Evaluación del riesgo de caídas en adultos mayores con Diabetes Mellitus tipo 2 / Evaluation of fall risk assessmentin in older adults with Type 2 Diabetes Mellitus / Avaliação do risco de quedas em idosos com Diabetes Mellitus tipo 2

Introducción: La diabetes mellitus 2 es una enfermedad frecuente en adultos mayores, con múltiples complicaciones que pueden llegar a afectar el equilibrio y la marcha e incrementar el riesgo de caída. Objetivo: Determinar el riesgo de caídas en dos grupos de adultos mayores, uno con padecimiento de DM2 y otro sin este padecimiento. Metodología: Estudio de enfoque cuantitativo, alcance descriptivo, diseño observacional, y de cohorte transversal; muestra poblacional de 120 adultos mayores en la ciudad de Guayaquil divididos en dos grupos: grupo A con 60 adultos mayores que no padecían DM2 y grupo B con 60 adultos mayores con DM2; que cumplen con los criterios de inclusión y a quienes se evalúan mediante las técnicas: observación, evaluación y entrevista; y los instrumentos: Escala de Berg, Mini-BESTest y formulario estándar. Se utilizó la prueba estadística Chi cuadrado para la comparación de los resultados obtenidos. Resultados: Los resultados indican que, en la determinación del riesgo de caídas, se encontraron diferencias estadísticamente significativas (p0.05). El estudio además encontró que los resultados obtenidos, en las dos pruebas de riesgo de caídas, difieren entre sí. Conclusiones: Los adultos mayores diabéticos presentan un mayor riesgo de caída a comparación de adultos mayores no diabéticos.

Introduction: Diabetes mellitus 2 is a common disease in older adults, with multiple complications that can affect balance and gait and increase the risk of falling. Objective: To determine the risk of falls in two groups of older adults, one with and the other without DM2. Methodology: Quantitative approach study, descriptive scope, observational design, and cross-sectional cohort; population sample of 120 older adults in the city of Guayaquil divided into two groups: group A with 60 older adults who did not suffer from DM2 and group B with 60 older adults with DM2; who meet the inclusion criteria and who are evaluated by means of the techniques: observation, evaluation and interview; and the instruments: Berg scale, Mini-BESTestest and standard form. The Chi-square statistical test was used to compare the results obtained. Results: The results indicate that, in the determination of the risk of falls, statistically significant differences (p0.05) were found. The study further found that the results obtained, in the two fall risk tests, differed from each other. Conclusions: Diabetic older adults present a higher risk of falling compared to non-diabetic older adults.

Introdução: O diabetes mellitus tipo 2 é uma doença comum em idosos, com múltiplas complicações que podem afetar o equilíbrio e a marcha e aumentar o risco de quedas. Objetivo: Determinar o risco de quedas em dois grupos de idosos, um com DM2 e outro sem essa condição. Metodologia: Estudo com abordagem quantitativa, escopo descritivo, desenho observacional e coorte transversal; amostra populacional de 120 idosos da cidade de Guayaquil dividida em dois grupos: grupo A com 60 idosos que não sofriam de DM2 e grupo B com 60 idosos com DM2; que atendam aos critérios de inclusão e que sejam avaliados pelas técnicas: observação, avaliação e entrevista; e os instrumentos: Escala de Berg, Mini-BESTest e formulário padrão. O teste estatístico Qui-quadrado foi utilizado para comparação dos resultados obtidos. Resultados: Os resultados indicam que, na determinação do risco de quedas, foram encontradas diferenças estatisticamente significativas (p0,05). O estudo também constatou que os resultados obtidos nos dois testes de risco de queda diferem entre si. Conclusões: Idosos diabéticos apresentam maior risco de queda em comparação aos idosos não diabéticos.

Minimal Clinically Important Difference for Mini-Balance Evaluation Systems Test and Berg Balance Scale：A Systematic Review / The Japanese Journal of Rehabilitation Medicine

Objective：The Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS) are widely used to test balance function in adults. However, the information on the minimal clinically important difference (MCID) for the measure has not been consolidated. This review summarizes all available information on the MCID for the Mini-BESTest and BBS.Methods：We searched three electronic databases (PubMed, Cumulative Index to Nursing & Allied Health Literature, and Web of Knowledge) for relevant literature and additionally conducted a hand search.We included all articles that reported an MCID for the Mini-BESTest and BBS.We excluded articles if the MCID was determined by a procedure other than receiver operating characteristic (ROC) curve analysis. Articles were abstracted for information on participants, interventions, balance assessment documentation, and the determination of MCID.Results：A search yielded 21 articles on the Mini-BESTest and 87 articles on the BBS, four articles on the Mini-BESTest and six articles on the BBS were selected based on adherence to the inclusion and exclusion criteria. The MCIDs with an area under the ROC curve of 0.7 or greater ranged from 1.5-4.5 points for the Mini-BESTest and 3.5-6 points for the BBS.Conclusion：A change of 1.5-4.5 points for the Mini-BESTest and 3.5-6 points for the BBS may be clinically important across multiple patient groups.

Effect Of Whole Body Vibration On Lower Body Strength And Balance In Osteoarthritis Knee

Background: Knee osteoarthritis causes pain, functional limitation, and disability in the elderly. Whole-body vibration has gained a lot of attention in recent years. It is currently used in alleviating pain and improve physical function along with strength and balance. Methods: 34 individuals aged between 50-70 years fulfilling the inclusion criteria were selected and randomized into two groups. Baseline assessment was done using the VAS scale, WOMAC scale, Berg Balance Scale, and 30seconds chair stand test. Group A received whole-body vibration, and knee strengthening exercises, and group B received only strengthening exercises. The treatment was given thrice in a week for four weeks. The assessment was done by the end of the 2nd and 4th weeks. Results: Whole body vibration had shown greater improvement of VAS on rest (p<0.05) compared to VAS on activity. Also, the WOMAC score was statistically improved between and within the group with p<0.05. Conclusion: Whole body vibration, along with strengthening exercises, showed superior effects in reducing pain, stiffness, physical function, balance, and lower limb strength in osteoarthritis knee patients.

Minimal Clinically Important Difference for Mini-Balance Evaluation Systems Test and Berg Balance Scale：A Systematic Review / The Japanese Journal of Rehabilitation Medicine

Objective：The Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS) are widely used to test balance function in adults. However, the information on the minimal clinically important difference (MCID) for the measure has not been consolidated. This review summarizes all available information on the MCID for the Mini-BESTest and BBS.Methods：We searched three electronic databases (PubMed, Cumulative Index to Nursing & Allied Health Literature, and Web of Knowledge) for relevant literature and additionally conducted a hand search.We included all articles that reported an MCID for the Mini-BESTest and BBS.We excluded articles if the MCID was determined by a procedure other than receiver operating characteristic (ROC) curve analysis. Articles were abstracted for information on participants, interventions, balance assessment documentation, and the determination of MCID.Results：A search yielded 21 articles on the Mini-BESTest and 87 articles on the BBS, four articles on the Mini-BESTest and six articles on the BBS were selected based on adherence to the inclusion and exclusion criteria. The MCIDs with an area under the ROC curve of 0.7 or greater ranged from 1.5-4.5 points for the Mini-BESTest and 3.5-6 points for the BBS.Conclusion：A change of 1.5-4.5 points for the Mini-BESTest and 3.5-6 points for the BBS may be clinically important across multiple patient groups.

Prophylactic Impact of Beta vulgaris L in Ameliorating Cyclosporine A-Induced Hepatotoxicity in Rats

Background: Hepatotoxicity induced by Cyclosporine A (CsA) remains one of the major side effects. The aim of this studywas to determine the protective effects of beet root (Beta Vulgaris L) extract and silymarin against hepatotoxicity induced byCyclosporine A in rats. Methods: Sixty male albino rats, were divided into 6 groups (n=10). Group I control group. GroupII CsA-treated and received (50mg/kg weight, orally). Group III received (500mg/kg b.wt) beet root extract orally. Group IVreceived beet root extract and CsA as in group II and III. Group V was received (100 mg/kg b.wt) silymarin orally. Group VIreceived CsA and silymarin as in group II and V. Serum levels of (ALT, AST, ALP) and bilirubin (Total and Direct) weremeasured. Oxidative stress biomarkers, antioxidant status, damage to DNA, apoptosis and inflammatory mediators weremeasured in the tissues of the liver. Result: CsA administration significantly increased serum levels of the liver enzymesALT, AST, ALP and bilirubin. In addition, significant increase in MDA, Nitrite, 8-OHdG, caspase3, NF-κB, TNF-α andsignificant decrease of GST in liver tissues was noticed. Furthermore, histopathological changes occurred in CsA treatedrats exhibited disruption of normal liver architecture, congested central vein, vacuolated cytoplasm and inflammatory cellsinfiltration. Co-administration of beet root extract or silymarin +CsA ameliorated all these parameters. Conclusion: Thepresent study suggests that beet root extract and silymarin have beneficial effect in reducing hepatotoxicity induced by CsAvia decreasing oxidative stress, inflammation, DNA damage, apoptosis and repairing the histopathological changes.

To Compare The Functional Balance Between Normal Elderly, Elderly With Diabetes, Elderly With Diabetic Polyneuropathy

Background: We aimed in this study to compare functional balance using berg balance scale amongst three groups namely elderly without diabetes, elderly with diabetes and elderly with diabetic polyneuropathy. There were total 108 patients included in the study. Purpose: The main objective of the study was to compare functional balance by using berg balance scale among the three groups namely elderly without diabetes, elderly with diabetes and elderly with diabetic polyneuropathy. Methodology: A total of 108 patients were taken for the study, were divided into three groups namely: Group A- Elderly without diabetes, Group B- Elderly with diabetes and Group C- Elderly with diabetic polyneuropathy. Berg balance scale was administered in the above mentioned three groups. Results: The mean of age, gender and duration since diabetes was calculated in all groups. Berg balance scale scores were calculated and in that high fall risk there were 20(55.56%) participants in elderly with diabetic polyneuropathy. In medium fall risk there was 1(2.78%) participant in elderly with diabetes and 16(44.44%) participants in elderly with diabetic polyneuropathy. While in low fall risk there were 36 (100%) participants in normal elderly, 35(97.22%) participants in elderly with diabetes and 0(0%) in elderly with diabetic polyneuropathy. One way Anova was done and all the three groups were having significant difference in their BBS scores. Conclusion: this study concluded that elderly with diabetic polyneuropathy were at high risk of fall than the other two groups; however elderly with diabetics were also at low risk of fall compared to elderly without diabetes though the result was not significant.

Application of Berg Balance Scale, Mini-Balance Evaluation Systems Test and Brief-Balance Evaluation Systems Test for Falls in Chronic Obstructive Pulmonary Disease Patients / 中国康复理论与实践

@#Objective To compare the differentiating effect of Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (Mini-BESTest) and Brief-BESTest on the risk of falls in chronic obstructive pulmonary disease (COPD) patients. Methods From September, 2016 to March, 2017, 22 COPD patients with history of falls and other age-matched 66 COPD patients without history of falls were assessed with BBS, Mini-BESTest and Brief-BESTest. The data were compared with paired Logistic regression, Log-likelihood estimate, and the skewness coefficient were calculated. Results BBS, Mini-BESTest and Brief-BESTest all were valuable for differentiating the risk of falls in COPD patients. Log-likelihood estimate value was the least in Brif-BESTest (5.372), followed with Mini-BESTest (12.918) and BBS (17.644). There was not a ceiling effect in Brief-BESTest and Mini-BESTest, but there was in BBS. Conclusion All the BBS, Mini-BESTest and Brief-BESTest can predict the risk of falls in patients with COPD, and Brief-BESTest is the most predictive. There is a ceiling effect in BBS for COPD patients, but not in Brief-BESTest and Mini-BESTest.

Clinical Observation of JIN's Three-needle Acupuncture plus Modern Nerve Facilitation Technique for Infantile Cerebral Palsy / 上海针灸杂志

Objective To observe the clinical efficacy of JIN'sthree needle acupuncture plus modern nerve facilitation technique in treating infantile cerebral palsy.Method Fifty-two patients were randomized into a treatment group of 26 cases and a control group of 26 cases. The treatment group was intervened by JIN'sthree-needle acupuncture plus modern nerve facilitation technique, while the control group was by bionic electrical stimulation. After 2 treatment courses, the treatment group and control group were compared with each other by the Gross Motor Function Measure (GMFM), time taken for 10 m walk, Berg Balance Scale (BBS), modified Barthel Index (MBI) and therapeutic efficacy.Result After the treatment, the GMFM, time taken for 10 m walk, BBS, and MBI scores were significantly improved in the two groups (P<0.05). There were significant differences in comparing the GMFM, time for 10 m walk, BBS, and MBI scores between the two groups (P<0.05). The total effective rates were respectively 92.3% and 76.9%in the treatment group and control group, and the difference was statistically significant (P<0.05).Conclusion JIN's three-needle acupuncture plus modern nerve facilitation technique can significantly boost the efficacy in treating cerebral palsy.

Effect of Early-stage Acupuncture Intervention on Activities of Daily Living in Patients with Hemiplegic Balance Disturbance / 上海针灸杂志

Objective To observe the clinical efficacy of balance acupuncture predominantly by puncturing Jiaji points (EX-B2) from C4 to T1and from T12 to L1in treating hemiplegic balance disturbance after cerebral stroke. Method A total of 180 hemiplegia patients were randomized into 3 groups, 60 cases in balance acupuncture group, 60 cases in ordinary acupuncture group, and 60 cases in basic control group. After 1-month treatment and 3 months after the treatment, the motor function (Fugl-Meyer Assessment, FMA), balance function (Berg Balance Scale, BBS; Timed Up and Go Test, TUGT), and activities of daily living (ADL) (Barthel Index, BI) were observed.Result After 1-month treatment and 3 months after the treatment, limb function, balance ability and ADL were significantly different from those before the treatment in balance acupuncture group (P<0.01); after 1-month treatment, limb function in balance acupuncture group was significantly different from that in basic control group (P<0.05), and the differences were more statistically significant in comparing the rest indexes between the two groups (P<0.01); there were significant differences between ordinary acupuncture group and basic control group (P<0.05). Three months after the treatment, there was a significant difference in comparing balance function between balance acupuncture group and basic control group (P<0.05), and the differences were more statistically significant in comparing the rest indexes between the two groups (P<0.01), there was no significant difference in comparing balance function between ordinary acupuncture group and basic control group (P>0.05).Conclusion In combination with basic treatment, balance acupuncture works better than ordinary acupuncture and basic control in improving limb function, ADL and balance function of hemiplegia patients.

Effect of Early-stage Acupuncture Intervention on Activities of Daily Living in Patients with Hemiplegic Balance Disturbance / 上海针灸杂志

Objective To observe the clinical efficacy of balance acupuncture predominantly by puncturing Jiaji points (EX-B2) from C4 to T1and from T12 to L1in treating hemiplegic balance disturbance after cerebral stroke. Method A total of 180 hemiplegia patients were randomized into 3 groups, 60 cases in balance acupuncture group, 60 cases in ordinary acupuncture group, and 60 cases in basic control group. After 1-month treatment and 3 months after the treatment, the motor function (Fugl-Meyer Assessment, FMA), balance function (Berg Balance Scale, BBS; Timed Up and Go Test, TUGT), and activities of daily living (ADL) (Barthel Index, BI) were observed.Result After 1-month treatment and 3 months after the treatment, limb function, balance ability and ADL were significantly different from those before the treatment in balance acupuncture group (P<0.01); after 1-month treatment, limb function in balance acupuncture group was significantly different from that in basic control group (P<0.05), and the differences were more statistically significant in comparing the rest indexes between the two groups (P<0.01); there were significant differences between ordinary acupuncture group and basic control group (P<0.05). Three months after the treatment, there was a significant difference in comparing balance function between balance acupuncture group and basic control group (P<0.05), and the differences were more statistically significant in comparing the rest indexes between the two groups (P<0.01), there was no significant difference in comparing balance function between ordinary acupuncture group and basic control group (P>0.05).Conclusion In combination with basic treatment, balance acupuncture works better than ordinary acupuncture and basic control in improving limb function, ADL and balance function of hemiplegia patients.

The role of frontal lobe functional rating score in identifying two subtypes of vascular cognitive impairment / 中华老年医学杂志

Objective To compare 6 sub-function scale differences of frontal lobe function rating scale or a Frontal Assessment Battery(FAB)among patients with two subtypes of vascular cognitive impairment(VCI) to provide clues for the distinctive intervention and disease prevention and control of patients with two subtypes.Methods Totally 220 non-dementia vascular cognitive impairment (NDVCI)patients and 68 patients with vascular dementia(VaD)with final diagnosis were selected.The overall function and six sub-function scores were tested by FAB.Analyzing the score difference and probing a progress tendency from NDVCI to VaD were performed.Results The scores of frontal lobe function rating scale were higher in NDVCI(14.0 ± 2.8)than in VaD (9.5±2.0) patients with significant difference(t =29.92,P =0.00).The scales of frontal lobe function rating score of conceptualization ability (t =6.24,P =0.00),intelligence flexibility (t =7.00,P =0.00),antiinterference ability(t =7.21,P =0.00) and attention suppression(t =5.32,P =0.00) were lower in VaD group than in NDVCI group.The conceptualization weight capacity was significantly lower in VaD group than in NDVCI group(0.04 versus 0.32).Conclusions During a transitive process from NDVCI to VaD,it is important to focus on the mutation and deterioration of conceptualization capacity.

Variations in gait features in elderly adults during walking considering their balance

The aim of this study was to evaluate the influence of balance on the spatiotemporal features, lower-limb kinematics, and center of mass (COM) of the non-faller elderly during walking. In this study, 20 healthy elderly women (age, 76.2 ± 5.6 years; height, 150.1 ± 3.2 cm; weight, 55.8 ± 9.0 kg) were enrolled. Based on the Berg balance scale (BBS), the elderly were classified into two groups: poor balance (PB; BBS scores 0.05). The ROM of the mediolateral COM was greater in PB than in GB. Hip transversal movements in the two groups were different. The impairment of the lateral balance function might contribute to an increase in the incidence of fall events in the elderly with poor balance.

Clinical Observation of Acupuncture plus Rehabilitation for Lower-limb Dysfunction Due to Different Types of Ataxia After Stroke / 上海针灸杂志

Objective To observe the clinical efficacy ofXing Nao Kai Qiao(brain-awakening orifice-opening) needling method plus Frenkel's balance rehabilitation exercise in treating lower-limb dysfunction due to different types of ataxia after stroke.MethodA total of 115 eligible patients were randomized into two groups. Fifty-seven cases in the treatment group were intervened by Xing Nao Kai Qiaoneedling plus rehabilitation training; 58 cases in the control group were intervened byXing Nao Kai Qiaoneedling method alone. Berg Balance Scale (BBS) was adopted to evaluate the symptoms, balance function, and therapeutic efficacy before and after the treatment.Result In the treatment group, the markedly effective rate was respectively 72.2%, 83.3% and 61.1% in the cerebella subtype, brainstem subtype and basal ganglia subtype, and the total effectiverate was respectively 100.0%, 94.4% and 94.4%; in the control group, the markedly effective rate was respectively 21.1%, 35.0% and 58.8%, and the total effective rate was respectively 94.7%, 85.0% and 82.4%, and the between-group differences were statistically significant (P<0.05). After the treatment, the BBS score showed significant intra-group differences in both groups (P<0.01); the between-group comparisons showed that there were significant differences in comparing the scores of cerebella and brainstem subtypes after the treatment (P<0.05).ConclusionXing Nao Kai Qiaoneedling method plus Frenkel's rehabilitation exercise can effectively improve the symptoms of poststroke lower-limb ataxia, especially for cerebella and brainstem subtypes.

Balance Assessment in Subacute Stroke Patients Using the Balance Control Trainer (BalPro)

OBJECTIVE: To demonstrate the efficacy of the balance control trainer (BCT), developed for training patients with balance problems, as a balance assessment tool in subacute stroke patients. METHODS: A prospective cross-sectional study was carried out on 38 subacute stroke patients in their first episode of a stroke, and having the ability to maintain a standing position without aid for at least 5 minutes. Patients were assessed using the BCT (BalPro) 43.7±35.7 days after stroke. The balance was assessed using the Berg Balance Scale (BBS), the Timed Up and Go Test (TUG), a 10-meter walking test (10mWT), a 6-minute walking test (6MWT), and the Korean version of the Modified Barthel Index. The correlation and validity between the BCT and various balance assessments were analyzed. RESULTS: Statistically significant linear correlations were observed between the BCT score and the BBS (r=0.698, p<0.001). A moderate to excellent correlation was seen between the BCT score and 11 of the 14 BBS items. The BCT scores and other secondary outcome parameters (6MWT r=0.392, p=0.048; TUG r=–0.471, p=0.006; 10mWT r=–0.437, p=0.012) had a moderate correlation. CONCLUSION: Balance control training using the BCT (BalPro) showed significant statistical correlation with the BBS, and could therefore be a useful additional balance assessment tool in subacute stroke patients.

The Association Between Fall History and Physical Performance Tests in the Community-Dwelling Elderly: A Cross-Sectional Analysis

OBJECTIVE: To evaluate the association between baseline characteristics, three physical performance tests and fall history in a sample of the elderly from Korean population. METHODS: A total of 307 participants (mean age, 76.70±4.85 years) were categorized into one of two groups, i.e., fallers and non-fallers. Fifty-two participants who had reported falling unexpectedly at least once in the previous 12 months were assigned to the fallers group. Physical performance tests included Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), Timed Up and Go test. The differences between the two study groups were compared and we analyzed the correlations between fall histories and physical performance tests. RESULTS: SPPB demonstrated a significant association with fall history. Although the BBS total scores did not show statistical significance, two dynamic balance test items of BBS (B12 and B13) showed a significant association among fallers. CONCLUSION: This study suggests that SPPB and two dynamic balance test items of the BBS can be used in screening for risk of falls in an ambulatory elderly population.

Reliability of Berg Balance Scale in Patients with Parkinson's Disease / 中国康复理论与实践

Objective To investigate the reliability of Berg Balance Scale (BBS) applied in patients with Parkinson's disease (PD). Methods 121 PD inpatients from March to December, 2011 were assessed with BBS by 2 raters, and the testing procedure was videoed. One of the raters assessed with BBS via video 4 weeks later. The intraclass correlation coefficient (ICC) and Kappa coefficient between raters and between tests were investigated. Results The ICC was 1.00 of the total score between raters and 0.99 between tests, while the Kappa co-efficient were 0.66 to 0.93 and 0.69 to 0.99 of the items. Conclusion BBS is reliable in interrater and test-retest as applied in PD patients.

Relationships among the Y balance test, Berg Balance Scale, and lower limb strength in middle-aged and older females

Background: Older females have less dynamic postural control and muscle strength than do middle-aged females. Aging-related strength losses may limit balancing performance. Objective: The purpose of this study was to investigate the ability of the Y Balance Test (YBT) and lower limb strength to discriminate between females in 2 age groups, the relationship between YBT distance and the Berg Balance Scale (BBS), and the degree to which performance on YBT distance is related to lower limb strength in middle-aged and older females. Method: The 40 healthy, independently active females were divided into 2 groups: older and middle-aged. The participants underwent measurements of YBT distance using the YBT, maximal muscular strength of the lower limbs using a handheld dynamometer, and the BBS. Results: The YBT distance in 3 directions and lower limb muscle strength for both lower limbs were significantly lower in the older adults than in the middle-aged group. A moderate correlation but insignificant correlation was found between the YBT composite distance and the BBS score. In the older females, YBT distance was significantly positively correlated with strength of the knee flexor and hip abductor. In the middle-aged group, YBT distance was significantly positively correlated with strength of the knee flexor and hip extensor. Conclusions: Performance on the YBT was influenced by the strength of lower limb. We suggested that YBT can be used to alternative as a measurement of dynamic balance. Proper training programs for older people could include not only strengthening exercises but also YBT performance to improve balance. .

Effect of hippo therapy on balance and function in children with spastic diplegia.

Introduction: Hippo therapy is a form of physical, occupational and speech therapy in which a therapist uses the characteristic movements of a horse. The horse's pelvis has a similar three dimensional movement to the human's pelvis at the walk. This movement provides physical and sensory input which is variable, rhythmic and repetitive which leads to improvement in spasticity and balance. Objective: The study aimed to find the effect of hippo therapy on balance and function in children with spastic diplegia Material and methods: A quasi-experimental study was conducted at College of Physiotherapy, Ahmadabad. Sixteen children (8 in control group (A) and 8 in experimental group (B) with spastic cerebral palsy, aged 3 to 10 years with GMFCS level 1, 2, body weight less than 35 kg were include. Children with history of botulism toxin injection within 6 months, selective dorsal rhizotomy or orthopedic surgery within 1 year, moderate to severe intellectual disability, uncontrolled seizures, and poor visual or hearing acuity were exclude. Both groups were given neuro developmental technique (NDT), group B was given additional hippo therpy (riding on horse with minimal support as required) for 15 minutes twice a week. Outcome measures were Pediatric balance scale (PBS), GMFM 66, 88, Modified Ashworth scale. Level of significance was kept at 5%. Result: Within group, analysis did not show significant difference in PBS score ( W2.214, p = 0.027). Within group analysis for group B showed significant difference in both GMFM score (W= 2.207, p = 0.027) and PBS score (W = 2.214, p = 0.027). Between group analysis for GMFM score showed significant difference (U = 0.500, p = 0.005). But there was no significant difference in between group analysis for PBS score (U = 12.00, p = 0.321). Conclusion: Hippo therapy and NDT both have similar effect for improving balance in spastic diplegic children. But Hippo therapy has an additional effect for improving gross motor function.

Discriminant analysis for predictor of falls in stroke patients by using the Berg Balance Scale

<p><b>INTRODUCTION</b>An observational study was carried out to estimate the strength of the relationships among balance, mobility and falls in hemiplegic stroke inpatients. The objective was to examine factors that may aid in the prediction of the likelihood of falls in stroke patients.</p><p><b>METHODS</b>A total of 53 stroke patients (30 male, 23 female) aged 67.0 ± 11.1 years were interviewed regarding their fall history. Physical performance was assessed using the Berg Balance Scale (BBS) and the Functional Independence Measure (FIM) scale. Variables that differed between fallers and non-fallers were identified, and a discriminant function analysis was carried out to determine the combination of variables that effectively predicted fall status.</p><p><b>RESULTS</b>Of the 53 stroke patients, 19 were fallers. Compared with the non-fallers, the fallers scored low on the FIM, and differed with respect to age, time from stroke onset, length of hospital stay, Brunnstrom recovery stage and admission BBS score. Discriminant analysis for predicting falls in stroke patients showed that admission BBS score was significantly related to the likelihood of falls. Moreover, discriminant analysis showed that the use of a significant BBS score to classify fallers and non-fallers had an accuracy of 81.1%. The discriminating criterion between the two groups was a score of 31 points on the BBS.</p><p><b>CONCLUSION</b>The results of this study suggest that BBS score is a strong predictor of falls in stroke patients. As balance is closely related to the risk of falls in hospitalised stroke patients, BBS might be useful in the prediction of falls.</p>

Revisão de dois instrumentos clínicos de avaliação para predizer risco de quedas em idosos / Review of two clinical assessment tools to predict risk of falls in elderly

Introdução: Quedas são um problema clínico comum nos idosos, que pode reduzir sua mobilidade e independência. O uso de instrumentos simples para detecção do risco de quedas é fundamental para prevenção e tratamento de tais eventos. Não há, porém, consenso quanto aos testes mais adequados para cada situação. Objetivo: Revisar estudos sobre eficácia, sensibilidade e especificidade dos testes Timed Up and Go Test e Berg Balance Scale, a fim de verificar qual é o mais apropriado para predizer quedas em idosos. Métodos: Realizou-se revisão bibliográfica nas bases de dados MEDLINE, PubMed, ISI, LILACS e Portal de Periódicos CAPES, entre os anos de 2001 e 2011. Resultados: Foram selecionados 37 artigos, sendo 17 sobre a Berg Balance Scale e 20 sobre o Timed Up and Go Test. A revisão mostrou que os dois testes podem ser bons preditores de quedas, mas os artigos diferiram quanto à definição de queda e caidor, tipo de estudo, quantidade e característica da amostra e avaliação de quedas, levando a diferentes resultados quanto a nota de corte, sensibilidade, especificidade e predição de quedas. Há controvérsias quanto à capacidade de predição em perfis específicos, como os idosos ativos. Conclusão: Os testes avaliados são eficazes para predição de quedas, desde que adaptados para cada perfil. Novos estudos devem ser realizados com metodologia homogênea, a fim de favorecer a comparação de resultados sobre a eficácia desses testes. .

Introduction: Fall is a common problem in the elderly and it can reduce their mobility and independence. The use of simple tools to detect risk of falls is essential to prevent and treat such events. However, there is no consensus about the most appropriate tools for each situation. Objective: To review studies about efficacy, sensitivity and specificity of Timed Up and Go Test (TUGT) and Berg Balance Scale (BBS) in order to ascertain which is the most appropriate to predict falls in the elderly. Methods: We performed a literature review from MEDLINE, PubMed, ISI, LILACS and Portal de Periódicos CAPES databases, between 2001 and 2011. Results: We selected 17 different articles about BBS and 20 articles about TUGT. The review showed the two tools can be good predictors of falls. However, the articles differed in definition of fall and faller, type of study, quantity and characteristics of sample and assessment of falls, leading to different results as cutoff scores, sensitivity, specificity and prediction of fall. There is controversy about the ability of tools to predict falls in specific samples, such as active elderly. Conclusion: TUGT and BBS are effective to predict falls, provided they are adapted to each sample. Further studies should be performed using articles with homogeneous methods in order to support comparison of results about the effectiveness of tools. .