Screening cutoff values to identify the risk of falls after stroke: A scoping review

Abstract

Objective: The present scoping review aimed to summarize and determine the accuracy of the variables and cutoff values reported to date for identifying fall risk in patients with stroke and identify the commonalities, limitations, and clinical implications. Methods: Articles published by the end of 2023 were searched using PubMed, Cumulative Index of Nursing and Allied Health Literature, and Scopus electronic databases. Two reviewers created a search formula, searched the databases, and conducted primary and secondary screenings. Results: This review included 21 articles. The most commonly used individual indicator for identifying fall risk after stroke was the Berg Balance Scale; the cutoff values were relatively consistent, ranging between 46.5 and 50.5 points (area under the curve: 0.72–0.81). For the Timed Up and Go test and Falls Efficacy Scale-International, the cutoff values were in the range of 15–19 s and 27–29 points, respectively, and were relatively consistent across the articles. However, the area under the curve values were low (0.66–0.70 and 0.68–0.71, respectively). Conclusion: Among various assessments, the Berg Balance Scale is the most extensively studied tool, with established cutoff values associated with falls risk. It serves as a reliable indicator for detecting fall risk, especially in community-dwelling individuals with chronic stroke.

Keywords

• Berg Balance Scale
• Falls Efficacy Scale-International
• fall risk
• stroke
• Timed Up and Go test