PT  - JOURNAL ARTICLE
AU  - Almeida, Lorena R.S.
AU  - Valenca, Guilherme T.
AU  - Negreiros, Nádja N.
AU  - Pinto, Elen B.
AU  - Oliveira-Filho, Jamary
TI  - Comparison of Self-report and Performance-Based Balance Measures for Predicting Recurrent Falls in People With Parkinson Disease: Cohort Study
DP  - 2016 Jul 01
TA  - Physical Therapy
PG  - 1074--1084
VI  - 96
IP  - 7
4099  - http://jcore-reference.highwire.org/content/96/7/1074.short
4100  - http://jcore-reference.highwire.org/content/96/7/1074.full
SO  - Phys Ther2016 Jul 01; 96
AB  - Background Balance confidence and fear of falling are factors associated with recurrent falls in people with Parkinson disease (PD). However, the accuracy for predicting falls on the basis of self-report measures has not been widely investigated.Objective The study objectives were: (1) to compare the accuracy of the Activities-specific Balance Confidence Scale (ABC) and the Falls Efficacy Scale–International (FES-I) with that of the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Functional Reach Test (FRT), and Timed “Up & Go” Test (TUG) for predicting recurrent falls in people with PD and (2) to explore the ability of combinations of up to 3 tests to predict recurrent falls.Design This was a prospective cohort study involving 225 people with PD.Methods Participants were assessed with the ABC, FES-I, BBS, FRT, TUG, and DGI. Participants who reported 2 or more falls in the 12-month follow-up period were classified as recurrent fallers. Areas under the receiver operating characteristic curves were determined, and the Akaike information criterion was used to select the best predictive model.Results Eighty-four participants (37.3%) were classified as recurrent fallers. Areas under the receiver operating characteristic curves for the ABC, FES-I, TUG, FRT, DGI, and BBS were 0.73, 0.74, 0.72, 0.74, 0.76, and 0.79, respectively. Two-test models provided additional discriminating ability compared with individual measures and had Akaike information criterion values similar to those of 3-test models, particularly the combination of the BBS with the FES-I.Limitations The lack of an external validation sample was a limitation of this study.Conclusions The ABC and FES-I demonstrated moderate accuracy in predicting recurrent falls and a predictive ability similar to that of performance-based balance measures, especially the FRT and the TUG. Two-test models showed performance similar to that of 3-test models, suggesting that a combination of 2 measures may improve the ability to predict recurrent falls in people with PD. Specifically, the combination of the BBS with the FES-I may be considered.