Balancing Access with Technology: Comparing In-Person and Telerehabilitation Berg Balance Scale Scores among Stroke Survivors

Objective: To investigate the effects of Morning Walk®–assisted gait training for patients with stroke. Design: Prospective randomized controlled trial. Setting: Three hospital rehabilitation departments (two tertiary and one secondary). Patients: We enrolled 58 patients with hemiparesis following a first-time stroke within the preceding year and with Functional Ambulation Category scores ⩾2. Intervention: The patients were randomly assigned to one of two treatment groups: 30 minutes of training with Morning Walk®, a lower limb rehabilitation robot, plus 1 hour of conventional physiotherapy (Morning Walk® group; n = 28); or 1.5 hour of conventional physiotherapy (control group; n = 30). All received treatment five times per week for three weeks. Main outcome measurements: The primary outcomes were walking ability, assessed using the Functional Ambulation Category scale, and lower limb function, assessed using the Motricity Index-Lower. Secondary outcomes included the 10 Meter Walk Test, Modified Barthel Index, Rivermead Mobility Index, and Berg Balance Scale scores. Results: A total of 10 patients were lost to follow-up, leaving a cohort of 48 for the final analyses. After training, all outcome measures significantly improved in both groups. In Motricity Index-Lower of the affected limb, the Morning Walk® group (∆mean ± SD; 19.68 ± 14.06) showed greater improvement ( p = .034) than the control group (∆mean ± SD; 11.70 ± 10.65). And Berg Balance Scale scores improved more ( p = .047) in the Morning Walk® group (∆mean ± SD; 14.36 ± 9.01) than the control group (∆mean ± SD; 9.65 ± 8.14). Conclusion: Compared with conventional physiotherapy alone, our results suggest that voluntary strength and balance of stroke patients with hemiparesis might be improved with Morning Walk®–assisted gait training combined with conventional physiotherapy.

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Comparison of Mini-Bestest and Berg Balance Scale to Evaluate Balance Deficits in Community Dwelling Stroke Survivors

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2016.08.258 ◽

2016 ◽

Vol 97 (10) ◽

pp. e84

Author(s):

Alka Bishnoi ◽

Sangeetha Madhavan

Keyword(s):

Berg Balance Scale ◽

Community Dwelling ◽

Stroke Survivors ◽

Balance Scale ◽

Balance Deficits

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Interrater Reliability of the Berg Balance Scale When Used by Clinicians of Various Experience Levels to Assess People With Lower Limb Amputations

Physical Therapy ◽

10.2522/ptj.20130182 ◽

2014 ◽

Vol 94 (3) ◽

pp. 371-378 ◽

Cited By ~ 21

Author(s):

Christopher K. Wong

Keyword(s):

Lower Limb ◽

Interrater Reliability ◽

Clinical Training ◽

Intraclass Correlation ◽

Berg Balance Scale ◽

Intrarater Reliability ◽

Rater Reliability ◽

Study Objective ◽

Balance Scale ◽

Scale Scores

Background People with lower limb amputations frequently have impaired balance ability. The Berg Balance Scale (BBS) has excellent psychometric properties for people with neurologic disorders and elderly people dwelling in the community. A Rasch analysis demonstrated the validity of the BBS for people with lower limb amputations of all ability strata, but rater reliability has not been tested. Objective The study objective was to determine the interrater reliability and intrarater reliability of BBS scores and the differences in scores assigned by testers with various levels of experience when assessing people with lower limb amputations. Design This reliability study of video-recorded single-session BBS assessments had a cross-sectional design. Methods From a larger study of people with lower limb amputations, 5 consecutively recruited participants using prostheses were video recorded during an in-person BBS assessment. Sixteen testers independently rated the video-recorded assessments. Testers were 3 physical therapists, 1 occupational therapist, 3 third-year and 4 second-year doctor of physical therapy (DPT) students, and 5 first-year DPT students without clinical training. Rater reliability was calculated using intraclass correlation coefficients (ICC [2,k]). Differences in scores assigned by testers with various levels of experience were determined by use of an analysis of variance with Tukey post hoc tests. Results The average age of the participants was 53.0 years (SD=15.7). Amputations had occurred at the ankle disarticulation, transtibial, and transfemoral levels because of vascular, trauma, and medical etiologies an average of 8.2 years earlier (SD=7.9). Berg Balance Scale scores spanned all ability strata. Interrater reliability (ICC [2,k]=.99) and intrarater reliability of scores determined in person and through video-recorded assessments by the same testers (ICC [2,k]=.99) were excellent. For participants with the lowest levels of ability, licensed professionals assigned lower scores than did DPT students without clinical training. Limitations Intrarater reliability calculations were based on 2 testers. Conclusions Berg Balance Scale scores assigned to people using prostheses by testers with various levels of clinical experience had excellent interrater reliability and intrarater reliability.

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Community Delivery of a Comprehensive Fall-Prevention Program in People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2014-086 ◽

2016 ◽

Vol 18 (1) ◽

pp. 42-48 ◽

Cited By ~ 7

Author(s):

Cinda L. Hugos ◽

Debra Frankel ◽

Sara A. Tompkins ◽

Michelle Cameron

Keyword(s):

Multiple Sclerosis ◽

Fall Prevention ◽

Berg Balance Scale ◽

Timed Up And Go ◽

Balance Confidence ◽

Balance Scale ◽

Scale Scores ◽

The Impact ◽

Confidence Scale

Background: People with multiple sclerosis (MS) fall frequently. In 2011, the National Multiple Sclerosis Society launched a multifactorial fall-prevention group exercise and education program, Free From Falls (FFF), to prevent falls in MS. The objective of this study was to assess the impact of participation in the FFF program on balance, mobility, and falls in people with MS. Methods: This was a retrospective evaluation of assessments from community delivery of FFF. Changes in Activities-specific Balance Confidence scale scores, Berg Balance Scale scores, 8-foot Timed Up and Go performance, and falls were assessed. Results: A total of 134 participants completed the measures at the first and last FFF sessions, and 109 completed a 6-month follow-up assessment. Group mean scores on the Activities-specific Balance Confidence scale (F1,66 = 17.14, P < .05, η2 = 0.21), Berg Balance Scale (F1,68 = 23.39, P < .05, η2 = 0.26), and 8-foot Timed Up and Go (F1,79 = 4.83, P < .05, η2 = 0.06) all improved significantly from the first to the last session. At the 6-month follow-up, fewer falls were reported (χ2 [4, N = 239] = 10.56, P < .05, Phi = 0.21). Conclusions: These observational data suggest that the FFF group education and exercise program improves balance confidence, balance performance, and functional mobility and reduces falls in people with MS.

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