Validation of the Narrowing Beam Walking Test in Lower Limb Prosthesis Users.
Andrew Sawers, Brian Hafner
PMID 29653108WHAT IT FOUND
In 40 established prosthesis users, the Narrowing Beam Walking Test gave lower scores to fallers than non-fallers and separated them better than Berg, TUG, FSST, and ABC.
It may be useful for balance assessment, but it was not tested for predicting future falls.
Key findings
01None of the 40 participants reached the NBWT maximum or minimum score, and only four (10%) scored near the minimum; by contrast, 35% scored near the FSST minimum and 63% scored near the BBS and ABC maximums.
02NBWT scores were strongly related to BBS scores (.85), FSST times (-.80), and TUG times (-.70), and moderately related to ABC scores (.49).
03Participants with a fall history scored lower on the NBWT (0.33) than non-fallers (0.51), and the NBWT ROC area was 0.81, higher than TUG 0.71, FSST 0.70, BBS 0.66, and ABC 0.65; only the NBWT was significantly better than chance (p=.006).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 40 adults with unilateral prostheses, so it does not show how the NBWT performs for bilateral users, new users, or people who cannot walk 10 feet without an assistive device. The sample had more traumatic amputations than is common in the literature, and only 7 dysvascular participants, so the lack of difference by amputation cause may be a sample-size problem. Falls were recalled over the past 12 months, so participants may have forgotten or misreported falls. The study was cross-sectional, so it cannot show that NBWT scores predict future falls. Reliability, minimal detectable change, responsiveness, and prospective validity were not assessed. The definition of a faller was one or more falls, which may make discrimination metrics look stronger than if multiple falls were required.
Declared interests
No conflicts-of-interest declaration is included in the supplied text. The publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read the NBWT ROC area of 0.81 as proof that the test predicts future falls. The study used recalled falls from the past 12 months and did not follow participants forward in time.