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Relationship between balance abilities and mobility aids in elderly patients at discharge from an acute care setting
1Department of Physical Therapy, Hahnemann University Hospital, Philadelphia, PA, USA.
Background And Purpose:
At the time of discharge from the acute care setting, patients may not be evaluated for a mobility aid and it is possible this may represent an unmet need. The first purpose of this study was to examine the agreement between the Berg Balance Test (BBT) (Newton, 1997) and the Global Balance Rating scale (GBR) (Leahy, 1991) in terms of acute care patients' need for mobility aids. The second was to determine if there was an increase in mobility aid usage at the time of discharge.
Method:
Thirty inpatients (mean age 76.7 years) were assessed by use of the BBT and the GBR. The therapist rating patients with the GBR also determined the type of mobility aid provided at discharge.
Results:
At admission, 23/30 individuals did not use a mobility aid and server, used a cane. At discharge, nine subjects were independent ambulators, 10 needed a cane and 11 needed a walker. There was no significant agreement between the GBR in relation to the BBT to determine the need for a mobility aid. There was a significant increase (p = 0.05) in the number of subjects using a mobility aid at the time of discharge as compared to admission to the acute care setting.
Conclusions:
Therapists should not rely on the GBR as an indicator of balance, hence the need for an assistive device until reliability and validity measures have been conducted. Therapists should use a functional assessment tool, such as the BBT, since it is reliable and a valid measure of balance ability and has been demonstrated to predict cane use. Since patients are relatively inactive in the acute care setting, referral to physical therapy for functional assessment and mobility aid recommendations should be an integral part of discharge planning.