Balance confidence and functional balance in relation to falls in older persons with hip fracture history

PURPOSE: To investigate whether self-assessed balance confidence and functional balance are associated with falls in older persons with hip fracture history.

METHODS: This study is a part of a larger study on functional capacity and exercise rehabilitation in hip fracture patients. Seventy-nine patients, operated at the local hospital for collum or trochanter fracture within one-half to 7 years, participated in the laboratory measurements. Balance confidence was assessed with Activities-specific Balance Confidence scale (ABC) and functional balance using the Berg Balance Scale (BBS). According to self-reported number of falls during the previous 6 months participants were classified as those with falls vs. no falls; recurrent falls (3 or more falls) vs. occasional/no falls (< 3 falls); indoor falls vs. no indoor falls; outdoor falls vs. no outdoor falls. The relationships between ABC, BBS, and fall status were tested by logistic regression.

RESULTS: Lower BBS score was associated with all falls during previous 6 months (OR 0.929, 95% CI 0.875-0.987). Lower ABC score was associated with recurrent falling (OR 0.974, 0.952-0.998), as well as lower BBS score (OR 0.876, 0.797- 0.962). Additionally, lower ABC and lower BBS scores were related to indoor falls (ABC OR 0.975, 0.957-0.993; BBS OR 0.913, 0.852-0.978). Participants with outdoor falls did not differ from those with no outdoor falls in ABC scores or BBS.

CONCLUSIONS: Self-assessed balance confidence and functional balance are related to prevalence of recurrent and indoor falls in older hip fracture patients. Therefore use of Activities-specific Balance Confidence scale and Berg Balance Scale might be reasoned to expand in evaluating the probability for falls among at-risk elders.