Usefulness of the berg balance scale in stroke rehabilitation: A systematic review
Usefulness of the berg balance scale in stroke rehabilitation: A systematic review
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DOI：
10.2522/ptj.20070205
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发表时间：
2008-05-01
期刊：
影响因子：
3.2
通讯作者：
Korner-Bitensky, Nicol
中科院分区：
文献类型：
--
作者：
Blum, Lisa;Korner-Bitensky, Nicol
背景资料。在最近一项针对655名中风患者的物理治疗师的研究中，Berg Balance Scale(BBS)被确定为中风康复过程中最常用的评估工具。鉴于BBS的广泛流行，批判性地评价BBS在中风人群中的使用是很重要的。本研究的目的是对BBS针对中风的心理测量学特性进行系统的回顾，并找出其在中风康复方面的优势和劣势。检索了21项研究，考察了中风人群的BBS的心理测量特性。内部一致性良好(Cronbachα=.92-.98)，评委间信度(组内相关系数[ICCS]=.95-.98)，组内信度(ICC=.97)，重测信度(ICC=.98)。16项研究集中在效度上，总体上发现与Barthel指数、中风患者姿势评估量表、功能伸展测试、Fugl-Meyer评估的平衡子量表、功能独立性测量、Rivermead活动指数(除体重转移和步态项目外)和步速具有良好的相关性。Berg平衡量表评分预测中风后180天的住院时间、出院目的地、运动能力和90天的残疾水平，但这些评分不能预测跌倒。八项研究的重点是响应性；所有报告的敏感度都是中等到极高。三项研究发现地板或天花板效应。讨论和结论。BBS是用于中风后评估的平衡障碍的心理测量学指标。考虑到地板和天花板的影响，临床医生可能希望将BBS与其他平衡措施结合使用。
Background. In a recent study of 655 physical therapists working with a stroke population, the Berg Balance Scale (BBS) was identified as the most commonly used assessment tool across the continuum of stroke rehabilitation. Given the widespread popularity of the BBS, it is important to critically appraise the BBS for its use with a stroke population.Objective. The purposes of this study were to conduct a systematic review of the psychometric properties of the BBS specific to stroke and to identify strengths and weaknesses in its usefulness for stroke rehabilitation.Results. Twenty-one studies examining the psychometric properties of the BBS with a stroke population were retrieved. Internal consistency was excellent (Cronbach alpha=.92-.98) as was interrater reliability (intraclass correlation coefficients [ICCS] = .95-.98), intrarater reliability (ICC = .97), and test-retest reliability (ICC = .98). Sixteen studies focused on validity and generally found excellent correlations with the Barthel Index, the Postural Assessment Scale for Stroke Patients, Functional Reach Test, the balance subscale of Fugl-Meyer Assessment, the Functional Independence Measure, the Rivermead Mobility Index (except for weight shift and step-up items), and gait speed. Berg Balance Scale scores predicted length of stay, discharge destination, motor ability at 180 days poststroke, and disability level at 90 days, but these scores were not predictive of falls. Eight studies focused on responsiveness; all reported moderate to excellent sensitivity. Three studies found floor or ceiling effects.Discussion and Conclusion. The BBS is a psychometrically sound measure of balance impairment for use in poststroke assessment. Given the floor and ceiling effects, clinicians may want to use the BBS in conjunction with other balance measures.