Berg Balance Scale Predicts Walking
Louie DR & Eng JJ (2018) Berg Balance Scale score at admission can predict walking suitable for community ambulation at discharge from inpatient stroke rehabilitation. Journal of Rehabilitation Medicine, 50 (1), 37-44, DOI: https://doi.org/10.2340/16501977-2280
One of my very favourite academic researchers is Janice Eng and I’m so excited, because, guess what; she’s a keynote speaker at the Stroke 2018 conference in Sydney next week. If you-re going, let’s try and catch up! Although I do realise this is a hugely challenging thing to do at scientific conferences.
Two of my very favourite topics, as CS followers will already know, are using standardised assessments to measure recovery after stroke and predicting recovery potential on the basis of stroke assessments.
So, in my humble opinion, this article is a hit for three very good reasons!
Why don’t we do this more? Why don’t we measure function at baseline or on admission to our services, and then, when we can, use that data to predict what is most likely to occur in most patients? We do this in almost every other aspect of our personal and professional lives. For example, when we calculate a housing loan with the bank, or put in the time and effort to apply for a job on the basis of our estimates on the chances we have of success. There’s more and more reason to do this in those recovering from stroke! These researchers have demonstrated you can use admission Berg Balance Scale data to predict mobility at discharge from inpatient rehabilitation.
This article is freely available. You can find the abstract in the 2018 Journal Club, and I’ve posted “humble opinion” below. If you’re in Sydney next week, why not attend the Stroke 2018 conference? Hopefully I’ll see some of you there!
Humble Opinion: As Janice Eng and Denise Louie point out, early after stroke, only 53% of patients have regained independence in walking. So, can we predict who those people are most likely to be? These researchers demonstrated that the Berg Balance Scale (BBS) was able to predict the degree of improvement. This study is essentially a sub-analysis of a larger, randomised controlled trial, which means that it has high scientific integrity. Louie and Eng also investigated factors which might also influence walking early after stroke, such as, cognition, stroke sub-type and admission walking speed. All three, when coupled with the BBS, were found to influence walking after stroke.
The admission BBS was 41 for those who achieved what the researchers refer to as “community ambulation”, which was more than twice the median for those that didn’t (medBBS=16), and they concluded that all those who had an admission BBS 12 are likely to regain independence in walking. Of the 85 patients who were not able to mobilise on admission, 53 were able to do so without physical assistance at follow-up. As the authors state: “Better cognitive status, greater initial walking speed or balance ability and haemorrhagic stroke” were…predictors of achieving community walking speed; [but] only balance ability was a predictor for regaining unassisted walking”.
This evidence has significant clinical application to those working in stroke rehabilitation. As always, this is just my humble opinion, and I encourage you to read and appraise the evidence for yourself.
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