Balance outcomes from two small rural hospitals


Mr Stephen Downs, Transitional Aged Care, Bellingen Hospital, Church Street, Bellingen, New South Wales, 2454, Australia. Email:


Objectives:  To describe predicted and measured balance changes in patients receiving physiotherapy in two rural hospitals, and to explore the relationship among balance at discharge, carer availability and patients' discharge destination.

Design:  Prospective measurement study.

Setting:  Two rural Australian hospitals.

Participants:  Eighty-nine inpatients with a median age of 84.

Main outcome measures:  Berg Balance Scale (BBS) on admission and the treating physiotherapist's estimate at admission of individual patient's discharge BBS. Follow-up measures included discharge BBS, carer availability after discharge and patient discharge destination.

Results:  Although change in measured balance of study participants had wide variability, balance measured by the BBS displayed a statistically and clinically significant improvement. A strong relationship was found between balance scores and discharge destination. However, no relationship was found between carer availability and discharge destination. Physiotherapists' estimates of discharge BBS displayed an average error of 7/56.

Conclusions:  The strong relationship between measured balance and discharge destination in these elderly study participants suggests that maximising their balance might minimise admissions to nursing home. The high variability of measured balance change suggests outcomes are difficult to predict. The study results suggest that premature assessment of patient's suitability for nursing home placement should be avoided. The accuracy of physiotherapist's estimates of discharge BBS suggests that greater weight might be placed on their input to facilitate the discharge planning process.