scholarly journals Balance Confidence Among People With Lower-Limb Amputations

2002 ◽  
Vol 82 (9) ◽  
pp. 856-865 ◽  
Author(s):  
William C Miller ◽  
Mark Speechley ◽  
A Barry Deathe

AbstractBackground and Purpose. Confidence in a person's balance has been shown to be an important predictor of social activity among people with lower-limb amputations. The purposes of this study were to describe confidence in balance among people with transtibial or transfemoral lower-limb amputations and to compare people whose amputations were due to vascular and nonvascular causes. Subjects and Methods. A survey of a sample of 435 community-dwelling individuals from 2 regional clinics was conducted. The sample consisted of people with unilateral transfemoral (26.7%) and transtibial (73.3%) amputations who lost their limb for vascular (53%) and nonvascular (47%) reasons. The mean age of the primarily male (71%) sample was 62.0 years (SD=15.7). Results. Mean scores, using the Activities-specific Balance Confidence (ABC) Scale, were 63.8 for the total sample, 54.1 for the subjects with amputations due to vascular reasons, and 74.7 for the subjects with amputations due to nonvascular reasons. Given a maximum possible ABC Scale score of 100, the results suggest that confidence was low. A difference between the subjects with amputations due to vascular reasons and those with amputations due to nonvascular reasons was observed over each item of the ABC Scale. Variables that were statistically related to balance confidence included age, sex, etiology, mobility device use, the need to concentrate while walking, limitations in activities of daily living, depression, and fear of falling. Discussion and Conclusion. Balance confidence scores among the study sample were low when compared with values previously reported by other researchers. Confidence was particularly low among individuals who had their amputation for vascular reasons. Balance confidence might be an important area of clinical concern.

2021 ◽  
Author(s):  
Jacqueline Giovanna De Roza ◽  
David Wei Liang Ng ◽  
Blessy Koottappal Mathew ◽  
Teena Jose ◽  
Ling Jia Goh ◽  
...  

Abstract BackgroundFalls in older adults is a common problem worldwide. Fear of falling (FoF) is a consequence of falls which has far-reaching implications including activity restriction, functional decline and reduced quality of life. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. MethodsThis descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors and clinical factors including history of falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine predictors of high FoF.ResultsOut of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had three or more chronic conditions. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77 – 19.13), use of walking aids (OR = 3.67, 95% CI = 1.54 – 8.77) and increasing frailty were significant predictors for high FoF. The odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66 – 17.37), mildly frail older adults (OR =18.58, 95% CI = 4.88 – 70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86 – 1512.60).ConclusionsFoF is a prevalent and compelling issue in community-dwelling older adults, particularly those with frailty. The demographic and clinical factors identified in this study will be helpful to develop targeted and tailored interventions for FoF.


2009 ◽  
Vol 15 (2) ◽  
pp. 117 ◽  
Author(s):  
A. Foley ◽  
S. Hillier ◽  
R. Barnard

Pre and post testing were conducted on community-dwelling older adults referred to a geriatric day rehabilitation centre (DRC). Consecutive DRC clients were screened for inclusion over a 16-month period and were eligible if: aged 60+ years; cognitively intact; and reason for referral involved spinal or lower limb musculoskeletal impairment, disability or surgery, and/or reduced functional mobility or falls. Clients were excluded if they had a neurological disorder, or did not complete the program. Outcome measures included: lower limb strength; balance; mobility; self-reported pain; activities of daily living; and quality of life. Data were summarised using descriptive statistics and analysed using paired t-tests. Of the 137 participants recruited, 110 were female and the mean age was 79.5 ± 7.3 years. In total, 106 participants completed the DRC program and were assessed at baseline and re-assessed at discharge. The mean length of stay was 12.4 ± 2.9 weeks, with 21.4 ± 5.4 attendances. From baseline to discharge, statistically significant differences were found for all objective measures of physical functioning, balance, and for all lower limb strength tests (P < 0.0001). Glasgow Pain Questionnaire scores demonstrated statistically significant improvements in all five domains of the scale (P < 0.0001). The Barthel Index and Multi-dimensional Functional Assessment Questionnaire both showed a statistically significant improvement in the level of independence in activities of daily living (ADL) (P < 0.05). The Assessment of Quality of Life Questionnaire showed a statistically significant improvement (P = 0.027). The Exercise Benefits/Barriers Scale also showed a statistically significant improvement over DRC attendance (P = 0.005). The Falls Efficacy Scale showed a positive change, but the improvement was not statistically significant (P = 0.80). The study’s results indicate that community-dwelling older adults with physical disabilities and multiple comorbidities who attended the interdisciplinary geriatric DRC, significantly improved their lower limb strength, balance and physical function, and also showed significant decreases in self-reported pain, and improvements in independence in ADL and quality of life. Given the limitations of the current study, further research, in the form of high quality studies with larger sample sizes that involve direct comparisons with other forms of care or against a control group, is needed to determine whether day rehabilitation centre programs provide the optimum mode of rehabilitation for this population in the most cost effective manner.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Shirley S. M. Fong ◽  
Shamay S. M. Ng ◽  
Karen P. Y. Liu ◽  
Marco Y. C. Pang ◽  
H. W. Lee ◽  
...  

Objectives.To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants.Methods.Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups.Results.Elderly VT practitioners had higher radial bone strength on the dominant side(P<0.05), greater lower limb muscular strength(P=0.001), better functional balance performance(P=0.003), and greater balance confidence(P<0.001)than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score(r=-0.575, P=0.013).Conclusions.VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly.


2003 ◽  
Vol 83 (12) ◽  
pp. 1072-1079 ◽  
Author(s):  
Janine Hatch ◽  
Kathleen M Gill-Body ◽  
Leslie G Portney

Background and Purpose. The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study. Subjects. The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (X̄=81.7, SD=6.7). Methods. Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up & Go Test. The Activities-specific Balance Scale was used to assess balance confidence. Data were analyzed using Pearson correlation, multiple regression analysis, and t tests. Results. Fifty-seven percent of the variance in balance confidence could be explained by balance performance. Functional mobility and subject characteristics examined in this study did not contribute to balance confidence. Discussion and Conclusion. Balance performance alone is a strong determinant of balance confidence in community-dwelling elderly people.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 790-790
Author(s):  
Chad Tiernan ◽  
Allon Goldberg

Abstract Balance confidence assessment in older adults has implications for falls and quality of life. It remains unclear whether the original Activities-specific Balance Confidence (ABC-16) scale or the shortened 6-item (ABC-6) scale is recommended. To further inform the decision-making process of balance confidence tool selection, a secondary analysis of an existing dataset consisting of 77 community-dwelling older adults was performed. ABC-16 and ABC-6 association and agreement, internal consistencies, and relationships with self-rated health (SRH) were assessed. Participants were primarily female (80.5%) between the ages of 60 and 87 years. Results indicated a strong association between the scales [r = .97, p&lt;.001); ICC(2,1) = .80] but limited agreement (95% Limits of Agreement range = 22.1; mean difference of 7.2 points in the direction of the ABC-16). Cronbach’s alphas were .95 (ABC-16) and .89 (ABC-6), suggesting high internal consistency for both scales but possible item redundancy with the ABC-16. Regression model 1 (ABC-6 = primary predictor) explained more of the variance (R2=.36) in SRH compared to model 2 (ABC-16 = primary predictor; R2=.29). Hotelling’s t-test [t(74)=2.4, p=.008] indicated that the correlation coefficient (Multiple R) from the ABC-6 model was significantly higher than the correlation coefficient from the ABC-16 model. In conclusion, despite a high correlation, the two scales did not agree strongly and should not be considered interchangeable. Given that the ABC-16 takes longer to administer, does not relate to SRH as strongly, and could have redundant items, the ABC-6 should be considered for balance confidence assessment in older adults.


2007 ◽  
Vol 14 (2) ◽  
pp. 74-86 ◽  
Author(s):  
Nadja Schott

Zusammenfassung. Mit der vorliegenden Untersuchung wurde der Zusammenhang von Sturzangst (Survey of Activities and Fear of Falling in the Elderly: SAFE), funktionalem Gleichgewicht/Mobilität (Timed-Up-and-Go-Test, TUG; Gehgeschwindigkeit) und körperlicher Funktionsfähigkeit (SAFE Aktivitäten, Reduktionen; SF-36) bei älteren Erwachsenen untersucht. Darüber hinaus sollte die Mediatorfunktion sturzassoziierter Selbstwirksamkeit (Activities-Specific Balance Confidence (ABC) Scale) in einem Strukturgleichungsmodell an 91 Erwachsenen (17 Männer, 74 Frauen) im Alter von 60 bis 93 Jahren ohne Sturzhistorie geprüft werden. Man findet signifikant negative Pfade von der Subskala SAFE Angst auf die sturzassoziierte Selbstwirksamkeit (β = -0.931; t = -8.117, p.001), d. h. dass ältere Menschen ohne aktuelle Sturzbiographie und nur geringer Sturzangst eine hohe sturzassoziierte Selbstwirksamkeit berichten. Ebenso ist der Effekt von Sturzangst auf die körperliche Funktionsfähigkeit hochsignifikant (β = -0.432, t = -2.686, p = .007). Für die sturzassoziierte Selbstwirksamkeit liegt ein hoher Zusammenhang mit dem funktionalen Gleichgewicht/Mobilität vor (β = 0.482, t = 2.050, p = .040), jedoch nicht mit der körperlichen Funktionsfähigkeit (β = 0.118, t = 0.916, p = .359). Für den Zusammenhang zwischen Sturzangst und funktionalem Gleichgewicht/Mobilität liegt eine vollständige Mediation durch die sturzassoziierte Selbstwirksamkeit vor. Der signifikante Einfluss von funktionalen Messungen und Verhaltensdaten auf die Sturzangst verdeutlicht die Notwendigkeit von Interventionen, die auf die Stärkung der sturzassoziierten Selbstwirksamkeit fokussieren, um so zur Reduktion von Sturzangst beizutragen.


2012 ◽  
Vol 92 (2) ◽  
pp. 279-288 ◽  
Author(s):  
Arve Opheim ◽  
Reidun Jahnsen ◽  
Elisabeth Olsson ◽  
Johan Kvalvik Stanghelle

Background Balance function is central in walking, and impaired balance function may be related to walking deterioration in adults with spastic bilateral cerebral palsy (CP). Objectives The purposes of this study were: (1) to compare balance confidence, fear of falling, and balance ability in adults with spastic bilateral CP, with and without self-reported walking deterioration; (2) to characterize balance confidence, fear of falling, and balance ability across all participants; and (3) to examine the relationship between balance confidence and balance ability across all participants. Design A case-control design was used. Methods Sixteen adults from a 7-year follow-up study who had spastic bilateral CP and were under 40 years of age in the 2006 survey participated. Eight participants reported walking deterioration (cases), and 8 participants did not report walking deterioration (controls). Outcome variables were: the Activities-specific Balance Confidence (ABC) Scale, the Falls Efficacy Scale–International (FES-I), and the Balance Evaluation Systems Test (BESTest). Results No differences in any of the outcome variables were found between the cases and the controls. Across all participants, the ABC Scale and FES-I scores were 62% and 24 points, respectively. Reduced ABC Scale scores and increased FES-I scores were found when using escalators, walking in crowds, and walking on slippery surfaces. The BESTest subscale scores were 60% to 79% of the maximum score, but only 31% and 42% of the maximum score in postural responses and anticipatory adjustments, respectively. Balance confidence correlated positively with postural responses, sensory orientation, stability in gait, and BESTest total score. Limitations The lack of reliability and validity tests for the outcome variables in this study population and the small number of participants were limitations of the study. Conclusions Self-reported walking deterioration in this group could not be explained by differences in balance confidence, fear of falling, or balance ability. Across all participants, most balance problems seemed related to reduced postural responses and anticipatory adjustments.


2013 ◽  
Vol 21 (4) ◽  
pp. 375-386 ◽  
Author(s):  
Dennis W. Klima ◽  
Roberta A. Newton ◽  
Emily A. Keshner ◽  
Adam Davey

Studies examining fear of falling among older adult men remain limited. The objectives of this study were to compare balance confidence in 2 age cohorts of older clergy and identify predictive determinants of balance confidence in a liturgical research initiative. Participants included 131 community-dwelling Roman Catholic priests age 60–97 yr living in religious communities in 10 mid-Atlantic states. Subjects completed the Activities-specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), timed up-and-go (TUG) test, and 15-item Geriatric Depression Scale (GDS). Younger priests (60–74 yr) demonstrated a significantly higher ABC score than the older cohort (75 and above yr) of priests (89.1 ± 12.6 vs.78.4 ± 13.9,p= .001). Confidence was significantly correlated with BBS (rho = .69,p< .01), TUG (r= –.58,p< .01), and GDS (r= –.39,p< .01) scores. A stepwise-regression model demonstrated that balance ability, mood, assistive-device use, and physical activity predicted 52% of the variance in balance confidence.


2011 ◽  
Vol 35 (4) ◽  
pp. 379-385 ◽  
Author(s):  
William C Miller ◽  
A Barry Deathe

Background: Community living individuals with lower limb amputation have low balance confidence but the level of balance confidence in the first six months after discharge from prosthetic rehabilitation is not known.Objectives: To determine if balance confidence levels differ after discharge from prosthetic rehabilitation and to determine if balance confidence at discharge predicts social activity at three months post-discharge while controlling for important covariates such as walking ability.Study Design: Prospective study.Methods: Subjects ( n = 65) experiencing their first unilateral transfemoral or transtibial amputation were recruited and followed-up one and three months post-discharge. Measures of balance confidence (Activities-specific Balance Confidence Scale) and walking ability (L Test) collected at discharge were used to predict social activity (Frenchay Activities Index) at follow-up.Results: Despite a 14-second mean improvement in walking ability the mean balance confidence scores did not change significantly between discharge (71.2/100) and at three-month follow-up (69.4/100). Confidence scores and basic walking ability at discharge were the two strongest predictors of three-month social activity. Multiple regression modelling indicated that balance confidence and walking ability explained 64% of the variance (standardized beta = 0.34 and -0.37 respectively) in social activity (adjusted R2 = 39%).Conclusions: Balance confidence after discharge from prosthetic rehabilitation for lower limb amputation is low and scores do not improve over the first three months post-discharge despite improvements in walking ability. Discharge balance scores confidence independently predicts three-month social activity scores.


Sign in / Sign up

Export Citation Format

Share Document