노인에서 Berg 균형 척도, 보행 변수, 그리고 넘어짐과의 관계

이현주,이충휘,유은영 한국전문물리치료학회 2002 한국전문물리치료학회지 Vol.9 No.3

This study examined the correlations among the Berg Balance Scale, which is a clinical tool used to evaluate balance ability, spatiotemporal parameters of gait, and falling; determined the parameters most closely related to falling; and identified a discriminatory parameter and its predictability. Thirty-four subjects aged 72 to 92 years participated in this study. Following a questionnaire survey about falling, the Berg Balance Scale and spatiotemporal parameters of gait were measured. The results revealed that the incidence of falls increased with aging and an accompanying reduction in the flexion range of motion of the hip joint. The gait characteristics of elderly people who fell easily included a slower walking speed, shorter stride, and longer stance time than other elderly. When the cutoff score was set at 45, the Berg Balance Scale was able to identify correctly those individuals who truly have experience of falling than when the cutoff score was set at 39. But when the cutoff score was set at 39, the scale's specificity identifying correctly those individuals who truly have not experience of falling was higher than at the cutoff score of 45. Therefore, the Berg Balance Scale is an appropriate screening method in a clinical setting for the early detection of elderly people at risk of falling. In conclusion, elderly people with a Berg Balance Scale score below 45 are the most likely to fall owing to their decreased balance ability.

노인의 넘어짐을 예측하는 Berg 균형 척도의 민감도와 특이도

이충휘,이현주 연세대학교 보건과학연구소 2002 보건과학논집 Vol.12 No.-

만성 뇌졸중 환자의 낙상 예측을 위한 버그균형 척도와 플러턴 어드밴스드 균형 척도의 비교

김인섭,남택길,김경모,김준섭,김소정,강정하 한국전문물리치료학회 2018 한국전문물리치료학회지 Vol.25 No.1

Background: The Berg Balance Scale (BBS) and the Fullerton Advanced Balance (FAB) scale have been used to assess balance function in patients with chronic stroke. These clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate the incidence of and risk factors of falls and compare the predictive values of the BBS and FAB scale relative to fall risk in patients with stroke through receiver operating characteristic analysis. Methods: Sixty-three patients with stroke (faller=34, non-faller=29) who could walk independently for 10 meters participated in this study. The BBS and FAB scale were administered. Then, we verified the cut-off score, sensitivity, specificity, and the area of under the curve. Results: In this study, the BBS and FAB scale did not predict fall risk in patients with stroke in the receiver operator characteristic curve analysis. A cut-off score of 37.5 points provided sensitivity of .47 and specificity of .35 on the BBS, and a cut-off score of 20.5 points provided sensitivity of .44 and specificity of .45 on the FAB scale. Conclusion: The BBS and FAB scale were not useful screening tools for predicting fall risk in patients with stroke in this study, but those who scored 37.5 or lower on the BBS and 20.5 or lower on the FAB scale had a high risk for falls.

뇌졸중 환자의 Postural Assessment Scale for Stroke (축소형 PASS: 5항목-3점 척도)와 Berg Balance Scale (축소형 BBS: 7항목-3점 척도)의 비교 연구

안승헌 ( Seung Heon An ),김재현 ( Jae Hyun Kim ),송창호 ( Chang Ho Song ) 대한물리의학회 2010 대한물리의학회지 Vol.5 No.1

Purpose:This study were to examine the test-retest and inter-rater reliability as well as the concurrent validity, and convergent validity of the 2 simplified Postural Assessment Scale for Stroke: 5itmes-3Level(PASS: 5i-3L) & Berg Balance Scale: 7items-3Level(BBS: 7i-3L), and comparison between the original measures(PASS, BBS), Methods:A total of 33 patients participated in this part of the study, The 2 middle scores of the center of the PASS were averaged (ie, 0-1.5-3) to form the PASS-3Level. Similarly, the 3 level in the center of the BBS were collapsed to a single level (ie, 0-2-4) to from the BBS-3level, To examine test-retest reliability the PASS-3L and BBS-3L was administrated to each participant by rater A in 2 testing sessions 3days apart, To allow evaluation of inter-rater reliability the was rated simultaneously rater B (PASS, BBS-3L), C (BBS, PASS-3L) in the latter testing session. The reliability index (intra-class correlation coefficient, ICC2, 1) of both simplified PASS-3L & BBS 3L was used to examine the Test-retest and inter-rater reliability. We examined the distribution, concurrent validity, and convergent validity (Spearman correlation coefficient) of the data obtained with the simplified and original measures. Results:The PASS-3L, BBS-3L showed high test-retest(ICC2,1= .96, .97, respectively) and inter-rater reliability (.97, .96, respectively). and Reliability for single item scores were good(range, PASS-3L=88∼96, BBS-3L= .86 ∼93). The internal consistency of the PASS-3L, BBS-3L were high(Cronbach`s α coefficient =70, .80, respectively). The PASS-3L, BBS-3L showed high concurrent validity(r=80∼92, p<01) and convergent validity with the FM-B, MBI, & FM-M score(r=55∼82, p<01). Conclusion:The PASS-3L, BBS-3L showed high reliability and moderate to good validity so 2 simplified 3-Level scale is a useful clinical tool for evaluating balance in stroke patients. The both simplified PASS, BBS 3-Level scale was found to be adequate for assessing balance in patients with stroke.

파킨슨병 환자에서 낙상군과 비낙상군에 대한 버그균형검사의 타당도

조규행,우영근,황수진,Cho, Gyu-Hang,Woo, Young-Keun,Hwang, Su-Jin 대한고유수용성신경근촉진법학회 2011 PNF and Movement Vol.9 No.3

Purpose : The purpose of this study was to evaluate the criterion-related validity of the Berg balance test between fallers and non-fallers in individuals with Parkinson's disease. Methods : Thirty-one patients were recruited for this study. Their initial diagnosis had been made on average $30.1{\pm}10.1$ years earlier. Score of Berg balance test showed significant correlations with indicators of motor functioning and daily living capacity. Berg balance test score was inversely associated with the unified Parkinson's disease rating scale-motor score, and Schwab and England activities of daily living rating scale. Results : In all 3 correlations, lower scores on the Berg balance test correlated with higher unified Parkinson's disease rating scale-motor scores. Results support the criterion-related validity of the Berg balance test. Conclusion : Our research results agree with other published research in suggesting that the Berg balance test may be used as a screening tool and ongoing assessment tool for patients with Parkinson's disease.

아급성기 뇌졸중 환자들의 낙상 예측을 위한 modified Postural Assessment Scale for Stroke와 Berg Balance Scale의 타당도

박창식 ( Park Chang Sik ) 대구대학교 특수교육재활과학연구소 2014 특수교육재활과학연구 Vol.53 No.3

본 연구의 목적은 아급성기 뇌졸중 환자를 대상으로 자세 조절을 평가하는 수정된 뇌졸중자세 평가 척도(modified Postural Assessment Scale for Stroke, mPASS)와 버그 균형척도(Berg Balance Scale, BBS)를 이용하여 낙상의 위험성을 예측하거나 변별력이 있는지 그 타당도를 검증하고자 하였다. 본 연구는 후향적 연구(Retrospective study)로서 연구에 참여한 아급성기 뇌졸중 환자 62명을 대상으로 뇌졸중 발병 후 연구 시점을 기준으로 낙상횟수에 대한 기록을 하였다. 낙상 경험 예측 변별력은 mPASS와 BBS를 사용하였고 기능 수행평가로 수정된 바델 지수(Modified Barthel Index, MBI), 퓨글 마이어 상ㆍ하지ㆍ총합(Fugl Meyer-Upper/Lower extremity motor function, FM-UㆍL/Eㆍtotal)을 이용하였다. mPASS와 BBS의 낙상 경험 예측에 관한 선별 기준값(cutoff value)과 양ㆍ음성 예측도(PositiveㆍNegative predictive value, PPVㆍNPV)를 구하였고, mPASS와 BBS의 낙상 경험 예측 선별 기준값은 낙상군과 비낙상군의 위험정도를 예측하기 위하여 교차비(Odd ratio)를 구하였다. mPASS의 낙상 위험선별 기준값은 24.5점(AUC=.74, 민감도=63%, 특이도=71%), BBS는 40.5점(AUC=.71, 민감도=74%, 특이도=63%)으로 수용할 만 하였다. 낙상 경험 예측의 선별기준값인 mPASS≤24.5점, BBS≤40.5점에 해당하는 피실험자들은 각각 낙상의 위험성이 4.25배, 4.84배 증가하는 것으로 확인이 되었다. 낙상을 일으킬 수 있는 요소 중 자세 조절을 평가하는 mPASS와 BBS 모두 아급성기 뇌졸중 환자들의 낙상 위험성을 규명하는데 충분한 타당성이 있었으나 mPASS는 심리측정학적인 분석을 BBS는 외적인 타당도를 고려한 포괄적인 연구를 통한 타당도 검증이 이루어져야 할 것이다. The purpose of this study is to verify the validity of predicting the risk of falls or whether it has the distinction by using the modified Postural Assessment Scale for Stroke(mPASS) and Berg Balance Scale(BBS) that assesses the postural control targeting the subacute stroke patients. This is a retrospective study targeting 63 subacute stroke patients where the records on the number of falls were based within 6 months after the onset of stroke. mPASS and BBS were used for the predicted distinction on the experience of falls and Modified Barthel Index(MBI), Fugl Meyer-Upper/Lower extremity motor function were used for evaluation of functional performance. The Cutoff Value and PositiveㆍNegative predictive value(PPVㆍNPV) on the prediction of falls of mPASS and BBS were obtained. For the selection standard value of prediction of falls of mPASS and BBS, Odd ratio was obtained in order to predict the degree of risk for falls and non-falls. The selection standard value for risk of falls of mPASS was 24.5 points(AUC =.74, sensitivity=63%, specificity=71%) and BBS was 40.5 points(AUC=.71, sensitivity =74%, specificity=63%) which were in the acceptable range. Subjects corresponding to the selection standard value of mPASS ≤24.5 points, BBS ≤40.5 points for prediction of falls have shown that the risk of falls was increased by 4.25 times and 4.84 times respectively. Although both mPASS and BBS that assess the postural control among the factors that can cause falls had sufficient validity for identifying the risk of falls of subacute stroke patients, a comprehensive study should be made considering the psychometrics analysis of mPASS and the external validity of BBS.

통합적 평가 도구를 활용한 근감소증 분석 : 국내 65세 이상 노인을 대상으로

박채림,김해인,김명철 대한통합의학회 2023 대한통합의학회지 Vol.11 No.1

Purpose : This study was conducted to identify the common characteristics of older persons with sarcopenia and to explore the relationship between gait, balance, and stress using an integrated assessment tool. Methods : In this study, 95 people aged 65 years or older were screened using the sarcopenia diagnostic evaluation algorithm presented by the Asian Working Group for Sarcopenia in 2019. Skeletal muscle index, grip strength, and short physical performance battery were used as sarcopenia evaluation measurements. Based on the results of this evaluation, participants were grouped into the ‘non-sarcopenia group’ (41 participants) or the ‘sarcopenia group’ (54 participants). Participants underwent further assessment using an integrated evaluation tool capable of measuring gait, balance, and stress. Gait ability was evaluated using the timed up and go test, and balance ability was evaluated using the berg balance scale. And the stress of the last month was measured by modifying the stress index developed by a Korean researcher. Collected data were statistically analyzed using the independent t-test and Mann Whitney-U test. Results : The sarcopenia group and the non-sarcopenia group showed significant differences in all elements of the sarcopenia diagnostic evaluation. There were significant differences in all three integrated evaluation tools. For the evaluation of walking ability, the time measured in the timed up and go test was longer in the sarcopenia group, the berg balance scale score for the evaluation of balance ability was lower in the sarcopenia group, and the stress index was higher in the sarcopenia group. Conclusion : Through sarcopenia analysis using an integrated evaluation tool, it was confirmed that sarcopenia is closely related to decreased walking ability, poor balance, and increased stress. We recommend using this tool to reduce the risk of sarcopenia progression and stress exposure through the planning and implementation of an exercise program for sarcopenia prevention.

도시 생활 노인의 낙상요인 예측에 관한 연구

이현주(H. J. Lee),이태용(T. Y. Lee),태기식(K. S. Tae) 한국재활복지공학회 2018 재활복지공학회논문지 Vol.12 No.1

본 연구는 65세 이상 도시거주 노인 107명을 대상으로 일반적 특성, 만성질환 상태, 낙상 관련 의학적 변수, 균형 관련 자신감, 신체적 능력, 우울감을 평가하는 도구를 통해 낙상에 영향을 미치는 관련 주 요인을 찾고자 하였다. 또한 유의한 차이가 있는 변수들 간의 상관관계를 파악하며, 이 중 낙상을 유발하는 데 높은 영향력이 있는 변수를 도출하여 예측력을 알아보았다. 연구 결과, 낙상군에서 요실금, 발의 통증, 하지근력약화, 만성 질환수 및 복용 약물수 빈도수가 비낙상군에 비해 통계적으로 유의하게 높았다. 또한 ABC(Activities-specific Balance Confidence) 총점, BBS (Berg Balance Scale) 총점, SGDS (Short Geriatric Depression Scale) 총점, FRT(Functional Reach Test) 값에서 통계학적으로 유의한 차이가 있었다. 낙상에 영향을 주는 주요인은 ABC 총점으로 점수가 낮을수록 낙상 위험이 높아짐으로써 균형능력에 대한 자기 확신감이 낮을수록 낙상의 가능성이 높아지는 것으로 나타났으며, ABC, SDGS, BBS 척도가 결합하여 적용될 경우 낙상군과 비낙상군을 구분하는 예측력은 70.1%로 높게 나타났다. The purpose of this study was to investigate the factors affecting falls in 107 elderly living in the city aged 65 or older by evaluating general characteristics, chronic disease status, medical variables related to falls, balance-related confidence, physical ability and depression. Also, the correlations between the significant differences in variables were identified, and the prediction power was determined by deriving the variables with high influence to induce the fall. In the faller group, urinary incontinence, foot pain, lower extremity weakness, number of chronic disease and medication use were significantly higher than those of the nonfaller group. Also, statistically significant differences were evaluated in ABC (Activities-specific Balance Confidence) score, BBS (Berg Balance Scale) score, SGDS (Short Geriatric Depression Scale), FRT (Functional Reach Test) value. The main correlated factor for fall was ABC score, the lower the ABC score, fall risk is increased which is a significant negative impact. When the evaluation is performed by combining those scales, the hit ratio to classify whether faller or nonfaller is increased to 70.01% which is quite higher value.

편마비장애인을 위한 한국판 버그균형척도의 타당도 연구

송창순,김용섭 한국지체.중복.건강장애교육학회 2011 지체.중복.건강장애연구 Vol.54 No.4

The purpose of this study was to verify, through Rasch Analysis, if Berg Balance Scale(‘BBS’) fits as an evaluation tool for the balance abilities of people with hemiplegic stroke. With this ground, a reorganized BBS was proposed for the people with hemiplegic stroke. And with its use for the evaluation of the balance ability, should medical rehabilitation services run based on the accurate clinical measures, it would ultimately give them great support to improve gait and ambulation abilities which lead to assist their independent living and social participation. A total number of participants in this study were 202 patients who were living in Gwangju City, Gyunggi Province, Gangwon Province and Cholla Buk Province,and who were diagnosed with hemiplegic stroke, and who had been under rehabilitation treatment while hospitalized, discharged or in out-patients in medical facilities. Korean version of the BBS was conducted for the 202 participants. Collected data was reevaluated through Rasch analysis to identify "too difficult" or "too easy" items of BBS. 16 people were proved to be unfit which was then excluded. Then the level of reliability and difficulty of the clinical measures in BBS were analysed with the remaining fit population after excluding the 16 unfits. The results were shown as follow: “tandem standing” and “standing on one leg” were found to be ‘Unfit’ items. The most difficult item was “stool stepping” and the easiest item was “sitting unsupported”. 본 연구는 버그균형척도가 편마비장애인의 균형능력 평가도구로 적합한지 알아보기 위해 라쉬분석을 이용하여 검증하였다. 이러한 검증절차를 걸쳐 편마비장애인을 위해 재구성된 버그균형척도를 제안하였으며, 재구성된 버그균형척도가 향후 편마비장애인의 균형능력 평가에 사용되어 정확한 평가를 토대로 의료재활서비스를 실행하고, 나아가 편마비장애인 재활의 최대목표인 보행과 이동능력을 향상시켜서 자립생활 및 사회참여를 지지하고자 하는 것에 목적을 두었다. 연구대상자는 광주광역시, 경기도, 강원도 그리고 전라북도에 거주하며 뇌병변으로 인하여 편마비 진단을 받고 입원이나 외래를 통하여 재활치료 과정에 있거나, 퇴원한 편마비장애인 202명으로 하였다. 연구대상자 202명을 대상으로 한국판-버그균형척도를 평가하였으며, 수집된 자료는 라쉬분석을 적용하여 버그균형척도 평가항목의 수행이 지나치게 어렵거나 쉬운 대상자를 검증하였는데 16명이 부적합한 대상자로 판별되었다. 또한 부적합한 대상자를 제외한 후에 적합한 대상자를 대상으로 버그균형척도의 평가항목에 대한 적합도와 난이도를 검증한 결과, ‘한 발 앞에 다른 발을 일자로 두고 서 있기’ 항목과 ‘한 다리로 서 있기’ 항목이 부적합한 항목으로 판별되었다. ‘일정한 높이의 발판 위에 발을 교대로 놓기’ 항목이 가장 어려운 항목으로 판별되었고, ‘의자의 등받이에 기대지 않고 바른 자세로 앉기’ 항목이 가장 쉬운 평가항목으로 나타났다.

Effects of Blood Flow Restriction Exercise on Leg Muscle Thickness and Balance in Elderly Women with Sarcopenia

Park, Jae-Chul,Mun, Dal-ju,Choi, Seok-Ju Korea Proprioceptive Neuromuscular Facilitation As 2022 PNF and Movement Vol.20 No.1

Purpose: The purpose of this study was to investigate the effect of blood flow restriction bridge exercise on leg muscle thickness and balance. In addition, it is to promote blood flow restriction exercise as the basis for early prevention, diagnosis, and treatment of sarcopenia in clinical practice. Methods: Twenty elderly women aged 65 years or older were selected to participate in this study. The subjects were divided into two groups of 10: one with blood flow restriction with bridge exercise (BFRG) and the other with bridge exercise alone (BG). As for the exercise method, the thickness of rectus femoris and vastus medialis and Berg balance scale were investigated by intervention for 30 minutes a day, 3 times a week, for a total of 6 weeks. Results: There was significant difference in the thickness of the rectus femoris and vastus medial and within-group changes in the Berg balance scale (p <0.05) before and after the experiment in the BFRG and BG groups (p<0.05). There was a significant difference in change between the two groups (p <0.05). Conclusion: There was a significant difference in the intragroup change of the Berg balance scale in the BFRG before and after the experiment, but there was no significant difference in the BG, and there was no significant difference in the change between the two groups.