Article

Gait impairments, balance impairments, and falls are prevalent in
individuals with Parkinson disease (PD). Although the Berg Balance Scale (BBS)
can be considered the reference standard for the determination of fall risk, it
has a noted ceiling effect. Development of ceiling-free measures that can assess
balance and are good at discriminating "fallers" from "nonfallers" is needed.
The purpose of this study was to compare the Functional Gait
Assessment (FGA) and the Balance Evaluation Systems Test (BESTest) with the BBS
among individuals with PD and evaluate the tests' reliability, validity, and
discriminatory sensitivity and specificity for fallers versus nonfallers. DESIGN:
This was an observational study of community-dwelling individuals with idiopathic
PD. METHODS: The BBS, FGA, and BESTest were administered to 80 individuals with
PD. Interrater reliability (n=15) was assessed by 3 raters.
Test-retest
reliability was based on 2 tests of participants (n=24), 2 weeks apart.
Intraclass correlation coefficients (2,1) were used to calculate reliability, and
Spearman correlation coefficients were used to assess validity. Cutoff points,
sensitivity, and specificity were based on receiver operating characteristic
plots. RESULTS: Test-retest reliability was .80 for the BBS, .91 for the FGA, and
.88 for the BESTest. Interrater reliability was greater than .93 for all 3 tests.
The FGA and BESTest were correlated with the BBS (r=.78 and r=.87, respectively).
Cutoff scores to identify fallers were 47/56 for the BBS, 15/30 for the FGA, and
69% for the BESTest. The overall accuracy (area under the curve) for the BBS,
FGA, and BESTest was .79, .80, and .85, respectively. LIMITATIONS: Fall reports
were retrospective. CONCLUSION: Both the FGA and the BESTest have reliability and
validity for assessing balance in individuals with PD. The BESTest is most sensitive for identifying fallers.
- Chute

Langue : ANGLAIS