations and associated with balance confidence. But subjective confidence is not equivalent with physical ability. This multivariate analyses of community-dwelling adults with leg amputations examined relationships among individual characteristics, falls, balance ability and balance confidence. Design: Cross-sectional study. Subjects/Patients: Community-dwelling adults with leg amputations recruited from a support group and prosthetic clinic. Methods: Subjects provided self-reported medical/fall history, prosthetic functional use, and Activities-specific Balance Confidence (ABC) questionnaire data. Balance ability was assessed with the Berg Balance Scale (BBS). Fall incidence was categorized as any fall (one or more) and recurrent falls (more than one). Multivariate logistic regression analyzed relationships within the two fall categories. Cross tabulations and ANOVA analyzed differences among subcategories. Results: Fifty-four subjects (mean age 56.8) with various etiologies, amputation levels, and balance abilities participated. 53.7% had any fall; 25.9% had recurrent falls. Models for both fall categories correctly classified fall history in > 70% of subjects with combinations of the variables ABC, BBS, body-mass-index, and amputation level. Conclusion: Falls occurred regardless of clinical characteristics. Total BBS and select item scores were independent determinants of fall history. Unlike other balance-impaired populations, adults with leg amputation and better balance ability had greater odds of falling.

Frequency and Circumstances of Falls Reported by Ambulatory Unilateral Lower Limb Prosthesis Users: A Secondary Analysis

“…The results of this secondary analysis showed that the prevalence of falls in community‐living ambulatory LLP users remains high, at 57.6%. The prevalence of recurrent falls, 36.3%, also remains at or above historically reported values for LLP users (ie, 23.4%‐39.0%) . The relevance of the increased frequency of falls in LLP users should be judged not only on its magnitude alone but also on the severity and occurrence of adverse outcomes.…”

“…Historically, more than 50% of LLP users report falling at least once a year . The results of this secondary analysis showed that the prevalence of falls in community‐living ambulatory LLP users remains high, at 57.6%.…”

“…There is currently no consensus regarding recall period when asking LLP users about falls. In addition, commonly adopted definitions of a fall do not contain prosthetic‐specific language (eg, “a fall with or without your prosthesis”). Similar to guidelines proposed for older adults , future research could benefit from establishing the time window during which LLP users can accurately recall fall events and their related details and a fall definition that is meaningful to LLP users.…”

“…More than 50% of lower limb prosthesis (LLP) users report falling at least once a year [1][2][3][4][5], placing them at high risk for adverse health outcomes such as decreased mobility and diminished quality of life [3,6,7]. Attempts to lower the prevalence of falls in LLP users have traditionally focused on developing and validating clinical tests to assess fall risk [8][9][10][11][12], designing and testing prosthetic components to improve patient safety [13][14][15][16], characterizing the biomechanics of key balance strategies to identify deficits in those at risk for falls [17][18][19][20][21][22][23], and identifying risk factors to help recognize potential fallers [2,5,7,24,25]. However, little attention has been directed toward recording, reporting, and characterizing the circumstances of falls in LLP users [1,4,7].…”

Research on Teenagers’ Static Balance Ability Based on Somatosensory Interaction

“…Standing balance is a very important part of balance control. The evaluation methods of that include clinical observation (Hedetoft & Hyldegaard, 2015), scale evaluation (Wong, et al, 2015) and instrument evaluation. During the first two methods, graders mainly observe subjects' state of the completing the task intuitively，then give the artificial scores.…”