Discriminant analysis for predictor of falls in stroke patients by using the Berg Balance Scale

Abstract

INTRODUCTIONAn observational study was carried out to estimate the strength of the relationships among balance, mobility and falls in hemiplegic stroke inpatients. The objective was to examine factors that may aid in the prediction of the likelihood of falls in stroke patients.METHODS A total of 53 stroke patients (30 male, 23 female) aged 67.0 ± 11.1 years were interviewed regarding their fall history. Physical performance was assessed using the Berg Balance Scale (BBS) and the Functional Independence Measure (FIM) scale. Variables that differed between fallers and non-fallers were identified, and a discriminant function analysis was carried out to determine the combination of variables that effectively predicted fall status. RESULTSOf the 53 stroke patients, 19 were fallers. Compared with the non-fallers, the fallers scored low on the FIM, and differed with respect to age, time from stroke onset, length of hospital stay, Brunnstrom recovery stage and admission BBS score. Discriminant analysis for predicting falls in stroke patients showed that admission BBS score was significantly related to the likelihood of falls. Moreover, discriminant analysis showed that the use of a significant BBS score to classify fallers and non-fallers had an accuracy of 81.1%. The discriminating criterion between the two groups was a score of 31 points on the BBS. CONCLUSIONThe results of this study suggest that BBS score is a strong predictor of falls in stroke patients. As balance is closely related to the risk of falls in hospitalised stroke patients, BBS might be useful in the prediction of falls.

Comparison of the Mini-Balance Evaluations Systems Test with the Berg Balance Scale in relationship to walking speed and motor recovery post stroke

“…Previously numerous cut-off points have been reported for the BBS. A cut-off score of lesser than 31 on the BBS is an indication of fall risk in stroke, 29 and less than 19 indicates stroke survivors with low function. 15 We are the first to report cut-off points for the BBS and Mini-BESTest to identify fast walkers.…”

Balance impairment limits ability to increase walking speed in individuals with chronic stroke

“…[21] A variety of cutscores are available in the literature, allowing clinicians to identify “at-risk” clients. Fall risk cutscores range from 31 [24] to 50 [25] for discriminating between fallers and non-fallers, and 42 [26] to 52 [11] for identification of “multiple fallers” or “injurious falls” among individuals with stroke. Given the balance requirements for maintaining stability, the relationship between BBS scores and fall risk is not surprising; however, BBS scores also appear to provide insight into walking ability in individuals with stroke.…”

Falls and Fear of Falling After Stroke: A Case‐Control Study

“…Previous studies have found that patients who had a history of falling during hospitalization were more likely to fall after discharge [2,3]. Attributes of physical function, such as balance [2–4] and lower extremity strength [5], have also been shown to predict falls among stroke survivors. Other factors, such as taking more medications [2], impaired cognition [6], and depression [5], have also been identified as potential risk factors.…”