The Berg Balance Scale as a clinical screening tool to predict fall risk in older adults: a systematic review.

BACKGROUND: The Berg Balance Scale (BBS) is often used in clinical practice to predict falls in the older adults. However, there is no consensus in research regarding its ability to predict falls. OBJECTIVE: To verify whether the BBS can predict falls risk in older adults. DATA SOURCE: Manual and electronic searches (Medline, EMBASE, CINAHL, Ageline, Lilacs, Web of Science, Cochrane Library and PEDro) were conducted using blocks of words (older adults, falls, BBS, study design) and their synonyms, with no language restrictions and published since 1989. STUDY SELECTION CRITERIA: Prognostic studies or clinical trials were used to assess the BBS and falls history. DATA EXTRACTION AND DATA SYNTHESIS: In this narrative synthesis, two independent assessors extracted data from articles and a third reviewer provided consensus, in case of disagreement. The methodological quality was assessed using the Quality In Prognosis Studies tool. RESULTS: 1047 studies were found and 8 studies were included in this review. The mean BBS score was high, regardless of the history of falls. Three studies presented cut-off scores for BBS, ranging from 45 to 51 points. Two studies reported a difference in the BBS score between fallers and non-fallers. Studies presented low to moderate risk of bias. LIMITATIONS: Unfeasible to conduct a meta-analysis due the heterogeneity of included studies. CONCLUSION: The evidence to support the use of BBS to predict falls is insufficient, and should not be used alone to determine the risk of falling in older adults. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42016032309.

The effects of acrobatic exercise on brain plasticity: a systematic review of animal studies.

Acrobatic exercise is considered a complex motor activity and may promote motor learning and neuroplasticity. The objective of this systematic review was to verify possible plastic brain changes induced by acrobatic exercise in non-lesioned rat and mouse through the analysis of experimental studies. Manual and electronic searches were conducted in MEDLINE, EMBASE and ISI Web of Science databases, without restriction to language or publication date. Synaptogenesis and neurogenesis were selected as the primary outcomes. To evaluate the risk of bias of individual studies, we used the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) RoB tool. We found 1780 studies, from which 18 fulfilled the inclusion criteria in this review. Seventeen studies evaluated the cerebellum, six the motor cortex, five the striatum and two evaluated the hippocampus. The results showed that acrobatic exercise promotes plastic changes in brain areas of rats, and such changes are dependent of training frequency and duration. However, studies were heterogeneous regarding the proteins analyzed and the training protocols, which made it difficult to compare and determine ideal acrobatic exercise parameters for neuroplasticity. Concerning the methodological quality of studies, most of them presented high risk of bias with absence of relevant study design information. New research with detailing training protocols and analysis might contribute to clarify the role of acrobatic exercise in neuroplasticity and how it could be used in translational research.

Intracoronary radiation with gamma wire inhibits recurrent in-stent restenosis.

To study the safety and efficacy of intracoronary gamma radiation delivered via a new high-activity (192)Ir source wire for the treatment of in-stent restenosis. In-stent restenosis results from neointimal tissue proliferation especially in its diffused form and presents a therapeutic challenge. Gamma radiation has been shown to decrease neointima formation within stents in animal models and in initial clinical trials. A total of 26 patients with in-stent restenosis underwent successful intervention and was treated with open-label (192)Ir using a high-activity line source. The specific activity of the source wire was 372+/-51 mCi, and the dwell time was 10.8+/-1.9 min. Primary endpoints were freedom from death, myocardial infraction (MI), and repeat target lesion revascularization (TLR) at 6 months. Secondary endpoints included angiographic restenosis and intravascular ultrasound (IVUS) neointimal hyperplasia. Procedural success was high (96.2%), and in-hospital and 30-day complications were low with no deaths, MI, or requirement for repeat revascularization. At 6 months, event-free survival was 85%: one patient required repeat PTCA, one underwent bypass surgery, and two had an MI. Baseline lesion length measured 15.77 mm. Follow-up angiography was available in 21/25 (84%) patients. The binary restenosis rates were 19.0% (4/21) in-stent and 23.8% (5/21) in-lesion. Follow-up IVUS was available in 20/25 patients. There was no increase in intimal hyperplasia from postintervention to follow-up (3.11.8 vs. 3.41.8 mm(2); P=.32). Eight patients had a reduction of neointimal intimal tissue at follow-up. These results indicate that intracoronary gamma radiation with the Angiorad source wire is safe and effective in preventing in-stent restenosis.

Beck Depression Inventory--II: College population study.

This study expands on the normative data available for the newly revised Beck Depression Inventory-II. Data from both an outpatient, counseling-center sample (n = 152: 106 women, 46 men) and a classroom sample (n = 152: 79 women, 65 men) of college students are presented, including sex differences on the inventory. Means and standard deviations of individual items and total scores are reported, along with statistical tests of differences between groups. Comparisons of these data with norms reported by the authors of the inventory (Beck, Steer, & Brown, 1996) are offered. The lack of sex differences found in comparison of total scores for both samples is presented. Implications for the use of the inventory with college populations are discussed.