The Diagnostic Accuracy of Static Posturography in Predicting Accidental Falls in People With Multiple Sclerosis

Background. Quantitative posturography has been reported as a reliable tool to measure balance in people with multiple sclerosis (MS). However, data on its diagnostic accuracy in predicting the occurrence of falls are lacking. Objective. To determine sensitivity, specificity, predictive values, and...

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Veröffentlicht in:Neurorehabilitation and neural repair 2013-01, Vol.27 (1), p.45-52
Hauptverfasser: Prosperini, Luca, Fortuna, Deborah, Giannì, Costanza, Leonardi, Laura, Pozzilli, Carlo
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container_issue 1
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container_title Neurorehabilitation and neural repair
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creator Prosperini, Luca
Fortuna, Deborah
Giannì, Costanza
Leonardi, Laura
Pozzilli, Carlo
description Background. Quantitative posturography has been reported as a reliable tool to measure balance in people with multiple sclerosis (MS). However, data on its diagnostic accuracy in predicting the occurrence of falls are lacking. Objective. To determine sensitivity, specificity, predictive values, and accuracy of posturography in detecting falls in MS subjects over a 3-month follow-up period. Methods. One hundred consecutive patients with MS were tested by the Berg Balance Scale (BBS) and by static posturography on a monoaxial platform. Participants recorded the occurrence of accidental falls for the next 3 months. Abnormal cutoff values for static standing balance measures were set at 2 standard deviations above the mean values obtained from 50 healthy controls (HC). The diagnostic accuracy of the BBS and static posturography was analyzed with respect to the prospectively collected data on the occurrence of falls. Results. Posturometric measures in participants with MS were significantly worse than in HC (all P values
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Quantitative posturography has been reported as a reliable tool to measure balance in people with multiple sclerosis (MS). However, data on its diagnostic accuracy in predicting the occurrence of falls are lacking. Objective. To determine sensitivity, specificity, predictive values, and accuracy of posturography in detecting falls in MS subjects over a 3-month follow-up period. Methods. One hundred consecutive patients with MS were tested by the Berg Balance Scale (BBS) and by static posturography on a monoaxial platform. Participants recorded the occurrence of accidental falls for the next 3 months. Abnormal cutoff values for static standing balance measures were set at 2 standard deviations above the mean values obtained from 50 healthy controls (HC). The diagnostic accuracy of the BBS and static posturography was analyzed with respect to the prospectively collected data on the occurrence of falls. Results. Posturometric measures in participants with MS were significantly worse than in HC (all P values &lt;.0001); however, only the center of pressure (COP) path with open eyes condition had substantial test–retest reliability. Static posturography was more sensitive (88% vs 37%) and accurate (75% vs 63%), but slightly less specific (67% vs 81%), than the BBS in predicting accidental falls. A logistic regression analysis revealed that the worse the COP path, the greater the risk for accidental falls (odds ratio = 1.08; P &lt; .0001), even after adjusting for sex, age, disease duration, body mass index, MS subtype, Expanded Disability Status Scale, and BBS score. Conclusion. The COP path measurement in static position is a sensitive and accurate tool to identify people with MS who are at risk of accidental falls.</description><identifier>ISSN: 1545-9683</identifier><identifier>EISSN: 1552-6844</identifier><identifier>DOI: 10.1177/1545968312445638</identifier><identifier>PMID: 22593115</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Accidental Falls ; Adult ; Age ; Body mass ; Body mass index ; Data processing ; Disabilities ; Disability Evaluation ; Female ; Follow-Up Studies ; Humans ; Male ; Multiple sclerosis ; Multiple Sclerosis - diagnosis ; Multiple Sclerosis - physiopathology ; Neurologic Examination ; Neurology ; Postural Balance - physiology ; Predictive Value of Tests ; Pressure ; Regression analysis ; Rehabilitation ; Reproducibility of Results ; Sensitivity ; Sensitivity and Specificity ; Sex ; Standard deviation ; Young Adult</subject><ispartof>Neurorehabilitation and neural repair, 2013-01, Vol.27 (1), p.45-52</ispartof><rights>The Author(s) 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-bef6ed6b7c1158d8d1db2914ad3cb3637bb92e4f1d2ebb7a6d1b9f2923ab60163</citedby><cites>FETCH-LOGICAL-c370t-bef6ed6b7c1158d8d1db2914ad3cb3637bb92e4f1d2ebb7a6d1b9f2923ab60163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1545968312445638$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1545968312445638$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22593115$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prosperini, Luca</creatorcontrib><creatorcontrib>Fortuna, Deborah</creatorcontrib><creatorcontrib>Giannì, Costanza</creatorcontrib><creatorcontrib>Leonardi, Laura</creatorcontrib><creatorcontrib>Pozzilli, Carlo</creatorcontrib><title>The Diagnostic Accuracy of Static Posturography in Predicting Accidental Falls in People With Multiple Sclerosis</title><title>Neurorehabilitation and neural repair</title><addtitle>Neurorehabil Neural Repair</addtitle><description>Background. Quantitative posturography has been reported as a reliable tool to measure balance in people with multiple sclerosis (MS). However, data on its diagnostic accuracy in predicting the occurrence of falls are lacking. Objective. To determine sensitivity, specificity, predictive values, and accuracy of posturography in detecting falls in MS subjects over a 3-month follow-up period. Methods. One hundred consecutive patients with MS were tested by the Berg Balance Scale (BBS) and by static posturography on a monoaxial platform. Participants recorded the occurrence of accidental falls for the next 3 months. Abnormal cutoff values for static standing balance measures were set at 2 standard deviations above the mean values obtained from 50 healthy controls (HC). The diagnostic accuracy of the BBS and static posturography was analyzed with respect to the prospectively collected data on the occurrence of falls. Results. Posturometric measures in participants with MS were significantly worse than in HC (all P values &lt;.0001); however, only the center of pressure (COP) path with open eyes condition had substantial test–retest reliability. Static posturography was more sensitive (88% vs 37%) and accurate (75% vs 63%), but slightly less specific (67% vs 81%), than the BBS in predicting accidental falls. A logistic regression analysis revealed that the worse the COP path, the greater the risk for accidental falls (odds ratio = 1.08; P &lt; .0001), even after adjusting for sex, age, disease duration, body mass index, MS subtype, Expanded Disability Status Scale, and BBS score. Conclusion. The COP path measurement in static position is a sensitive and accurate tool to identify people with MS who are at risk of accidental falls.</description><subject>Accidental Falls</subject><subject>Adult</subject><subject>Age</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Data processing</subject><subject>Disabilities</subject><subject>Disability Evaluation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - diagnosis</subject><subject>Multiple Sclerosis - physiopathology</subject><subject>Neurologic Examination</subject><subject>Neurology</subject><subject>Postural Balance - physiology</subject><subject>Predictive Value of Tests</subject><subject>Pressure</subject><subject>Regression analysis</subject><subject>Rehabilitation</subject><subject>Reproducibility of Results</subject><subject>Sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Sex</subject><subject>Standard deviation</subject><subject>Young Adult</subject><issn>1545-9683</issn><issn>1552-6844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkTtPwzAUhS0E4r0zIY8sgfiZZKyAAlIRlQpijPy4aY3cJNjJ0H9PQoEBCTH52ue7R773IHRG0ktCsuyKCC4KmTNCOReS5TvokAhBE5lzvjvWXCSjfoCOYnxLU8ryIt1HB5SKghEiDlH7vAJ849SybmLnDJ4Y0wdlNrip8KJT49N8UPrQLINqVxvsajwPYJ3pXL0ccWeh7pTHU-V9_JShaT3gV9et8GPvOzfeFsZDaKKLJ2ivUj7C6dd5jF6mt8_X98ns6e7hejJLDMvSLtFQSbBSZ2b4Zm5zS6ymBeHKMqOZZJnWBQVeEUtB60xJS3RR0YIypWVKJDtGF1vfNjTvPcSuXLtowHtVQ9PHklCRZQWRw3b-RynjNM-pGNB0i5phmBigKtvg1ipsSpKWYyTl70iGlvMv916vwf40fGcwAMkWiGoJ5VvTh3pYzN-GHzVGlE0</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Prosperini, Luca</creator><creator>Fortuna, Deborah</creator><creator>Giannì, Costanza</creator><creator>Leonardi, Laura</creator><creator>Pozzilli, Carlo</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201301</creationdate><title>The Diagnostic Accuracy of Static Posturography in Predicting Accidental Falls in People With Multiple Sclerosis</title><author>Prosperini, Luca ; Fortuna, Deborah ; Giannì, Costanza ; Leonardi, Laura ; Pozzilli, Carlo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-bef6ed6b7c1158d8d1db2914ad3cb3637bb92e4f1d2ebb7a6d1b9f2923ab60163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Accidental Falls</topic><topic>Adult</topic><topic>Age</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Data processing</topic><topic>Disabilities</topic><topic>Disability Evaluation</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Multiple sclerosis</topic><topic>Multiple Sclerosis - diagnosis</topic><topic>Multiple Sclerosis - physiopathology</topic><topic>Neurologic Examination</topic><topic>Neurology</topic><topic>Postural Balance - physiology</topic><topic>Predictive Value of Tests</topic><topic>Pressure</topic><topic>Regression analysis</topic><topic>Rehabilitation</topic><topic>Reproducibility of Results</topic><topic>Sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>Sex</topic><topic>Standard deviation</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prosperini, Luca</creatorcontrib><creatorcontrib>Fortuna, Deborah</creatorcontrib><creatorcontrib>Giannì, Costanza</creatorcontrib><creatorcontrib>Leonardi, Laura</creatorcontrib><creatorcontrib>Pozzilli, Carlo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Neurorehabilitation and neural repair</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prosperini, Luca</au><au>Fortuna, Deborah</au><au>Giannì, Costanza</au><au>Leonardi, Laura</au><au>Pozzilli, Carlo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Diagnostic Accuracy of Static Posturography in Predicting Accidental Falls in People With Multiple Sclerosis</atitle><jtitle>Neurorehabilitation and neural repair</jtitle><addtitle>Neurorehabil Neural Repair</addtitle><date>2013-01</date><risdate>2013</risdate><volume>27</volume><issue>1</issue><spage>45</spage><epage>52</epage><pages>45-52</pages><issn>1545-9683</issn><eissn>1552-6844</eissn><abstract>Background. Quantitative posturography has been reported as a reliable tool to measure balance in people with multiple sclerosis (MS). However, data on its diagnostic accuracy in predicting the occurrence of falls are lacking. Objective. To determine sensitivity, specificity, predictive values, and accuracy of posturography in detecting falls in MS subjects over a 3-month follow-up period. Methods. One hundred consecutive patients with MS were tested by the Berg Balance Scale (BBS) and by static posturography on a monoaxial platform. Participants recorded the occurrence of accidental falls for the next 3 months. Abnormal cutoff values for static standing balance measures were set at 2 standard deviations above the mean values obtained from 50 healthy controls (HC). The diagnostic accuracy of the BBS and static posturography was analyzed with respect to the prospectively collected data on the occurrence of falls. Results. Posturometric measures in participants with MS were significantly worse than in HC (all P values &lt;.0001); however, only the center of pressure (COP) path with open eyes condition had substantial test–retest reliability. Static posturography was more sensitive (88% vs 37%) and accurate (75% vs 63%), but slightly less specific (67% vs 81%), than the BBS in predicting accidental falls. A logistic regression analysis revealed that the worse the COP path, the greater the risk for accidental falls (odds ratio = 1.08; P &lt; .0001), even after adjusting for sex, age, disease duration, body mass index, MS subtype, Expanded Disability Status Scale, and BBS score. Conclusion. The COP path measurement in static position is a sensitive and accurate tool to identify people with MS who are at risk of accidental falls.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>22593115</pmid><doi>10.1177/1545968312445638</doi><tpages>8</tpages></addata></record>
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subjects Accidental Falls
Adult
Age
Body mass
Body mass index
Data processing
Disabilities
Disability Evaluation
Female
Follow-Up Studies
Humans
Male
Multiple sclerosis
Multiple Sclerosis - diagnosis
Multiple Sclerosis - physiopathology
Neurologic Examination
Neurology
Postural Balance - physiology
Predictive Value of Tests
Pressure
Regression analysis
Rehabilitation
Reproducibility of Results
Sensitivity
Sensitivity and Specificity
Sex
Standard deviation
Young Adult
title The Diagnostic Accuracy of Static Posturography in Predicting Accidental Falls in People With Multiple Sclerosis
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