Measurement properties of the Berg Balance Scale and the Timed Up Go Test in patients hospitalized for brain tumor treatment
DOI:
https://doi.org/10.11606/issn.2317-0190.v31i4a228104Keywords:
Brain Neoplasms, Mobility Limitation, Postural BalanceAbstract
Objective: To analyze the reliability and the convergent and discriminative validity of the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) in patients hospitalized for brain tumor treatment. Methods: We performed a prospective observational study, including patients diagnosed with brain tumors from a tertiary referral hospital in Salvador, Brazil. The BBS and the TUG were used to assess balance and functional mobility, respectively. To assess the inter-examiner reliability the instruments were applied by two independent evaluators on the same day, while for the intra-examiner reliability, each individual was assessed twice by the same evaluator within a period of 7 to 14 days. The convergent and discriminative validation were analyzed by comparing both instruments with the Modified Barthel Index (MBI). Results: Forty-three patients were assessed and an excellent inter-rater reliability was observed for both the TUG and the BBS, with ICC=0.981 (p<0.001) and ICC= 0.995 (p<0.001), respectively. Intra-rater reliability was classified as good for the BBS (ICC= 0.74; p<0.001) and for the TUG (ICC= 0.779; p<0.001). Both instruments converged to MBI (BBS Rho= 0.85; p<0.001; TUG Rho= -0.70; p<0.001) and both were also proper of discriminating individuals according to their level of functional dependence (p<0.001). Conclusion: The BBS and TUG are valid for assessing balance and functional mobility in individuals hospitalized for brain tumor treatment.
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References
GBD 2016 Brain and Other CNS Cancer Collaborators. Global, regional, and national burden of brain and other CNS cancer, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(4):376-393. Doi: https://doi.org/10.1016/S1474-4422(18)30468-X
Institute for Health Metrics and Evaluation. Brain and central nervous system cancer—Level 3 cause. Seattle: IHME; 2021 [cited 2024 June 16]. Available from: https://www.healthdata.org/research-analysis/diseases-injuries-risks/factsheets/2021-brain-and-central-nervous-system-cancer
Santos MO, Lima FCS, Martins LFL, Oliveira JFP, Almeida LM, Cancela MC. Estimativa de Incidência de Câncer no Brasil, 2023-2025. Rev Bras Cancerol. 2023;69(1):e-213700. Doi: https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3700
Park J, Park YG. Brain Tumor Rehabilitation: Symptoms, Complications, and Treatment Strategy. Brain Neurorehabil. 2022;15(3):e25. Doi: https://doi.org/10.12786/bn.2022.15.e25
Kushner DS, Amidei C. Rehabilitation of motor dysfunction in primary brain tumor patients†. Neurooncol Pract. 2015;2(4):185-191. Doi: https://doi.org/10.1093/nop/npv019
Shumway-cook A, Woollacott MH. Motor control - translating research into clinical practice. 5 ed. Philadelphia: Wolters Kluwer; 2017.
Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35 Suppl 2:ii7-ii11. Doi: https://doi.org/10.1093/ageing/afl077
Miyamoto ST, Lombardi Junior I, Berg KO, Ramos LR, Natour J. Brazilian version of the Berg balance scale. Braz J Med Biol Res. 2004;37(9):1411-21. Doi: https://doi.org/10.1590/S0100-879X2004000900017
Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. Doi: https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
Winser SJ, Kannan P, Bello UM, Whitney SL. Measures of balance and falls risk prediction in people with Parkinson's disease: a systematic review of psychometric properties. Clin Rehabil. 2019;33(12):1949-1962. Doi: https://doi.org/10.1177/0269215519877498
Valet M, Lejeune T, Devis M, van Pesch V, El Sankari S, Stoquart G. Timed Up-and-Go and 2-Minute Walk Test in patients with multiple sclerosis with mild disability: reliability, responsiveness and link with perceived fatigue. Eur J Phys Rehabil Med. 2019;55(4):450-455. Doi: https://doi.org/10.23736/S1973-9087.18.05366-2
Taghizadeh G, Martinez-Martin P, Fereshtehnejad SM, Habibi SA, Nikbakht N, Alizadeh NH, et al. Psychometric properties of the Berg balance scale in idiopathic Parkinson' disease in the drug off-phase. Neurol Sci. 2018;39(12):2175-2181. Doi: https://doi.org/10.1007/s10072-018-3570-4
Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke. 2002;33(4):1022-7. Doi: https://doi.org/10.1161/01.STR.0000012516.63191.C5
Christopher A, Kraft E, Olenick H, Kiesling R, Doty A. The reliability and validity of the Timed Up and Go as a clinical tool in individuals with and without disabilities across a lifespan: a systematic review. Disabil Rehabil. 2021;43(13):1799-1813. Doi: https://doi.org/10.1080/09638288.2019.1682066
Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral: impacto da escolaridade. Arq Neuro-Psiquiatr. 1994;52(1):01–7. Doi: https://doi.org/10.1590/S0004-282X1994000100001
Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83 Suppl 2:S7-11.
Minosso JSM, Amendola F, Alvarenga MRM, Oliveira MAC. Validação, no Brasil, do Índice de Barthel em idosos atendidos em ambulatórios. Acta paul enferm. 2010;23(2):218–23. Doi: https://doi.org/10.1590/S0103-21002010000200011
Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155-63. Doi: https://doi.org/10.1016/j.jcm.2016.02.012
Borg DN, Bach AJE, O'Brien JL, Sainani KL. Calculating sample size for reliability studies. PM R. 2022;14(8):1018-1025. Doi: https://doi.org/10.1002/pmrj.12850
Correia MS, Neville IS, Almeida CC, Hayashi CY, Ferreira LTD, Quadros DG, et al. Clinical outcome assessments of motor status in patients undergoing brain tumor surgery. Clin Neurol Neurosurg. 2021;201:106420. Doi: https://doi.org/10.1016/j.clineuro.2020.106420
Pieczyńska A, Pilarska A, Hojan K. Predictors of functional outcomes in adults with brain tumor undergoing rehabilitation treatment: a systematic review. Eur J Phys Rehabil Med. 2022;58(5):666-674. Doi: https://doi.org/10.23736/S1973-9087.22.07510-4
Geler-Kulcu D, Gulsen G, Buyukbaba E, Ozkan D. Functional recovery of patients with brain tumor or acute stroke after rehabilitation: a comparative study. J Clin Neurosci. 2009;16(1):74-8. Doi: https://doi.org/10.1016/j.jocn.2008.04.014
Liljehult MM, Buus L, Liljehult J, Rasmussen BK. Walking ability in patients with glioblastoma: prognostic value of the Berg Balance Scale and the 10 meter walk test. J Neurooncol. 2017;135(2):335-342. Doi: https://doi.org/10.1007/s11060-017-2579-5
Downs S, Marquez J, Chiarelli P. The Berg Balance Scale has high intra- and inter-rater reliability but absolute reliability varies across the scale: a systematic review. J Physiother. 2013;59(2):93-9. Doi: https://doi.org/10.1016/S1836-9553(13)70161-9
Viveiro LAP, Gomes GCV, Bacha JMR, Carvas Junior N, Kallas ME, Reis M, et al. Reliability, Validity, and Ability to Identity Fall Status of the Berg Balance Scale, Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest in Older Adults Who Live in Nursing Homes. J Geriatr Phys Ther. 2019;42(4):E45-E54. Doi: https://doi.org/10.1519/JPT.0000000000000215
Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88(5):559-66. Doi: https://doi.org/10.2522/ptj.20070205
Kudlac M, Sabol J, Kaiser K, Kane C, Phillips RS. Reliability and Validity of the Berg Balance Scale in the Stroke Population: A Systematic Review. Phys Occup Ther Geriatr. 2019;37(3):196-221. Doi: https://doi.org/10.1080/02703181.2019.1631423
Scalzo PL, Nova IC, Perracini MR, Sacramento DR, Cardoso F, Ferraz HB, et al. Validation of the Brazilian version of the Berg balance scale for patients with Parkinson's disease. Arq Neuropsiquiatr. 2009;67(3B):831-5. Doi: https://doi.org/10.1590/S0004-282X2009000500010
Rogers JL, De La Cruz Minyety J, Vera E, Acquaye AA, Payén SS, Weinberg JS, et al. Assessing mobility in primary brain tumor patients: A descriptive feasibility study using two established mobility tests. Neurooncol Pract. 2022;9(3):219-228. Doi: https://doi.org/10.1093/nop/npac013
Varedi M, Lu L, Phillips NS, Partin RE, Brinkman TM, Armstrong GT, et al. Balance impairment in survivors of pediatric brain cancers: risk factors and associated physical limitations. J Cancer Surviv. 2021;15(2):311-324. Doi: https://doi.org/10.1007/s11764-020-00932-5
Krug J, Litofsky NS. Relationship of Balance and Mobility Status to Quality of Life in Patients with Primary Brain Tumors: A Pilot Study. Int J Phys Med Rehabil. 2014;2(3):196. Doi: https://doi.org/10.4172/2329-9096.1000196
Hafsteinsdóttir TB, Rensink M, Schuurmans M. Clinimetric properties of the Timed Up and Go Test for patients with stroke: a systematic review. Top Stroke Rehabil. 2014;21(3):197-210. Doi: https://doi.org/10.1310/tsr2103-197
Rydwik E, Bergland A, Forsén L, Frändin K. Psychometric Properties of Timed Up and Go in Elderly People: A Systematic Review. Phys Occup Ther Geriatr. 2011;29(2):102-125. Doi: https://doi.org/10.3109/02703181.2011.564725
Verissimo DS, Valle ERM do. A experiência vivida por pessoas com tumor cerebral e por seus familiares. Psicol Argumento. 2017;24(45):45. Doi: https://doi.org/10.7213/rpa.v24i45.20093
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