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The Mini-Balance Evaluation System Test Can Predict Falls in Clinically Stable Outpatients With COPD: A 12-MO
Ana Carolina A C Pereira1, Rafaella F Xavier, Aline C Lopes
1Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil (Mss Pereira, Xavier, Lopes, da Silva, and Carvalho); Department of Physical Therapy, Life Sciences Institute, Federal University of Juiz de Fora-GV Campus, Minas Gerais, Brazil (Dr Oliveira); and Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, Brazil (Drs Fernandes and Stelmach).
Purpose:
This study evaluated the accuracy of the Mini-Balance Evaluation System Test (Mini-BESTest) for predicting falls in patients with chronic obstructive pulmonary disease (COPD) and investigated whether postural balance is a risk factor for falls.
Methods:
Postural balance was evaluated by the Mini-BESTest at baseline, and the incidence of falls over a 12-mo period was prospectively measured by a self-reported falls diary and confirmed by telephone calls. A discriminative power analysis was performed using receiver operating characteristic (ROC) curve and logistic regression analysis.
Results:
Sixty-seven outpatients with COPD (mean age ± SD = 67 ± 9.3 yr) were included. Twenty-five patients (37.3%) experienced ≥1 fall, and 28.2% of the falls resulted in injuries. The Mini-BESTest predicted falls in patients with COPD at the 6- and 12-mo follow-ups with a cut-off score of 22.5 (area under the curve = 0.85 and 0.87) with good sensitivity and specificity (85.7% and 66.7%; 84% and 73.8%, respectively). Higher scores on the Mini-BESTest were associated with a lower risk of falls at 12 mo (OR = 0.50; 95% CI, 0.36-0.70; P < .001).
Conclusions:
Postural balance assessed by the Mini-BESTest is a good predictor of falls in patients with COPD. Our results imply that impaired balance contributes to the risk of falling and that balance training and fall prevention programs may be required for this population.
