title: Dynamic longitudinal evaluation of the utility of the Berg Balance Scale in individuals with motor incomplete spinal cord injury.
abstract: OBJECTIVE
  To examine the utility of the Berg Balance Scale among patients with motor incomplete spinal cord injuries (SCIs), to determine how the utility of the Berg Balance Scale changes over time with activity-based therapy, and to identify differences in scale utility across patient groups defined by status of recovery.
  
  
  METHODS
  Prospective observational cohort.
  
  
  METHODS
  The NeuroRecovery Network (NRN), a network of clinical centers for patients with motor incomplete SCI.
  
  
  METHODS
  Patients with motor incomplete SCI (n=124) with American Spinal Injury Association Impairment Scale grade C or D, who were enrolled in the NRN between February 2008 and June 2009.
  
  
  METHODS
  Standardized locomotor training.
  
  
  METHODS
  The Berg Balance Scale items were examined with longitudinal principal components analyses. Patients were categorized by phase using the Neuromuscular Recovery Scale.
  
  
  RESULTS
  In the full sample, the first principal component explained a large percentage of overall scale variance (77%), items were loaded homogeneously on the first principal component, and item scores were well correlated with first principal component scores. In subgroups of low and high functioning of patients, first principal component variance accounting was reduced (49%) and only a few of the simplest and most difficult items substantially loaded onto the first principal component. Item loading coefficients evolved over time as patients recovered, with simpler items becoming less important to the full scale and difficult items more important.
  
  
  CONCLUSIONS
  The utility of the Berg Balance Scale in patients with motor incomplete SCI in early and advanced phases of recovery is limited. Specific item utility changes as patients recover. Thus, a more comprehensive and dynamic instrument is necessary to adequately measure balance across the spectrum of patients with motor incomplete SCI.
authors.affiliation: Department of Bioinformatics and Biostatistics, School of Public Health and Information Science, University of Louisville, Louisville, KY 40202, USA. somnath.datta@louisville.edu
authors.forename: Somnath
authors.initials: S
authors.lastname: Datta
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Lorenz
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Harkema
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010045:Outpatients; D004856:Postural Balance; D011446:Prospective Studies; D020127:Recovery of Function; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D015599:Trauma Severity Indices; D016138:Walking; D055815:Young Adult