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I had my first patient fall in clinic last week so the topic of balance and fall risk has been on my brain. This article is a nice summary of some of the cutoff scores, reliability, validity of common balance measures that might be used in the OP setting. No discussion needed, just figured this might be a nice resource for the library.
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Sorry to hear that August. I hope all is well. This article is a nice review of all the balance measures we use. I just started seeing medicare recently and have just started using these outcome measures/assessments. I have been trying to refresh myself on cutoff scores for these tests. Thanks.
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Falls suck. Sorry Auggie. This article is a great review. I certainly don’t administer enough standardized balance measures! Either through subjective or functional testing, I can usually determine the PQRS question about fall risks, and implement appropriate balance interventions. I like the guideline stated in the conclusion, which is basically to adminster the TUG test, and then if they score over the cutoff score (13.5 seconds per shummway cook 2000), then administer a test more sensitive to change like the berg or tinetti.
We had a great lecture in PT school about how every 0.1 m/s increase in gait speed is $10,000 less care that a person will need to receive. I like using gait speed when possible!
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Falls history is one of the greatest predictors of falls and this is where the focus has been with the implementation of PQRS. I think the questioning for PQRS has been good because it has gotten P.T.’s in a better habit of asking about fall history. My observation is that we tend to do these tests When there is a history of falling or the patient presents with overt signs of impaired balance or strength. I have watched Physical Therapy become a doctoring profession and it is slowly becoming a profession that is focused more on community wellness and prevention. It would be great if we could get in the habit of using these tests to screen for early deficits and take steps to prevent the ‘fall history’. This could be a valuable (literally, by saving many medical dollars) part of an annual P.T. preventative physical.
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