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Abstract
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BACKGROUND: Vertebral compression fractures, which are commonly associated with older age and osteoporotic fractures, have an increased risk of re-fracture. Therefore, improving balance function is important to prevent falls. The minimal important change (MIC) has been recommended for interpreting clinically meaningful changes in rating scales. The MIC of the Berg Balance Scale for use in older women with a vertebral compression fracture has not been established.
OBJECTIVE: To identify the MIC of the Berg Balance Scale that can be used in older women with vertebral compression fractures using predictive modeling methods and the receiver operating characteristic (ROC-based) method.
DESIGN: A retrospective longitudinal multicenter study. PATIENTS: Sixty older women (age 84.1 ± 7.0 years) with vertebral compression fractures who were unable to ambulate independently on a level surface.
METHODS: A change of one point in the Functional Ambulation Categories (FAC) was used as an anchor to calculate the MIC of the Berg Balance Scale based on the change between admission and discharge. We calculated the MIC for the women whose FAC score improved by ≥1 point. We used three anchor-based methods to examine the MIC: the ROC-based method (MIC(ROC) ), the predictive modeling method (MIC(pred) ), and the MIC(pred) -based method adjusted by the rate of improvement and reliability of transition (MIC(adj) ).
RESULT: Thirty-nine women comprised the "important change" group based on their FAC score improvement. In this group, the MIC(ROC) (95% CI) value of the Berg Balance Scale was 10.0 points (5.5-15.5) with an area under the curve of 0.71. The MIC(pred) (95% CI) value was 9.7 (8.1-11.0), and the MIC(adj) (95%CI) was 7.0 (5.5-8.5) points.
CONCLUSION: For women with vertebral compression fracture who are unable to ambulate independently, a 7.0-point improvement in the Berg Balance Scale score may be a useful indicator for reducing the amount of assistance required for walking. This article is protected by copyright. All rights reserved.
Language: en |