Berg Balance Scale and Outcome Measures in Acquired Brain Injury

2001 ◽  
Vol 15 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Jody A. Feld ◽  
Meheroz H. Rabadi ◽  
Alan D. Blau ◽  
Barry D. Jordan
Keyword(s):  
Brain Injury ◽  
Functional Independence Measure ◽  
Quantitative Measure ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Community Dwelling ◽  
Strongly Correlated ◽  
Balance Scale ◽  
Clinical Measures

Objective: To examine the relationship of the Berg Balance Scale (BBS) to out come after acquired brain injury. Methods: Forty consecutive patients with acquired brain injury were admitted for multidisciplinary rehabilitation. Patients were assessed with the BBS. The BBS was originally designed as a quantitative measure of balance and risk for falls in community-dwelling elderly patients. The BBS comprises 14 dif ferent tasks graded on a 56-point scale. Community-dwelling elders with a BBS score of ≤42 have >90% risk for falls. Results: In our study, there were 27 patients with a low BBS score (≤42) and 13 patients with a high BBS score (≥43). The discharge total Functional Independence Measure (FIM) scores were lower in the low BBS pa tients (96.4 ± 21.2) compared with the high BBS patients (111.5 ± 12.5) (p < 0.007). The length of stay (LOS) was significantly longer in the low BBS patients (38.9 ± 18.5 days) compared with the high BBS patients (14.2 ± 6.1 days; p < 0.000). Among the three patients that experienced falls during their hospitalization, all exhibited low BBS scores. The admission BBS score strongly correlated with admission total FIM scores (r = 0.86; p < 0.000) and moderately correlated with discharge total FIM scores (r = 0.56; p < 0.000) and LOS (r = -0.55; p < 0.000). Using a multiple regression analysis, the admission FIM score was found to be the better predictor of discharge FIM scores, and time admitted after injury was the better predictor of LOS. Conclusions: Prediction of rehabilitative outcome might be enhanced by the use of the BBS scores in combination with other clinical measures on admission to inpatient acute rehabil itation. Key Words: Functional Independence Measure—Berg Balance Scale—Ac quired brain injury.

scholarly journals Nutritional and Rehabilitation goals in Acquired Brain Injury patients: a new decannulation protocol

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M d’Angelo ◽  
A Michelutti ◽  
E Biasutti ◽  
R Quattrin ◽  
S Brusaferro
Keyword(s):  
Brain Injury ◽  
Functional Independence Measure ◽  
Acquired Brain Injury ◽  
Rehabilitation Medicine ◽  
Functional Independence ◽  
Oral Feeding ◽  
Respiratory Complications ◽  
Outcome Indicators ◽  
Physical And Rehabilitation Medicine ◽  
Process And Outcome

Abstract Background One of the first goals for the rehabilitation of patients with Acquired Brain Injury (ABI) is the removal of the tracheocannula: the aim is not only to allow respiration by airways and reduce respiratory complications but also to obtain rehabilitation of dysphagia and verbal communication: for this purpose from July 2017 the ABI unit of the Institute of Physical and Rehabilitation Medicine ’Gervasutta” adopted a new decannulation protocol, recommended by the Italian Society of Physical Medicine and Rehabilitation (SIMFER). Methods Clinical data of ABI patients with tracheal cannula from May 2014 were collected as both process and outcome indicators associated with the adoption of the new protocol were defined. ABI patients were therefore divided into two groups depending on whether they were treated with or without the new procedure. Data have been processed with “Simple Interactive Statistical Analysis” (SISA) software. Results A sample of 141 patients with tracheocannula was analyzed; among these 57 (40.4%) were treated with the new decannulation protocol. No statistical significant differences were found between the two groups in terms of systemic or respiratory complications, Functional Independence Measure (FIM) or Level of Cognitive Functioning (LCF) at the entrance as well as for both the time (days) between entry or tracheotomy and decannulation. However decannulation rate is significantly higher when the new protocol is applied (OR = 1.8; 95% CI = 1.2- 9.8; p = 0.01) as the time (days) between entry and oral feeding resumption (p &lt; 0.001; 95% CI = -10 - -34 days). Conclusions The introduction of the new protocol has allowed the achievement of both nutritional and rehabilitation goals with a significantly faster oral feeding resumption and an increase of decannulation rate and. Further efforts are needed to support its use in the future, with the aim of further improving of either process or outcome performances. Key messages Promising prospects for the decannulation of patients with acquired brain injury. Achievement of nutritional and rehabilitation goals.

scholarly journals Postural control in blind subjects

2011 ◽  
Vol 9 (4) ◽  
pp. 470-476 ◽  
Author(s):  
Antonio Vinicius Soares ◽  
Cláudia Silva Remor de Oliveira ◽  
Rodrigo José Knabben ◽  
Susana Cristina Domenech ◽  
Noe Gomes Borges Junior
Keyword(s):  
Postural Control ◽  
Visual Loss ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Compensatory Mechanisms ◽  
Balance Scale ◽  
Brazilian Version ◽  
Congenitally Blind ◽  
The Mean

ABSTRACT Objective: To analyze postural control in acquired and congenitally blind adults. Methods: A total of 40 visually impaired adults participated in the research, divided into 2 groups, 20 with acquired blindness and 20 with congenital blindness − 21 males and 19 females, mean age 35.8 ± 10.8. The Brazilian version of Berg Balance Scale and the motor domain of functional independence measure were utilized. Results: On Berg Balance Scale the mean for acquired blindness was 54.0 ± 2.4 and 54.4 ± 2.5 for congenitally blind subjects; on functional independence measure the mean for acquired blind group was 87.1 ± 4.8 and 87.3 ± 2.3 for congenitally blind group. Conclusion: Based upon the scale used the results suggest the ability to control posture can be developed by compensatory mechanisms and it is not affected by visual loss in congenitally and acquired blindness.

Partnering to Increase Access to Community Exercise Programs for People With Stroke, Acquired Brain Injury, and Multiple Sclerosis

2014 ◽  
Vol 11 (4) ◽  
pp. 838-845 ◽  
Author(s):  
Nancy Margaret Salbach ◽  
Jo-Anne Howe ◽  
Karen Brunton ◽  
Kathryn Salisbury ◽  
Lorene Bodiam
Keyword(s):  
Multiple Sclerosis ◽  
Brain Injury ◽  
Physical Therapists ◽  
Exercise Program ◽  
Acquired Brain Injury ◽  
Berg Balance Scale ◽  
Community Dwelling ◽  
Municipal Recreation ◽  
Neurological Conditions ◽  
Exercise Classes

Background:The purpose of this article is to describe the development and evaluation of a task-oriented group exercise program, delivered through a municipal recreation program, for community-dwelling people with neurological conditions.Methods:Physical therapists (PTs) at a rehabilitation hospital partnered with a municipal recreation provider to develop and evaluate a 12-week exercise program for people with stroke, acquired brain injury, and multiple sclerosis at 2 community centers. Fitness instructors who were trained and supported by PTs taught 1-hour exercise classes twice a week. In a program evaluation of the safety, feasibility and effects of the program, standardized measures of physical function were administered before and after the program.Results:Fourteen individuals (mean age: 63 years) participated and attended 92% of exercise classes, on average. Two minor adverse events occurred during 293 attendances. Improvement in mean score on all measures was observed. In people with stroke, a statistically significant improvement in mean Berg Balance Scale (mean ± SD change = 3 ± 2 points, P = .016, n = 7) and 6-minute walk test scores (change = 26 ± 26 m, P = .017, n = 9) was observed.Conclusions:This model of exercise delivery provides people with neurological conditions with access to a safe, feasible and potentially beneficial exercise program in the community.

Predicting the Probability for Fall Incidence in Stroke Patients Using the Berg Balance Scale

2009 ◽  
Vol 37 (3) ◽  
pp. 697-704 ◽  
Author(s):  
N Maeda ◽  
J Kato ◽  
T Shimada
Keyword(s):  
Logistic Model ◽  
Functional Independence Measure ◽  
Length Of Hospital Stay ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Stroke Patients ◽  
Balance Scale ◽  
Patients At Risk ◽  
The Relationship ◽  
State Examination

This observational study investigated the relationship between balance, mobility and falls in 72 hemiplegic stroke inpatients, with the aim of developing a model for predicting fall risk. Fall history was recorded by interview, balance was assessed using the Berg Balance Scale (BBS) and activities of daily living were evaluated using the Functional Independence Measure (FIM). Variables differing between fallers and non-fallers were identified, and a stepwise regression analysis was performed to identify a combination of variables that effectively predicted fall status. Fallers (occasional and repeat; n = 27) had a shorter time from stroke onset, lower FIM scores on admission and discharge, lower BBS and Mini-Mental State Examination scores, a greater age and longer length of hospital stay compared with non-fallers (all differences were significant). A logistic model for predicting falls showed that BBS at admission was significantly related to falls, with fallers having lower BBS scores at admission (cut-off ≤ 29; sensitivity 80%; specificity 78%). These data suggest BBS is a sensitive and specific measure for identifying stroke patients at risk of falling.

Adipokines as Potential Biomarkers in the Neurorehabilitation of Obese Stroke Patients

2020 ◽  
Vol 17 (4) ◽  
pp. 437-445
Author(s):  
Irene Ciancarelli ◽  
Giovanni Morone ◽  
Marco Iosa ◽  
Stefano Paolucci ◽  
Loris Pignolo ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Functional Recovery ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Enzyme Linked Immunosorbent Assay ◽  
Stroke Patients ◽  
Rehabilitation Outcomes ◽  
Before And After ◽  
Forward Stepwise ◽  
Clinical Measures

Background: Limited studies concern the influence of obesity-induced dysregulation of adipokines in functional recovery after stroke neurorehabilitation. Objective: To investigate the relationship between serum leptin, resistin, and adiponectin and functional recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential significance as prognostic markers of rehabilitation outcomes was also verified. Methods: Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale (mRS), and Functional Independence Measure (FIM). Results: Compared to controls, higher leptin and resistin values and lower adiponectin values were observed in stroke patients before neurorehabilitation and no correlations were found between adipokines and clinical outcome measures. Neurorehabilitation was associated with improved scores of BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and resistin together increased adiponectin were detected in stroke patients, while leptin decreased but not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score, and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified leptin as prognostic factor for BI, mRS, and FIM. Conclusions: Our data show the effectiveness of neurorehabilitation in modulating adipokines levels and suggest that leptin could assume the significance of biomarker of functional recovery.

scholarly journals Prevalence and Treatment Patterns of Physical Impairments in Patients With Metastatic Breast Cancer

2008 ◽  
Vol 26 (16) ◽  
pp. 2621-2629 ◽  
Author(s):  
Andrea L. Cheville ◽  
Andrea B. Troxel ◽  
Jeffrey R. Basford ◽  
Alice B. Kornblith
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Functional Independence Measure ◽  
Metastatic Breast ◽  
Functional Independence ◽  
Physical Rehabilitation ◽  
Community Dwelling ◽  
Karnofsky Performance Score ◽  
Physical Impairments ◽  
Rehabilitation Intervention

Purpose Physical impairments cause profound functional declines in patients with cancer. Although common rehabilitation measures can address many impairments, the extent of their delivery is unknown. We studied these issues by quantifying physical impairments in patients with metastatic breast cancer and by assessing how they are addressed. Patients and Methods A consecutive sample of 163 community-dwelling patients with metastatic breast cancer was stratified by Karnofsky performance score and administered the Medical Outcomes Study Physical Function Subscale and the Older Americans Resource Study Activities of Daily Living subscales. Cancer-related physical impairments were identified through a physical examination, the 6-Minute Walk Test, and the Functional Independence Measure Mobility Subscale. Patients were questioned regarding the nature, type, and setting of treatments for impairments. Physical rehabilitation needs were determined through a consensus process involving physiatrists and physical/occupational therapists specializing in cancer. Results Ninety-two percent of patients (150 of 163) had at least one physical impairment. Among 530 identified impairments, 484 (92%) required a physical rehabilitation intervention and 469 (88%) required physical therapy (PT) and/or occupational therapy (OT). Only 30% of impairments requiring rehabilitation services and 21% of those requiring PT/OT received treatment. Impairments detected during hospitalization were overwhelmingly more likely to receive a rehabilitation intervention (odds ratio [OR] = 87.9; 95% CI, 28.5 to 271.4), and PT/OT (OR = 558.8; 95% CI, 187.0 to 1,669.6). Low socioeconomic and minority status were significantly associated with nontreatment. Conclusion Remediable physical impairments were prevalent and poorly addressed among patients with metastatic breast cancer, drastically so in the outpatient setting. Undertreatment was particularly prominent among minority and socioeconomically disadvantaged groups.

scholarly journals Association of frailty in hospitalized and institutionalized elderly in the community-dwelling

2016 ◽  
Vol 69 (4) ◽  
pp. 691-696 ◽  
Author(s):  
Suzele Cristina Coelho Fabrício-Wehbe ◽  
Rosalina Aparecida Partezani Rodrigues ◽  
Vanderlei Jose Haas ◽  
Jack Roberto Silva Fhon ◽  
Marina Aleixo Diniz
Keyword(s):  
Demographic Data ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Sampling Procedure ◽  
Community Dwelling ◽  
Specific Data ◽  
Follow Up Study ◽  
Dual Stage ◽  
The Subject

ABSTRACT Objective: to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents. Method: the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS), and functional capacity through the Functional Independence Measure. Results: we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years. Conclusion: the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.

Gender differences in the developmental outcomes of children with congenital cardiac defects

2012 ◽  
Vol 22 (5) ◽  
pp. 514-519 ◽  
Author(s):  
Annette Majnemer ◽  
Catherine Limperopoulos ◽  
Michael Shevell ◽  
Charles Rohlicek ◽  
Bernard Rosenblatt ◽  
...  
Keyword(s):  
Gender Differences ◽  
Brain Injury ◽  
Functional Independence Measure ◽  
Early Brain Injury ◽  
Functional Independence ◽  
Receptive Language ◽  
Full Scale ◽  
Fine Motor ◽  
Intellectual Quotient ◽  
Neuroprotective Strategies

AbstractObjectiveThis study compares the developmental and functional outcomes at school entry between boys and girls born with a congenital cardiac defect who required early surgical correction.Study designA prospective cohort of 94 children, including 49 percent boys, were followed up to 5 years of age and assessed for developmental progress. Developmental measures included Wechsler Preschool and Primary Scale of Intelligence – cognitive; Peabody Picture Vocabulary Test – receptive language; Peabody Developmental Motor Scale – motor; and Child Behaviour Checklist – behaviour. Measures of function included the Vineland Adaptive Behavior Scale and Functional Independence Measure for Children (WeeFIM).ResultsThe mean scores of the boys on the WeeFIM subscales, such as self-care, mobility, cognition, were significantly lower than that of the girls. There was a trend for a greater proportion of boys to have abnormalities on neurological examination (boys 37.5 percent abnormal, girls 19.5 percent abnormal). Verbal, performance, and full scale Intellectual Quotients were 5–7 points lower in boys but did not reach significance (full scale Intellectual Quotient: boys 87.7 plus or minus 22.2; girls 93.9 plus or minus 19.3). Boys were more likely to have fine motor delays (50 percent, 82.7 plus or minus 16.5) compared with girls (28.2 percent, 87.0 plus or minus 15.8). There were no gender differences in receptive language or behavioural difficulties.ConclusionsBoys born with congenital heart disease requiring early surgical repair appear to be at enhanced risk for neuromotor impairments and activity limitations. Findings support gender differences in the pathogenesis of early brain injury following hypoxic–ischaemic insults. This has implications for neuroprotective strategies to prevent brain injury.

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