On this episode of The O&P Check-in: an SPS Podcast, we spoke with Dr. Christopher Kevin Wong, PT, PhD, MS, about fall prevention. Dr. Wong is a Professor of Rehabilitation and Regenerative Medicine at Columbia University. He also serves as Associate Editor of Prosthetics Orthotics International and is the founding co-editor of the Journal of Clinical Education in Physical Therapy.
The following includes an excerpt from our conversation, edited for length and clarity. Click here to listen to the full interview.
The O&P Check-in: an SPS Podcast unpacks trends and stories from the tight-knit community of O&P professionals. From patient care to technology, best practices, and regulations, this podcast features topics that help you stay current.
In your research, what has been the most effective way of measuring a patient’s balance?
I became interested in this area after seeing a lot of research that looked at the Activities-specific Balance Confidence (ABC) Scale as a measure of balance confidence and how that related to falls in the population of people with amputation. In my own research using the ABC scale, I noticed some self-reported responses did not match the respondent's capabilities.
When researching, it is important to have a valid and reliable scale or measurement, but at the time, clinical assessment of balance ability for people with limb loss was lacking in research. We turned to the Berg Balance Scale, and through our analysis, found that it was a valid and practical tool for measuring balance ability for people in the limb loss community.
What are the limitations to studying fall risks in patients?
The Berg Balance Scale is complicated. It's 14 tasks, but it gives you a pretty good measure across many different populations of a person's balance ability—some of those things are related to prosthetics. For instance, standing in tandem (one foot in front of the other)—that's a difficult task for a person wearing a prosthesis. They don't have plantar and dorsal flexion without the movement of walking, so it's hard to stand that way. Turning in a circle is also hard to do because prostheses don't really provide much rotation. Stepping, which involves knee flexion, can also be challenging, particularly for people with a transfemoral prosthesis. Those kinds of tasks were identified with the Berg Balance Scale as things that might be related to falls. Trying to compare the balance with research related to falls and injury is complicated because what classifies as a fall? We sometimes think of it as recurrent falls or repeated falls. If you fall multiple times, that seems like a more significant problem.
To hear the entire conversation, click here: