Minimal clinically important difference of the Berg Balance Scale score in older adults with hip fractures

Abstract

Purpose

The minimal clinically important difference (MCID) is the smallest clinically significant difference in treatment identified as crucial to the patient. There is no known MCID for the Berg Balance Scale (BBS), which measures balance function in patients with hip fractures. We aimed to calculate the MCID of the BBS in older adults with hip fractures.

Materials and methods

This is a retrospective multicenter clinical study that included 187 older adults with hip fractures. MCID was calculated using functional ambulation categories (FACs), which were used as anchors for the change in BBS scores between admission and discharge. MCID was calculated as an improvement for more than one point and as a substantial change for improvement for more than two points in the FAC.

Results

MCID of the BBS was 11.5 points and that of the substantial change was 18.5 points, with an area under the curve of 0.76 and 0.81, respectively.

Conclusions

MCID for the BBS was 11.5 points in older adults with hip fractures. In addition, an improvement of more than 18.5 points in BBS can be considered a substantial change. These values may be useful in determining meaningful balance function improvement.

Implications for rehabilitation

• Hip fractures are a common injury for the older adults, and improvement in gait function has a bearing on prognosis.

• The effectiveness of meaningful rehabilitation is possible to determine by clarifying the minimal clinically important difference in balance function, which is important for the acquisition of gait.

• An improvement of 11.5 points or more on the Berg Balance Scale in an older adult with a hip fracture is considered a meaningful effect.

Keywords:

• Minimal clinically important difference
• Berg Balance Scale
• balance
• hip fractures
• older adults

Disclosure statement

The authors report no conflicts of interest.