Screening cutoff values to identify the risk of falls after stroke: A scoping review.
Daisuke Matsumoto, Takaaki Fujita, Ryuichi Kasahara and 2 others
PMID 39444285WHAT IT FOUND
For people with chronic stroke living at home, a Berg Balance Scale score between 46.5 and 50.5 points best identifies fall risk.
Other common tests like the Timed Up and Go and Falls Efficacy Scale have lower accuracy, so do not rely on them alone.
Key findings
01Berg Balance Scale cutoffs of 46.5 to 50.5 points showed consistent accuracy (AUC 0.72-0.81) for predicting falls in community-dwelling individuals with chronic stroke.
02Timed Up and Go (15-19 seconds) and Falls Efficacy Scale-International (27-29 points) had relatively consistent cutoffs but low accuracy (AUC 0.66-0.71), limiting their usefulness as standalone predictors.
03No included study established a cutoff value based on cognitive function for identifying fall risk after stroke.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review did not include a quality assessment of the individual studies. Most included studies had small sample sizes (fewer than 100 participants). The review only included studies that reported AUC, sensitivity, and specificity, potentially excluding relevant data. The highest accuracy finding (ABC Scale) came from a small study examining past falls, not prospective fall risk, making it less reliable for prediction. Cognitive function's role in fall risk was not addressed by any included study's cutoff calculations.
Declared interests
The authors declare no conflicts of interest. The work was funded by the Japan Society for the Promotion of Science, but the funders had no role in the study design, data collection, analysis, or manuscript preparation.
The easy way to misread this
Do not assume the Activities-specific Balance Confidence Scale is the best predictor because it had the highest AUC (0.92). That result came from a small study looking at past falls, not prospective risk, so it may reflect the impact of falling on confidence rather than predicting future falls.