Abstract
Objective
To determine whether Sway, a sway-based mobile application, predicts falls and to
evaluate its discriminatory sensitivity and specificity relative to other clinical
measures in identifying fallers in individuals with Parkinson disease (PD).
Design
Observational cross-sectional study.
Setting
Community.
Participants
A convenience sample of subjects with idiopathic PD in Hoehn and Yahr levels I-III
(N=59).
Interventions
Participants completed a balance assessment using Sway, the Movement Disorders Systems-Unified
PD Rating Scale motor examination, Mini-BESTest, Activities-specific Balance Confidence
(ABC) Scale, and reported 6-month fall history. Participants also reported falls for
each of the following 6 months. Binomial logistic regression was used to identify
significant predictors of future fall status. Cutoff scores, sensitivity, and specificity
were based on receiver operating characteristic plots.
Main Outcome Measures
Sway score.
Results
The most predictive logistic regression model included fall history, ABC Scale, and
Sway (P<.001). This model explained 61% (Nagelkerke R2) of the variance in fall prediction and correctly classified 85% of fallers. However,
only fall history and ABC Scale were statistically significant (P<.02). Participants were 32 times more likely to fall in the future if they fell in
the past. The ABC Scale and Mini Balance Evaluation Systems Test (Mini-BESTest) demonstrated
greater accuracy than Sway (area under the curve=0.76, 0.72, and 0.65, respectively).
Cutoff scores to identify fallers were 85% for the ABC Scale and 21 of 28 for the
Mini-BESTest.
Conclusion
Sway did not improve the accuracy of predicting future fallers beyond common clinical
measures and fall history.
Keywords
List of abbreviations:
ABC (Activities-specific Balance Confidence), AUC (area under the curve), H&Y (Hoehn and Yahr), Mini-BESTest (Mini Balance Evaluation Systems Test), mCTSIB (Modified Clinical Test of Sensory Interaction on Balance), MDS-UPDRS (Movement Disorder Society-Unified Parkinson’s Disease Rating Scale), PD (Parkinson’s disease), ROC (receiver operating characteristic)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 24, 2019
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
