Subtype-specific optimal cut-off values of the Berg Balance Scale for predicting independent walking in inpatient stroke rehabilitation: a multicentre cohort study.

OBJECTIVE

To determine whether admission Berg Balance Scale score independently predicts independent walking on discharge after adjustment for major confounders, and to derive subtype-specific optimal cut-off values for ischaemic and haemorrhagic stroke.

DESIGN

Multicentre retrospective cohort study.

SUBJECTS/PATIENTS: A total of 565 stroke patients (316 ischaemic, 249 haemorrhagic) admitted to 3 inpatient rehabilitation centres in the Republic of Korea.

METHODS

Multivariable logistic regression was used to evaluate the independent predictive value of the Berg Balance Scale. Optimal cut-off values were derived using receiver operating characteristic curve analysis and the Youden index. Bootstrap internal validation, calibration analysis, and decision curve analysis were performed.

RESULTS

Admission Berg Balance Scale was a significant independent predictor of independent walking (adjusted odds ratio 1.053, 95% confidence interval 1.030-1.076). The difference in discriminative ability between the Berg Balance Scale only and multivariable models was not statistically significant (p = 0.097). The overall optimal cut-off was 24 points; subtype-specific cut-offs were 33 for ischaemic and 12 for haemorrhagic stroke.

CONCLUSION

The Berg Balance Scale has different optimal cut-off values by stroke subtype and, as a standalone assessment, maintains discriminative ability equivalent to a multivariable model, providing clinical evidence for subtype-specific precision rehabilitation strategies.