Population descriptor N = Reference and intervention Responsive: Yes / No Data supporting responsiveness Hip or Knee replacement 27 Myers, 1998 49 Yes Baseline pre-surgery 72(17)% 6 weeks post-op 68(17)% 6 mos post-op 83(15)% Significant change across time. 59% improvement pre-op to 6 mos post-op. Vestibular Disorders 20-40 and matched 38 Whitney, 2002 50 Yes 20-40 year old: 57(24) initial; 67(23) at discharge 60-80 year old: 68(25) initial; 80(20) at discharge A clinically significant change on ABC set at 10 or greater. Central Vestibular dysfunction Chronic central and peripheral vestibular disorders 45 28 Brown, 2006 51 Custom-designed PT program Mean = visits, over 5 months Danilov, 2007 52 Patients were treated with the BrainPort balance device; 1-1.5 hr, BID 3-4.5 days/week. Treatment included joint mobility exercises and balance training using the BrainPort balance device. Yes Yes Pre to post change 13(23)%; p<.01 Mean d/c score: 55% The average ABC score increased 38%. Pre-treatment 61.72(20) Post-treatment 78.0 (19) p<0.001 Community dwelling balance impaired 27 Hess, 2005 53 10 wks; light intensity strength training program. Experimental (N=13) Control (N=14) Yes Experimental: Pre-exercise 80(15); Post 88(10); p<.04 Control Group: Pre-exercise 81(12); Post 81(14); 23 Silsupadol, 2009 54 45 min, 3x/wk x 4wk a) Single task balance training n=8 b )Dual task balance training w/fixed priority instructions n= 8 c) Dual task balance training variable-priority instructions n= 7 Yes – only with single task training a) Change =13.20 b) Change = 2.31 c) Change = 3.94 Difference between groups with single-task differs from dual-task p<.001
Population descriptor N = Reference and intervention Responsive: Yes / No Data supporting responsiveness Community dwelling balance impaired (continued) 60 Sze, 2008 55 Hong Kong community dwellers with high risk of falls participated in Falls prevention clinic (12 sessions 1x/wk) followed by community step down program (falls prevention education, weekly ex class, and 2 home visits in following 9 mos). Yes Pre-program 109(30)** ; post-program 123(21)** p =0.001 **seeking clarification of score totals from author 184 Hernandez, 2008 17 Older adults with at least mild balance impairment grouped by ability to stoop, crouch, or kneel (SCK) Yes No SCK difficulty 83(14)% Low SCK difficulty 73(19)% Hi SCK difficulty 65(18)% 157 Peretz, 2006 8 Subjects in three groups to study ABC -16 and ABC-6 with balance impaired and controls. High level gait disorders (HLGD) N=70 PD N=19 Controls N=68 Yes HLGD 60(19)% PD 81(13)% Controls 96(2)% Subjects with Multiple sclerosis 44 Cattaneo, Sept. 2007 56 (Clinical Rehabilitation) Three groups: 1)Balance rehab with both motor and sensory strategies 2) Balance rehab with only sensory strategies 3)”Conventional therapy” – no specific balance strategies No Pre to Post difference in scores: 2.32 12.55 0.9 No statistical difference for groups. Osteoporosis women 98 Liu-Ambrose, 2004 57 Randomized control; 13 weeks 1. Resistance (N=32) 2. Agility Training (N=34) 3. General strengthening (N=32) Improvement in group 1 and 2 = 6% small effect size (-.19) Yes 1. 76(23) to 81(17)%; p<.03 2. 78(15) to 83(12)%; p<.03 3. 76(24) to 76(18)%; p = NS Independent community dwelling 31 Murphy,2008 58 5 Form, Yang Style Tai Chi No No significant change in the ABC Scale following 12 week training at
older women with or at risk for osteoporosis 2x/wk for 12 wks. Tested pre intervention, post intervention, 6 months post and 12 months post. any retest time increment. Population descriptor N = Reference and intervention Responsive: Yes / No Data supporting responsiveness Older adults living in retirement villages 167 Cyarto, 2008 25 Exercise twice weekly for 20 weeks, subjects clustered in three groups: home based exercise program n=38 group based exercise program n=81 supervised walking program n=48 No Change: 6(3)% change significant p<.05 32% of group increased ABC score at least 10% -2(2)% NS 16% of group increased ABC score at least 10% -5(2)% NS15% of group increased ABC score at least 10% Discordance was noted between changes in ABC scores with improvement in balance ability, but little to no improvement in balance confidence as well as minimal change in balance ability and improvement in balance confidence. House hold or community ambulators with stroke 24 Yang, 200859 RCT to research the effects of virtual reality-based training on community ambulation in subjects post stroke. Control group (n=9) received treadmill training, 20 min/session, 3x/wk x 3wk. Experimental group (n=11) received virtual reality based treadmill training, 20min/session, 3x/wk x 3 wk. No Significant changes in pre-training to post-training in the experimental group. Pre-training 79(12), post training 87(7), p=0.05, but this was not maintained at one month post training. House hold or community ambulators with stroke 30 Lord, 200860 Subjects with stroke were seen for treatment in a hospital based setting under the direction of a physical therapist (n=16) or in the community supervised by a physical therapist assistant. No There was a noted decrease in second testing indicating a possible over estimation in the initial study.(at 95%CI) a) post intervention decline was (-14.8 to 13.5) p=NS b)six month follow up change was
-4.9 (-18.8 to 9.0) p=NS Older woman at risk of falling 213 Talley, 2008 5 Subjects were treated with a 12 week, randomized controlled trial of fall prevention. No ABC mean change in score = -1.1. Possible ceiling effect for less frail subjects. Population descriptor N = Reference and intervention Responsive: Yes / No Data supporting responsiveness Patients with chronic dizziness, ages 34-82 yr. 32 Badaracco, 2007 61 Patients underwent vestibular rehabilitation daily x 2 hrs/day for 12 sessions. Yes ABC significant change was 10%; p<0.001 Parkinson’s Disease 19 Lun, 2005 62 In home and PT groups, PT 2x/week for 8 wks. No No significant change in home or PT group Incomplete SCI (iSCI) 4 Musselman, 2009 63 Body weight supported treadmill training (BWSTT) and skill training for walking. Yes-varied Increase in balance confidence during skilled training (median =11% of change). Reduction in scores with BWSTT (medium = -2% of change). “Less Frail” Taiwanese community dwellers . 60 yr old 168 Huang, 20094 Pre and post Fear of Falling Intervention Program X 8 weeks Standardized response Grouped by mobility improvement Grouped by mobility deterioration No 0..41 7.93 6.61 Non demented seniors at risk for falls 25 McKinley, 200864 10 wk (40hr, 2hr, 2x/wk) pre, post and follow up testing 1)Tango class 2) walk group Percent change from baseline to post treatment: Tango class = 17% Walk group = 2% Healthy community dwelling seniors 36 Westlake, 2007 65 “FallProof Program” balance training (n=17) No No significant change in the balance training group.
and falls prevention education (n=19). Balance training included 3x/wk x 8 wk. Scores significantly declined in the education group. Pre 87.5(10.711), post 79(24.2), p =0.047 Population descriptor N = Reference and intervention Responsive: Yes / No Data supporting responsiveness Patients with essential tremor (ET) 58 Parisi, 200666 Studied three groups: 1) Essential tremor without head tremor (N=14) 2) Essential tremor with head tremor (N=16) 3) Control Group (N=28) Yes Statistically significant differences in group mean scores (difference = 11%, 95%CI, 1.3-19.6) between control group and ET with head tremor. Subjects on Antiepileptic Medications (AED) 30 Fife, 200667 Effects of three medications: A) Lamotrigine (N=10) B) Carbamazepine (N=10) C) Gabapentin (N=10) No No statistical difference in ABC scores 86% 82% 81% Ceiling & floor effect: Summary: There appears no be no ceiling effect in general with the ABC. In the ABCUK version 10% of subjects reached the ceiling (193 consecutive, new and return patients and their friends and relatives attending falls and syncope facility).11 Salbach et al, 20066 reported no ceiling effect for patients within one year of stroke. Kressig, et al (2001) reports no ceiling or floor effect in a study of 287 seniors living in senior living facilities.31 Cattaneo, et al (June, 2006) reports no ceiling effect on ABC with subjects with Multiple Sclerosis.29 Reference Data:
Subjects with Multiple Sclerosis (MS) Fallers (N=20) Non Fallers (N=31) 37(19)% 61(25)% Whitney, 2004 73 DHI = Dizziness Handicapped Inventory. DHI groups listed are significantly different. (N=23) Mild DHI (0-30) 74(14)% (N=44) Moderate DHI (31-60) 55(22)% (N=18) Severe DHI (61-100) 28(16)% Adken, 200374 (N=58) PD clients 69% (N=30) Control 93% (N=286) Residents in congregate living facilities.75 (N=145) Tai Chi participants 53(19)% (N=141) Wellness participants 50(21)% Whitehead, 2003 21 (N=73) Hip fracture, 4 mo. follow-up 50(23)% Reference data: (cont.) Table 1. Means (X), Standard Deviations (SD), and 95% Confidence Intervals (CI) of test results for the Activities Balance Confidence Scale (ABC) by Age and Gender Cohorts Total ABC % Age (y) Gender N X SD CI 50-59 Male 9 93 7 88-98 Female 15 5 92-98 60-69 Male 9 96 6 92-100 Female 10 93 5 89-96 70-79 Male 10 96 4 93-98 Female 14 86 15 77-95 80+ Male 4 91 13 71-100 Female 12 82 16 72-92 TOTAL SAMPLE 83 91 11 89-93