Related Experiment Video
Updated: Mar 22, 2026
Computerized Adaptive Testing System of Functional Assessment of Stroke
Published on: January 7, 2019
Comparative Predictive Validity of Fall-Risk Screening Assessments in Subacute Stroke
Prudence Plummer1, Megan E Schliep, Ehsan Sinaei
1MGH Institute of Health Professions, Boston, Massachusetts (P.P., M.E.S., E.S., L.J., M.C., L.A.); University of North Carolina at Chapel Hill, Chapel Hill, NC (V.S.M.); and Duke University, Durham, NC (J.A.).
Background And Purpose:
Poststroke fall prevention is hindered by inaccurate prediction of imminent fallers. We compared the predictive validity of the Berg Balance Scale (BBS), Functional Gait Assessment (FGA), 10-m gait speed, and a novel, step test + obstacle test (STOB) in subacute stroke.
Methods:
A total of 64 ambulatory stroke survivors discharging home from inpatient rehabilitation completed all tests before discharge. Falls were tracked prospectively for 3 months. Logistic regression estimated the odds of being a faller with a failed test. Sensitivity, specificity, likelihood ratios, area under the curve, accuracy, and posttest probabilities for classifying fall status for each test were calculated using existing and optimized cutoffs.
Results:
Twenty participants (31.3%) were fallers at 3 months. STOB had the best overall model fit with odds ratio 8.0 (95% CI 2.4-26.8). FGA ≤13 had the highest sensitivity of all tests (0.85), and gait speed ≤0.47 m/s had the highest specificity (0.89). A combination of positive tests for 10-m gait speed (≤0.47 m/s), STOB (≥3), FGA (≤13), and BBS (≤43) generated a cumulative diagnostic posttest probability of future falls of 94.5%.
Discussion And Conclusions:
No single test emerged with strong discriminative power for predicting future falls at discharge from inpatient rehabilitation for stroke, but a combination of gait speed, STOB, and FGA may enhance prognostic decision-making accuracy.
