Meta- analysis demonstrated fallers perform significantly worse than non-fallers on all measures analysed except the Timed Up and Go Cognitive ( p < 0.05 ) , but discriminative ability of the measures is commonly not reported .
Of those reported , the Activities-specific Balance Confidence Scale had the highest area under the receiver operating characteristic curve value ( 0.92 ) , but without reporting corresponding measures of clinical utility .
Conclusion : Clinical measures of balance differ significantly between fallers and non-fallers but have poor predictive ability for falls risk in people with multiple sclerosis
Objective : To determine the ability of clinical measures of balance to distinguish fallers from non-fallers and to determine their predictive validity in identifying those at risk of falls .
Utility of Disease-Specific Measures and Clinical Balance Tests in Prediction of Falls in Persons With Multiple Sclerosis
Background and Purpose : The sensory and motor deficits associated with multiple sclerosis ( MS ) contribute to falls with the majority of persons with MS falling at least once annually . To appropriately direct treatment , accurate fall prediction measures are needed . In this study of community-dwelling individuals with MS followed for 12 months , we sought to determine frequency of falls , utility of clinical balance tests to predict falls , and accuracy of participants ' retrospective recall of fall events . Methods : Independently ambulatory persons with MS underwent 5 clinical balance tests including Activities-specific Balance Confidence , Berg Balance Scale , Functional Reach , Timed Up and Go , and Dynamic Gait Index , and one disease-specific measure of disability  ( Exp and ed Disability Status Scale ) and then were followed for 1 year . Participants were queried monthly by phone to determine the number of fall events that had occurred . Accuracy of fall prediction was determined by receiver operating characteristic curve analysis and comparison of balance test performance between fallers and nonfallers . Results : Sixty-one percent of the 38 participants were classified as fallers at 12-month follow-up . Only the Berg Balance Scale , Dynamic Gait Index , and the Activities-specific Balance Confidence demonstrated clinical ly useful levels of accuracy . In addition , participants were generally poor in their accurate recall of fall events relative to their monthly fall reports . Discussion and Conclusions : The majority of participants fell during a 1-year prospect i ve follow-up . Only 2 balance performance measures and 1 balance confidence measure accurately distinguished between fallers and nonfallers as well as possessed clinical ly useful levels of sensitivity and specificity . These results also emphasized the inaccuracy of retrospective fall history in an MS sample . Video Abstract available ( see Supplemental Digital Content 1 , http://links.lww.com/JNPT/A55 ) for more insights from the author
Meta- analysis demonstrated fallers perform significantly worse than non-fallers on all measures analysed except the Timed Up and Go Cognitive ( p < 0.05 ) , but discriminative ability of the measures is commonly not reported .
Of those reported , the Activities-specific Balance Confidence Scale had the highest area under the receiver operating characteristic curve value ( 0.92 ) , but without reporting corresponding measures of clinical utility .
Conclusion : Clinical measures of balance differ significantly between fallers and non-fallers but have poor predictive ability for falls risk in people with multiple sclerosis
Objective : To determine the ability of clinical measures of balance to distinguish fallers from non-fallers and to determine their predictive validity in identifying those at risk of falls .