Makizako Hyuma, Kabe Norihito, Takano Asami, Isobe Kanako
Department of Functional Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-machi, Obu, Aichi 474-8511, Japan∗.
National Center for Geriatrics and Gerontology, Aichi, Japan; and Department of Physical Therapy, Funabashi Municipal Rehabilitation Hospital, Chiba, Japan(†).
PM R. 2015 Apr;7(4):392-9. doi: 10.1016/j.pmrj.2015.01.009. Epub 2015 Jan 26.
To examine whether the Berg Balance Scale (BBS) score on admission and after 1 month can be used to predict the Functional Independence Measure (FIM) walking level 6 or 7 (modified independent and independent gait respectively) after 3 months and to determine the optimal BBS cut-off score for predicting independent gait among inpatients with first stroke in a rehabilitation facility.
Retrospective cohort study.
Inpatient rehabilitation facility (Kaifukuki).
Two hundred fifty-one consecutive patients with first stroke and nonindependent gait on admission.
BBS on admission and after 1 month and FIM on admission and after 3 months.
Area under the receiver operating characteristic curves for predicting independent gait after 3 months were 0.81 (95% confidence interval [CI], 0.75-0.88) for BBS score on admission; the optimal cut-off score being ≥13 (63% sensitivity; 90% specificity). Achieving greater cut-off score on admission was significantly associated with subsequent independent gait (odds ratio, 9.7; 95% CI, 4.38-21.36; P < .001). A subanalysis of patients with poor balance on admission (BBS score <13; n = 191) showed area under the receiver operating characteristic curves for predicting independent gait after 3 months of 0.88 (95% CI, 0.80-0.95) for BBS scores 1 month after admission. In this subgroup, BBS scores at 1 month of ≥27 were significantly associated with subsequent independent gait (odds ratio, 21.6, 95% CI, 6.40-73.20; P < .001).
Admission BBS scores predicted FIM walking level 6 or 7, which denotes modified independent or independent gait, after 3 months, the optimal cut-off for BBS scores being ≥13 among inpatients with first stroke in a rehabilitation facility. Patients with poor balance on admission whose BBS scores had improved to ≥27 at 1 month after admission were likely to achieve modified independent or independent gait within 3 months after admission.
探讨入院时及入院1个月后的伯格平衡量表（BBS）评分是否可用于预测3个月后功能独立性评定量表（FIM）行走水平6级或7级（分别为改良独立行走和独立行走），并确定康复机构中首次发生卒中的住院患者预测独立行走的最佳BBS临界值。
回顾性队列研究。
住院康复机构（Kaifukuki）。
251例入院时首次发生卒中且步态不独立的连续患者。
入院时及入院1个月后的BBS评分，以及入院时及入院3个月后的FIM评分。
入院时BBS评分预测3个月后独立行走的受试者工作特征曲线下面积为0.81（95%置信区间[CI]，0.75 - 0.88）；最佳临界值为≥13（灵敏度63%；特异度90%）。入院时达到更高的临界值与随后的独立行走显著相关（比值比，9.7；95%CI，4.38 - 21.36；P <.001）。对入院时平衡能力差（BBS评分<13；n = 191）的患者进行的亚组分析显示，入院1个月后BBS评分预测3个月后独立行走的受试者工作特征曲线下面积为0.88（95%CI，0.80 - 0.95）。在该亚组中，入院1个月时BBS评分≥27与随后的独立行走显著相关（比值比，21.6，95%CI，6.40 - 73.20；P <.001）。
入院时BBS评分可预测3个月后FIM行走水平6级或7级，即改良独立行走或独立行走，康复机构中首次发生卒中的住院患者BBS评分的最佳临界值为≥13。入院时平衡能力差但入院1个月时BBS评分提高到≥27的患者在入院后3个月内可能实现改良独立行走或独立行走。
