Article

The correct identification of patients with Parkinson disease (PD) at
risk for falling is important to initiate appropriate treatment early.
This study compared the Fullerton Advanced Balance (FAB) scale with the
Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS)
to identify individuals with PD at risk for falls and to analyze which of the
items of the scales best predict future falls. DESIGN:
This was a prospective
study to assess predictive criterion-related validity. SETTING: The study was
conducted at a university hospital in an urban community. PATIENTS: Eighty-five
patients with idiopathic PD (Hoehn and Yahr stages: 1-4) participated in the
study. MEASUREMENTS: Measures were number of falls (assessed prospectively over 6
months), FAB scale, Mini-BESTest, BBS, and Unified Parkinson's Disease Rating
Scale. RESULTS: The FAB scale, Mini-BESTest, and BBS showed similar accuracy to
predict future falls, with values for area under the curve (AUC) of the receiver
operating characteristic (ROC) curve of 0.68, 0.65, and 0.69, respectively. A
model combining the items "tandem stance," "rise to toes," "one-leg stance,"
"compensatory stepping backward," "turning," and "placing alternate foot on
stool" had an AUC of 0.84 of the ROC curve. LIMITATIONS: There was a dropout rate
of 19/85 participants. CONCLUSIONS: The FAB scale, Mini-BESTest, and BBS provide
moderate capacity to predict "fallers" (people with one or more falls) from
"nonfallers." Only some items of the 3 scales contribute to the detection of
future falls. Clinicians should particularly focus on the item "tandem stance"
along with the items "one-leg stance," "rise to toes," "compensatory stepping
backward," "turning 360 degrees ," and "placing foot on stool" when analyzing
postural control deficits related to fall risk. Future research should analyze
whether balance training including the aforementioned items is effective in
reducing fall risk.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS