title: Use of the Berg Balance Scale to predict independent gait after stroke: a study of an inpatient population in Japan.
abstract: OBJECTIVE
  To examine whether the Berg Balance Scale (BBS) score on admission and after 1 month can be used to predict the Functional Independence Measure (FIM) walking level 6 or 7 (modified independent and independent gait respectively) after 3 months and to determine the optimal BBS cut-off score for predicting independent gait among inpatients with first stroke in a rehabilitation facility.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Inpatient rehabilitation facility (Kaifukuki).
  
  
  METHODS
  Two hundred fifty-one consecutive patients with first stroke and nonindependent gait on admission.
  
  
  METHODS
  BBS on admission and after 1 month and FIM on admission and after 3 months.
  
  
  RESULTS
  Area under the receiver operating characteristic curves for predicting independent gait after 3 months were 0.81 (95% confidence interval [CI], 0.75-0.88) for BBS score on admission; the optimal cut-off score being ≥13 (63% sensitivity; 90% specificity). Achieving greater cut-off score on admission was significantly associated with subsequent independent gait (odds ratio, 9.7; 95% CI, 4.38-21.36; P < .001). A subanalysis of patients with poor balance on admission (BBS score <13; n = 191) showed area under the receiver operating characteristic curves for predicting independent gait after 3 months of 0.88 (95% CI, 0.80-0.95) for BBS scores 1 month after admission. In this subgroup, BBS scores at 1 month of ≥27 were significantly associated with subsequent independent gait (odds ratio, 21.6, 95% CI, 6.40-73.20; P < .001).
  
  
  CONCLUSIONS
  Admission BBS scores predicted FIM walking level 6 or 7, which denotes modified independent or independent gait, after 3 months, the optimal cut-off for BBS scores being ≥13 among inpatients with first stroke in a rehabilitation facility. Patients with poor balance on admission whose BBS scores had improved to ≥27 at 1 month after admission were likely to achieve modified independent or independent gait within 3 months after admission.
authors: Department of Functional Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-machi, Obu, Aichi 474-8511, Japan∗. Electronic address: makizako@ncgg.go.jp.
authors: Hyuma
authors: H
authors: Makizako
authors: National Center for Geriatrics and Gerontology, Aichi, Japan; and Department of Physical Therapy, Funabashi Municipal Rehabilitation Hospital, Chiba, Japan(†).
authors: Norihito
authors: N
authors: Kabe
authors: Department of Speech Therapy, Funabashi Municipal Rehabilitation Hospital, Chiba, Japan(‡).
authors: Asami
authors: A
authors: Takano
authors: Department of Nursing and Care Work, Funabashi Municipal Rehabilitation Hospital, Chiba, Japan(§).
authors: Kanako
authors: K
authors: Isobe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation*; D006801:Humans; D007297:Inpatients; D007564:Japan; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation