Minimal Detectable Change for Balance Using the Biodex Balance System in Patients with Parkinson Disease

Autor: Carla Silva-Batista, Bianca Cristina dos Santos Vieira Yano, Daniel Boari Coelho, Renan Germano, Angelo Corrêa de Lima Miliatto, Carlos Ugrinowitsch, Rafael Yokoyama Fecchio, Acácio Moreira-Neto, Jumes Leopoldino de Oliveira Lira
Rok vydání: 2019
Předmět:
Zdroj: Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
ISSN: 1934-1563
1934-1482
DOI: 10.1002/pmrj.12216
Popis: Background Minimal detectable change (MDC) when assessing balance using the Biodex Balance System (BBS) in patients with Parkinson disease (PD) is currently unknown, limiting the interpretability of the scores. Objective To determine the MDC on the Anterior/Posterior Stability Index (APSI), Medial/Lateral Stability Index (MLSI), and Overall Stability Index (OSI) from postural stability and fall risk protocols of the BBS in patients with PD. Design This was a repeated-measures design (at a 1-week interval). Setting Strength training laboratory of a public university. Patients 46 patients with PD (men and women) at stages 2 and 3 (67.9 ± 7.4 years old) were assessed in the "on" state (fully medicated). Methods Patients performed three trials of 20 s for each protocol. Main outcome measurements Absolute and relative MDC (MDC%) calculated for APSI, MLSI, and OSI from the postural stability (stable condition) and fall risk protocols (unstable condition). Results For the postural stability, the MDC and MDC% were 0.26° and 17% for APSI, 0.41° and 21% for MLSI, and 0.22° and 12% for OSI, respectively. For the fall risk, the MDC and MDC% were 0.51° and 18% for APSI, 0.21° and 15% for MLSI, and 0.41° and 20% for OSI, respectively. These results were considered acceptable, despite indices with high MDC for MLSI (postural stability) and APSI (fall risk). Conclusions Patients with PD have more mediolateral and anteroposterior changes in the stable and unstable conditions, respectively. These abnormal balance strategies can occur principally due to postural instability of PD. However, our results demonstrated acceptable MDCs in both conditions in all of the assessed axes. Thus, BBS should be incorporated into the clinical evaluation to help therapists to determine if intervention-induced changes in balance are clinically significant or due to measurement error. Level of evidence II.
Databáze: OpenAIRE
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