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Group- and Individual-Level Responsiveness of the 3-Point Berg Balance Scale and 3-Point Postural Assessment Scale for Stroke Patients

  • Yi-Jing Huang
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Gong-Hong Lin
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Shih-Chieh Lee
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Author Footnotes
    ∗ Chen and S.-L. Huang contributed equally to this work.
    Yi-Miau Chen
    Footnotes
    ∗ Chen and S.-L. Huang contributed equally to this work.
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
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  • Author Footnotes
    ∗ Chen and S.-L. Huang contributed equally to this work.
    Sheau-Ling Huang
    Correspondence
    Corresponding author Sheau-Ling Huang, MS, School of Occupational Therapy, College of Medicine, National Taiwan University, F4, No 17, Xuzhou Rd, Zhongzheng Dist, Taipei City 100, Taiwan.
    Footnotes
    ∗ Chen and S.-L. Huang contributed equally to this work.
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
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  • Ching-Lin Hsieh
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan

    Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
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  • Author Footnotes
    ∗ Chen and S.-L. Huang contributed equally to this work.
Published:September 09, 2017DOI:https://doi.org/10.1016/j.apmr.2017.08.472

      Abstract

      Objectives

      To examine both group- and individual-level responsiveness of the 3-point Berg Balance Scale (BBS-3P) and 3-point Postural Assessment Scale for Stroke Patients (PASS-3P) in patients with stroke, and to compare the responsiveness of both 3-point measures versus their original measures (Berg Balance Scale [BBS] and Postural Assessment Scale for Stroke Patients [PASS]) and their short forms (short-form Berg Balance Scale [SFBBS] and short-form Postural Assessment Scale for Stroke Patients [SFPASS]) and between the BBS-3P and PASS-3P.

      Design

      Data were retrieved from a previous study wherein 212 patients were assessed at 14 and 30 days after stroke with the BBS and PASS.

      Setting

      Medical center.

      Participants

      Patients (N=212) with first onset of stroke within 14 days before hospitalization.

      Interventions

      Not applicable.

      Main Outcome Measures

      Group-level responsiveness was examined by the standardized response mean (SRM), and individual-level responsiveness was examined by the proportion of patients whose change scores exceeded the minimal detectable change of each measure. The responsiveness was compared using the bootstrap approach.

      Results

      The BBS-3P and PASS-3P had good group-level (SRM, .60 and SRM, .56, respectively) and individual-level (48.1% and 44.8% of the patients with significant improvement, respectively) responsiveness. Bootstrap analyses showed that the BBS-3P generally had superior responsiveness to the BBS and SFBBS, and the PASS-3P had similar responsiveness to the PASS and SFPASS. The BBS-3P and PASS-3P were equally responsive to both group and individual change.

      Conclusions

      The responsiveness of the BBS-3P and PASS-3P was comparable or superior to those of the original and short-form measures. We recommend the BBS-3P and PASS-3P as responsive outcome measures of balance for individuals with stroke.

      Keywords

      List of abbreviations:

      BBS (Berg Balance Scale), BBS-3P (3-point Berg Balance Scale), CI (confidence interval), MDC (minimal detectable change), PASS (Postural Assessment Scale for Stroke Patients), PASS-3P (3-point Postural Assessment Scale for Stroke Patients), SFBBS (short-form Berg Balance Scale), SFPASS (short-form Postural Assessment Scale for Stroke Patients), SRM (standardized response mean)
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