A new cutoff score for the Burke Lateropulsion Scale improves validity in the classification of pusher behavior in subactue stroke patients
A new cutoff score for the Burke Lateropulsion Scale improves validity in the classification of pusher behavior in subactue stroke patients
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DOI：
10.1016/j.gaitpost.2018.12.034
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发表时间：
2019-02-01
期刊：
影响因子：
2.4
通讯作者：
Jahn, Klaus
中科院分区：
文献类型：
--
作者：
Bergman, Jeannine;Krewer, Carmen;Jahn, Klaus
背景：卒中患者在坐、站和姿势转换过程中，推挤行为严重妨碍了平衡。建议使用Burke侧推量表（BLS）评价推送器行为。然而，它的临界值还没有得到验证，最近的研究发现有必要修改它的证据。由于没有诊断推行为的金标准，这些患者通常受到干扰的功能应该用于验证临界值。研究问题：为了研究在坐、站和姿势转换过程中，推动者行为是否与平衡性能相关，方法：44例脑卒中亚急性期患者（BLS ≥ 2分）纳入本研究。结果：BLS评分与POMA-B评分呈中度负相关（r（sp）=-0.602，p < 0.001），BLS评分越低，平衡能力越高。约登指数最大值（J = 0.864）出现在临界值>= 2.5时。BLS评分>= 2的患者POMA-B评分>= 1，而BLS评分>= 3的患者无项目评分或仅在坐姿平衡task.Significance：与以前的研究结果一致，本研究的结果支持使用BLS临界评分>= 3而不是>= 2来诊断PB，用于研究目的和干预计划。得分>= 3与严重的平衡障碍和额面垂直感受损相关，并且它提高了与内推量表的一致性。
Background: Pusher behavior substantially hampers balance during sitting, standing, and posture transitions in stroke patients. The Burke Lateropulsion Scale (BLS) was recommended to evaluate pusher behavior. However, its cutoff score has not been validated and recent studies found evidence for a need to modify it. As there is no gold standard for the diagnosis of pusher behavior, functions that are typically disturbed in these patients should be used for the validation of the cutoff score.Research question: To investigate whether pusher behavior correlates with balance performance during sitting, standing and posture transitions, and to validate the BLS cutoff score.Methods: 44 subacute stroke patients with pusher behavior (BLS >= 2) were included in this study. The BLS and the Performance-Oriented Mobility Assessment Balance subscale (POMA-B) were assessed several times at intervals of two weeks resulting in a total of 137 data sets.Results: Correlation analysis between the BLS score and the POMA-B score revealed a moderate negative correlation (r(sp) = -0.602, p < 0.001): The lower the BLS score, the higher the balance performance. The maximum Youden Index (J = 0.864) was found for a cutoff score >= 2.5. Patients with a BLS score >= 2 scored >= 1 on the POMA-B, while patients with a BLS score >= 3 scored at no item or only at the sitting balance task.Significance: In line with previous findings, the results of this study support using a BLS cutoff score >= 3 of instead of >= 2 to diagnose PB for research purposes and intervention planning. A score >= 3 correlates with severe balance impairments and with an impaired verticality perception in the frontal plane, and it improves the agreement with the Scale for Contraversive Pushing.