Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
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Comparison of the Pediatric Balance Scale and Fullerton Advanced Balance Scale for Predicting Falls in Children With Cerebral Palsy

  • Kim, Gyoung-mo (Dept. of Physical Therapy, Division of Health Science, Baekseok University)
  • Received : 2016.10.06
  • Accepted : 2016.11.07
  • Published : 2016.11.19
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Abstract

Background: The Pediatric Balance Scale (PBS) and the Fullerton Advanced Balance (FAB) scale were used to assess balance function in patients with balance problem. These multidimensional clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate and compare the predictive properties of the PBS and FAB scales relative to fall risk in children with cerebral palsy (CP) using a receiver operating characteristic analysis. Methods: In total, 49 children with CP (boy=21, girl=28) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS and FAB were performed, and verified cut-off score, sensitivity, specificity, and the area of under the curve (AUC). Results: In this study, the PBS scale was as a predictive measure of fall risk, but the FAB was not significant in children with CP. A cut-off score of 45.5 points provided optimal sensitivity of .90 and specificity of .69 on the PBS, and a cut-off score of 21.5 points provided optimal sensitivity of .90 and specificity of .62 on the FAB. Both scales showed moderately accurate of AUC with .79 and .76, respectively. Conclusion: The PBS is a useful screening tool for predicting fall risk in children with cerebral palsy, and those who score 45.5 or lower indicate a high risk for falls and are in need of balance intervention.

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References

  1. Boulgarides LK, McGinty SM, Willett JA, et al. Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Phys Ther. 2003;83(4):328-339.
  2. Brauer SG, Burns YR, Galley P. A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci. 2000;55(8): M469-M476. https://doi.org/10.1093/gerona/55.8.M469
  3. Darr N, Franjoine MR, Campbell SK, et al. Psychometric properties of the pediatric balance scale using Rasch analysis. Pediatr Phys Ther. 2015;27(4):337-348. https://doi.org/10.1097/PEP.0000000000000178
  4. Eng J. Receiver operating characteristic analysis: A primer. Acad Radiol. 2005;12(7):909-916. https://doi.org/10.1016/j.acra.2005.04.005
  5. Fortinsky RH, Baker D, Gottschalk M, et al. Extent of implementation of evidence-based fall prevention practices for older patients in home health care. J Am Geriatr Soc. 2008;56(4):737-743. https://doi.org/10.1111/j.1532-5415.2007.01630.x
  6. Franjoine MR, Darr N, Held SL, et al. The performance of children developing typically on the pediatric balance scale. Pediatr Phys Ther. 2010;22(4): 350-359. https://doi.org/10.1097/PEP.0b013e3181f9d5eb
  7. Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: A modified version of the Berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther. 2003;15(2):114-128. https://doi.org/10.1097/01.PEP.0000068117.48023.18
  8. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med. 2000;45(1-2):23-41. https://doi.org/10.1016/S0167-5877(00)00115-X
  9. Hajian-Tilaki K. Receiver Operating Characteristic (ROC) curve analysis for medical diagnostic test evaluation. Caspian J Intern Med. 2013;4(2):627-635.
  10. Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982;143(1):29-36. https://doi.org/10.1148/radiology.143.1.7063747
  11. Hernandez D, Rose DJ. Predicting which older adults will or will not fall using the Fullerton Advanced Balance scale. Arch Phys Med Rehabil. 2008;89(12):2309-2315. https://doi.org/10.1016/j.apmr.2008.05.020
  12. Klein PJ, Fiedler RC, Rose DJ. Rasch analysis of the Fullerton Advanced Balance (FAB) Scale. Physiother Can. 2011;63(1):115-125. https://doi.org/10.3138/ptc.2009-51
  13. Ko MS, Lee NH, Lee JA, et al. Inter-examiner reliability of the Korean version of the pediatric balance scale. Phys Ther Korea. 2008;15(1):86-95.
  14. Legters K. Fear of falling. Phys Ther. 2002;82(3): 264-272.
  15. Li F, Harmer P, Fitzgerald K, et al. Tai chi and postural stability in patients with Parkinson's disease. N Engl J Med. 2012;366(6):511-519. https://doi.org/10.1056/NEJMoa1107911
  16. Lim HW. A study of the usefulness of pediatric balance scale as a prediction indicator for gross motor function classification system in children with cerebral palsy. J Kor Phys Ther. 2016: 28(1):22-26. https://doi.org/10.18857/jkpt.2016.28.1.22
  17. Rose DJ, Lucchese N, Wiersma LD. Development of a multidimensional balance scale for use with functionally independent older adults. Arch Phys Med Rehabil. 2006;87(11):1478-1485. https://doi.org/10.1016/j.apmr.2006.07.263
  18. Rosenbaum P, Paneth N, Leviton A, et al. A report: The definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8-14.
  19. Rosenbaum PL, Walter SD, Hanna SE, et al. Prognosis for gross motor function in cerebral palsy: Creation of motor development curves. JAMA. 2002;288(11):1357-1363. https://doi.org/10.1001/jama.288.11.1357
  20. Schlenstedt C, Brombacher S, Hartwigsen G, et al. Comparison of the Fullerton Advanced Balance Scale, Mini-BESTest, and Berg Balance Scale to predict falls in Parkinson disease. Phys Ther. 2016;96(4):494-501. https://doi.org/10.2522/ptj.20150249
  21. Shumway-Cook A, Baldwin M, Polissar NL, et al. Predicting the probability for falls in community-dwelling older adults. Phys Ther. 1997;77(8): 812-819. https://doi.org/10.1093/ptj/77.8.812
  22. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.
  23. Shumway-Cook A, Hutchinson S, Kartin D, et al. Effect of balance training on recovery of stability in children with cerebral palsy. Dev Med Child Neurol. 2003;45(9):591-602. https://doi.org/10.1111/j.1469-8749.2003.tb00963.x
  24. Smania N, Corato E, Tinazzi M, et al. Effect of balance training on postural instability in patients with idiopathic Parkinson's disease. Neurorehabil Neural Repair. 2010;24(9):826-834. https://doi.org/10.1177/1545968310376057
  25. Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240(4857):1285-1293. https://doi.org/10.1126/science.3287615
  26. Swets JA. ROC analysis applied to the evaluation of medical imaging techniques. Invest Radiol. 1979; 14(2):109-121. https://doi.org/10.1097/00004424-197903000-00002
  27. Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;331(13):821-827. https://doi.org/10.1056/NEJM199409293311301
  28. van der Heide JC, Begeer C, Fock JM, et al. Postural control during reaching in preterm children with cerebral palsy. Dev Med Child Neurol. 2004;46(4):253-266.
  29. Verbecque E, Lobo Da Costa PH, Vereeck L, et al. Psychometric properties of functional balance tests in children: A literature review. Dev Med Child Neurol. 2015;57(6):521-529. https://doi.org/10.1111/dmcn.12657

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