Article

OBJECTIVE: To determine the ability of clinical measures of balance to
distinguish fallers from non-fallers and to determine their predictive validity
in identifying those at risk of falls. DATA SOURCES: AMED, CINAHL, Medline,
Scopus, PubMed Central and Google Scholar. First search:
July 2015. Final search:
October 2017. REVIEW METHODS: Inclusion criteria were studies of adults with a
definite multiple sclerosis diagnosis, a clinical balance assessment and method
of falls recording. Data were extracted independently by two reviewers. Study
quality was assessed using the Quality Assessment of Diagnostic Accuracy
Studies-2 scale and the modified Newcastle-Ottawa Quality Assessment Scale.
Statistical analysis was conducted for the cross-sectional studies using Review
Manager 5. The mean difference with 95% confidence interval in balance outcomes
between fallers and non-fallers was used as the mode of analysis. RESULTS: We
included 33 studies (19 cross-sectional, 5 randomised controlled trials, 9
prospective) with a total of 3901 participants, of which 1917 (49%) were
classified as fallers. The balance measures most commonly reported were the Berg
Balance Scale, Timed Up and Go and Falls Efficacy Scale International.
Meta-analysis demonstrated fallers perform significantly worse than non-fallers
on all measures analysed except the Timed Up and Go Cognitive ( p < 0.05), but
discriminative ability of the measures is commonly not reported. Of those
reported, the Activities-specific Balance Confidence Scale had the highest area
under the receiver operating characteristic curve value (0.92), but without
reporting corresponding measures of clinical utility. CONCLUSION: Clinical
measures of balance differ significantly between fallers and non-fallers but have
poor predictive ability for falls risk in people with multiple sclerosis.

Langue : ANGLAIS