Search

Objective: To determine which sections of the Balance Evaluation Systems Test (BESTest) distinguish levels of post-stroke functional walking status and to establish their cut-off scores. Design: A retrospective cross-sectional study. Subjects and methods: The BESTest was administered to 87 stroke patients who were able to walk without physical assistance upon discharge from the hospital. Subjects were divided into 3 functional walking status groups: namely, household ambulators, limited community ambulators, and unlimited community ambulators. The receiver operating characteristic curve was determined and the cut-off score and area under the receiver operating characteristic curve (AUROC) of each section calculated. Results: In the comparison of household and limited community ambulators, the accuracies of all BESTest sections were moderate (AUROC>0.7), and the cut-off scores were 36.1–78.6%. In the comparison of limited and unlimited community ambulators, one section (stability in gait) had high accuracy (AUROC=0.908, cut-off scores=73.8%) and 3 sections (biomechanical constraints, anticipatory postural adjustments, and postural response) had moderate accuracy (AUROC=0.8120–0.834, cut-off scores=75.0–83.4%). Conclusion: This study demonstrated that different sections of the BESTest had different abilities to discriminate levels of post-stroke functional walking status, and identified cut-off values for targeted improvement.

Missing (Commentary)

Objective: To clarify and compare the structural validity of 3 Balance Evaluation Systems Tests (BESTest, Mini-BESTest, and Brief-BESTest) in older adults with femoral or vertebral fractures. Design: Cross-sectional study. Subjects: Ninety-four older adults (age ?65 years) with femoral or vertebral fractures, who could walk without physical assistance. Methods: Four BESTest models (BESTest, one-factor Mini-BESTest, four-factor Mini-BESTest, and Brief-BESTest) were examined using confirmatory factor analysis, and the models goodness-of-fit was assessed. Unidimensionality of the best-fitting model was confirmed by Rasch principal component analysis on the residuals. Results: Confirmatory factor analysis showed that the four-factor Mini-BESTest model (comparative fit index?=?0.952; Tucker-Lewis index?=?0.937; root-mean square error of approximation?=?0.060; standardized root-mean-square residual?=?0.062) has a better structure than other models. The principal component analysis of standardized residuals showed that the variance attributable to Rasch factor was good, with eigenvalues

Aim: To investigate the factors and impact strength affecting mobility in community-dwelling older adults using a general linear model that can adequately address the issue of variables' distribution for more robust results. Methods: This cross-sectional study involving 103 participants was conducted to identify the factors affecting the Life-Space Assessment scores using a general linear model based on the data imputed using the hot-deck method. A complete case analysis was performed as a sensitivity analysis. Results and Conclusions: Three factors associated with life-space mobility were included in the model: walking speed, pain, and cognitive function. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to compare the psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) and S-BESTest and to evaluate which is more suitable for use in clinical settings for individuals with stroke. Methods. This multicenter retrospective cross-sectional study investigated 115 individuals with stroke (mean age, 70.8 y [SD=11.2 y]) who were able to stand without physical assistance. All individuals were examined with the BESTest and with the Mini-BESTest and S-BESTest scored based on the BESTest results. The data were analyzed using a Rasch analysis (partial credit model). Results. The Mini-BESTest results revealed a correctly functioning rating scale, good fit of the data to the model (apart from 1 overfit item), good reliability for both persons and items (6 statistically detectable levels of balance ability), local dependence between 1 item pair, and essential unidimensionality. The S-BESTest results demonstrated disordered rating scale thresholds (1 response option required collapsing), good fit of the data to the model (apart from 1 underfit item), good reliability for both persons and items (5 statistically detectable levels of balance ability), local dependence between 2 item pairs, and essential unidimensionality. Conclusion. The analyses confirmed that the reliability of the S-BESTest was good and unidimensional and that the test provides several improved points, such as item redundancy and local independence of items. Nevertheless, the Mini-BESTest results supported previous findings as a whole and were better than those from the S-BESTest. Impact. Rasch analysis demonstrated that the Mini-BESTest was a better balance assessment scale than the S-BESTest for individuals with stroke based on its psychometric properties. The Mini-BESTest may serve as a useful scale for assessing balance in individuals with stroke, and a keyform plot and strata may help clinical decision-making in terms of interpreting scores and goal setting. [ABSTRACT FROM AUTHOR]

[Purpose] The purpose of this study was to investigate the effect on motor skill and pinch grip of two different types of electrical stimulus, targeting the muscles and nerves, before exercise. [Subjects] The subjects were 8 healthy adults. [Method] We used a task of rotating a wooden ball in the palm of the hand. When subjects' performance had stabilized after practice, we applied the electrical stimulus. The electrical stimulus was delivered to the ball of the thumb (100 Hz, 120 sec) and to the ulnar nerve (centrally, 10 Hz, 60 min). Pinch grip strength and the number of ball rotations were measured before and after the electrical stimuli. [Results] For both stimuli, a significant increase in the number of rotations was found after stimulation, when compared to before, and in the comparison of percentage change, the muscle stimulation showed a significantly higher value. However, no change was found in pinch grip. [Conclusion] The results suggest the possibility that, compared to ulnar nerve stimulation, short-term muscle stimulation is a useful method for raising motor skill. [ABSTRACT FROM AUTHOR]

[Purpose] The purpose of this research was to verify the effect of a plastic ankle foot orthosis on the balance and waking ability of community-dwelling individuals with chronic stroke. [Subjects] Thirty-nine stroke subjects participated in this study. They were receiving hospital day-care and usually wore a shoehorn brace (SHB) on usual day. [Method] The Berg Balance Scale (BBS), the number of steps and time of the Timed "Up and Go" Test (TUG), and the walking speed, stride length, and walking rate of the Maximum Walking Speed (MWS) were measured with and without the SHB. [Result] When wearing the SHB, the BBS score increased significantly, except for seating position maintenance, the number of steps and time of TUG decreased significantly, and the walking speed, stride length, and walking rate of MWS increased significantly. [Conclusion] SHB improves the balance and walking ability of individuals with chronic stroke. [ABSTRACT FROM AUTHOR]

[Purpose] To investigate the effects of task prioritization on dual-task performance of patients with stroke. [Subjects] Forty-seven subjects with stroke who were able to walk independently or under supervision. [Method] The dual-task was the 10 m walking test while enouncing 3-digit numbers backwards (backward digit span). Dual-task performance was measured under two different conditions: paying attention equally to both walking and backward digit span (Dual-Task Complex: DTC), and paying attention mainly to backward digit span (Dual-Task backward digit span: DTB). [Result] Walking speed and cadence decreased, and the number of all answers and correct answers increased in DTB compared with DTC. [Conclusion] It is necessary to clearly specify the task prioritization, when we use dual-task as a predictor of falls or measure the walking ability of patients with stroke. [ABSTRACT FROM AUTHOR]

[Purpose] The purpose of this study was to investigate ward-based practice in a convalescence rehabilitation ward. [Subjects] The subjects were 682 patients who were admitted to and discharged from a convalescence rehabilitation ward in the period from April 2007 to March 2010. [Method] Records of all patients were retrospectively reviewed for length of stay, training time (number of units), Functional Independence Measure (FIM) scores at admission and discharge, FIM gain and efficiency, and the rate of discharge to home. [Results] The proportion of the patients who received ward-based practice in the convalescence rehabilitation ward was 45.8% in 2007, 26.8% in 2008 and 38.4% in 2009. Significant differences between the patients with ward-based practice and without ward-based practice were noted in length of stay, training time, FIM at admission, FIM gain and efficiency, and the rate of discharge to home. Those patients with ward-based practice performed better. [Conclusion] Our findings suggest that a ward-based practice improves activities of daily living and the rate of discharge to home in a convalescence rehabilitation ward. [ABSTRACT FROM AUTHOR]

[Purpose] The purpose of this study was to develop a Clinical Competence Evaluation Scale in Physical Therapy (CEPT). This scale was designed to be used in continuing education for physical therapists. We examined the reliability of the scale. [Method] Based on our previous qualitative study, a CEPT was developed with 53 items. The 90 participants in this study included novice physical therapists with less than 3 years' experience (n=30), as well as principal (n=30) and sub-tutors (n=30) who were mentoring the less experienced participants. Using CEPT, the novice physical therapists performed a self-evaluation, and the principal and sub-tutors evaluated the novice physical therapists. [Results] The score of the CEPT of the novice physical therapists was lower than those of the principal and sub-tutors. The intra-rater reliabilities of each item and total scores of the novice physical therapists and principal tutors ranged from moderate to high. Inter-rater reliability between the principal and the sub-tutors was low. [Conclusion] These results suggest that the intra-rater reliabilities of CEPT range from moderate to high. [ABSTRACT FROM AUTHOR]