目的:评估Berg平衡量表(BBS)在下肢截肢患者中使用的有效性和可靠性。
方法:横断面研究。
方法:研究实验室。
方法:个人(N=30;年龄,54±12y;20名男性)单侧经胫骨(n=13),单侧经股动脉(n=14),或双侧(n=3)下肢截肢血管不良(n=7),创伤性(n=14),传染性(n=6),或先天性(n=3)起源。
方法:不适用。
方法:BBS,2分钟步行测试,L试验,假肢评估问卷-流动性子量表,特定活动的平衡信心量表,和法国活动指数;还收集了自我报告的描述符,包括假体的使用频率,访问前12个月内的跌倒次数,害怕跌倒,和日常行动辅助工具的使用。
结果:BBS具有较高的评分者间可靠性(组内相关系数=.945)和内部一致性(α=.827)。BBS评分与其他结果指标之间的关系均具有统计学意义(P≤0.001)。由于害怕跌倒(P=.008)和使用行动辅助工具(P<.001),观察到BBS评分的显着组间差异,但不是在过去12个月内多次(≥2)下降(P=.381)。涉及前进的BBS项目,转动360°,串联站立,在参与者中,站在一条腿上的得分相对较低的频率相对较高.
结论:BBS似乎是评估下肢截肢患者平衡的有效和可靠的临床工具,但它可能无法区分跌倒风险较大或较小的个体。假肢运动和控制的限制可能是对性能较低的项目所经历的挑战的原因。未来的研究将有助于评估BBS对旨在改善下肢截肢患者平衡的干预措施的反应。
OBJECTIVE: To evaluate the validity and reliability of the Berg Balance Scale (BBS) for use in people with lower-limb amputation.
METHODS: Cross-sectional study.
METHODS: Research laboratory.
METHODS: Individuals (N=30; age, 54±12y; 20 men) with unilateral transtibial (n=13), unilateral transfemoral (n=14), or bilateral (n=3) lower-limb amputation of dysvascular (n=7), traumatic (n=14), infectious (n=6), or congenital (n=3) origin.
METHODS: Not applicable.
METHODS: BBS, 2-minute walk test, L test, Prosthesis Evaluation Questionnaire-Mobility Subscale, Activities-specific Balance Confidence Scale, and Frenchay Activities Index; self-reported descriptors were also collected, including frequency of prosthesis use, number of falls in 12 months before the visit, fear of falling, and daily mobility aid use.
RESULTS: The BBS had high interrater reliability (intraclass correlation coefficient =.945) and internal consistency (α=.827). Relations between the BBS scores and those of other outcome measures were all statistically significant (P≤.001). Significant group differences in BBS scores were observed for fear of falling (P=.008) and mobility aid use (P<.001), but not for multiple (≥2) falls in the previous 12 months (P=.381). BBS items involving reaching forward, turning 360°, tandem standing, and standing on 1 leg had relatively greater frequencies of lower scores across participants.
CONCLUSIONS: The BBS appears to be a valid and reliable clinical instrument for assessing balance in individuals with lower-limb amputation, but it may not be able to discriminate between individuals with greater or lesser fall risk. Limitations in prosthetic motion and control may be responsible for the challenges experienced on items of lower performance. Future studies would be useful to assess the responsiveness of the BBS to interventions aimed at improving balance in individuals with lower-limb amputation.