Authors (including presenting author) :
Lam CPY(1), Leung KKL(1), Cheung EYY(1), Wong JTM(1), Chau RMW(1)
Affiliation :
(1)Physiotherapy Department, Kowloon Hospital
Introduction :
Balance deficit is commonly observed in patients with neurological disorders and is associated with diminished balance confidence. Literatures reported that balance confidence was significantly related to balance performance and risk of falls. Discrepancies between perceived and actual balance ability was reported in healthy older adults. This disparity may also occur in neurological patients and lead to either unduly cautious or risk-taking behaviours, in both of which may increase the likelihood of falls. Thus, it is indispensable for clinicians to identify the discrepancy and prescribe corresponding interventions compatible to clinical conditions. To date, there is a paucity of literature investigating such discrepancy in neurological patients. Besides, no specific balance test has been reported to discriminate potential discrepancies between perceived and actual balance ability.
Objectives :
This study aimed to explore potential balance tests to identify discrepancies between perceived and actual balance ability in chronic neurological patients in addressing fall risk.
Methodology :
Patients with chronic neurological disorders, walking without manual assistance, were recruited from the out-patient physiotherapy unit of Kowloon Hospital. The perceived balance ability of the participants was evaluated by the Cantonese version of the Activities-specific Balance Confidence(ABC-C) scale while the actual balance ability was assessed by the Berg Balance Scale(BBS), Time Up and Go Test(TUG) and Sensory Organization Test(SOT). Participants with a mean ABC-C score of ≤70.0% and ≥ 90.0% were classified into low and high balance confidence groups respectively.
Result & Outcome :
From the initial pool of 70 eligible participants, 26 participants and 20 participants were classified into low and high balance confidence groups respectively, with mean ABC-C score of 56.51±11.55% and 94.78±4.39%. Age and duration since onset of disease were comparable between the groups. No significant between-group differences were found for TUG(p=0.514), somatosensory ratio of the SOT(p=0.839) and visual ratio of the SOT(p=0.381). Compared to the low balance confidence group, the high balance confidence group had significantly higher BBS score(p=0.010) and vestibular ratio of the SOT(p=0.016). Stepwise multiple linear regression was performed. The variables in order of significance at entry were the BBS and vestibular ratio of the SOT.
Our findings are important for future clinical practice since identifying the discrepancy with quantifiable balance measures may guide clinicians in formulating therapeutics in addressing balance confidence or balance control problems. For instance, if a patient demonstrates good balance ability but reports low balance confidence, management should emphasize cognitive behavioral approach, instead of balance training to address the root problem.
