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Kocer B, Soke F, Ataoglu NEE, Ersoy N, Gulsen C, Gulsen EO, Yasa ME, Uysal I, Comoglu SS, Bora HAT. The reliability and validity of the 3-m backward walk test in people with Parkinson's disease. Ir J Med Sci 2023; 192:3063-3071. [PMID: 37160569 DOI: 10.1007/s11845-023-03384-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND People with Parkinson's disease (PwPD) lose the ability in backward walking which is an important part of mobility in daily life. The 3-m backward walk test (3MBWT) evaluates backward walking; however, its reliability and validity have not been examined in PwPD yet. AIMS To examine (1) the test-retest reliability of the 3MBWT in PwPD; (2) the minimum detectable change in the 3MBWT times; (3) the concurrent and known-groups validity of the 3MBWT; and (4) the optimum cutoff time which best discriminates fallers from non-fallers with Parkinson's disease (PD). METHODS This cross-sectional study included 36 PwPD and 33 healthy people. The 3MBWT was conducted with the 10-m walk test, timed up and go test, Berg Balance Scale, four square step test, activity-specific balance confidence scale, Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale, and Hoehn and Yahr Scale. RESULTS The 3MBWT demonstrated excellent test-retest reliability (ICC = 0.965). The MDC of 2.13 s was determined. The 3MBWT had moderate to high correlations with the other outcome measures (correlation coefficient ranged from -0.592 to 0.858). On the 3MBWT times, there were significant differences between PwPD and healthy people, and between fallers and non-fallers with PD (p < 0.001 and p < 0.001, respectively). A 3MBWT time of 10.31 s was found to best discriminate fallers from non-fallers with PD. CONCLUSIONS The 3MBWT is a reliable, valid, and easy to administer outcome measure to assess backward walking performance in PwPD, indicating it to be used in practice and research.
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Affiliation(s)
- Bilge Kocer
- Ankara Etlik City Hospital, Department of Neurology, University of Health Sciences, Varlik Neighborhood, Halil Sezai Erkut Street, Yenimahalle, Ankara, Turkey.
| | - Fatih Soke
- Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | | | - Nursena Ersoy
- Faculty of Health Sciences, Department of Nutrition and Dietetic, Ankara University, Ankara, Turkey
| | - Cagri Gulsen
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Elvan Ozcan Gulsen
- Vocational School of Health Services, Elderly Care Program, Anadolu University, Eskisehir, Turkey
| | - Mustafa Ertugrul Yasa
- Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Ismail Uysal
- Fethiye Vocational School of Health Services, Department of Health Care Services, Mugla Sitki Kocman University, Ankara, Turkey
| | - Selim Selcuk Comoglu
- Ankara Etlik City Hospital, Department of Neurology, University of Health Sciences, Varlik Neighborhood, Halil Sezai Erkut Street, Yenimahalle, Ankara, Turkey
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Soke F, Aydin F, Karakoc S, Gulsen C, Yasa ME, Ersoy N, Gulsen EO, Yucesan C. Effects of backward walking training on balance, gait, and functional mobility in people with multiple sclerosis: A randomized controlled study. Mult Scler Relat Disord 2023; 79:104961. [PMID: 37683559 DOI: 10.1016/j.msard.2023.104961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/04/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Backward walking training (BWT) can have a positive effect on balance, gait, and functional mobility in neurological diseases; however, the effectiveness of BWT has not been examined in multiple sclerosis (MS). Therefore, the study aimed to investigate the effects of BWT on balance, gait, and functional mobility in people with MS (PwMS). METHOD Nineteen PwMS were randomly allocated to either the experimental group (n=10) and the control group (n=9). The experimental group received BWT in addition to conventional walking training (CWT) while the control group only received CWT. Both groups performed training three times a week for 8 weeks. Participants were assessed with the Berg Balance Scale (BBS), four square step test (FSST), activities-specific balance confidence scale (ABC), timed 25-foot walk test (T25FW), dynamic gait index (DGI), 3-meter backward walk test (3MBWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), and timed up and go test (TUG) before and after training. RESULTS After training, both groups showed significant improvements on the T25FW, and TUG (p<0.05) while only the experimental group showed significant improvements on the BBS, FSST, ABC, DGI, 3MBWT, and MSWS-12 (p<0.05). The experimental group significantly improved more than the control group in all outcomes (p<0.05) except for the T25FW (p=0.202). CONCLUSION BWT in addition to CWT is an effective way to improve balance, gait, and functional mobility for PwMS. These results suggest that BWT may be a potentially useful treatment approach when added to CWT in the rehabilitation of MS.
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Affiliation(s)
- Fatih Soke
- University of Health Sciences, Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
| | - Fatma Aydin
- University of Health Sciences, Ankara Etlik City Hospital, Department of Neurology, Ankara, Turkey
| | - Selda Karakoc
- Ankara Yildirim Beyazit University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Cagri Gulsen
- Osmangazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eskisehir, Turkey
| | - Mustafa Ertugrul Yasa
- University of Health Sciences, Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Nursena Ersoy
- Ankara University, Faculty of Health Sciences, Department of Nutrition and Dietetic, Ankara, Turkey
| | - Elvan Ozcan Gulsen
- Anadolu University, Vocational School of Health Services, Elderly Care Program, Eskisehir, Turkey
| | - Canan Yucesan
- Ankara University, Faculty of Medicine, Department of Neurology, Ankara, Turkey
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Soke F, Erkoc Ataoglu NE, Ozcan Gulsen E, Yilmaz O, Gulsen C, Kocer B, Kirteke F, Basturk S, Comoglu SS, Tokcaer AB. The psychometric properties of the figure-of-eight walk test in people with Parkinson's disease. Disabil Rehabil 2023; 45:301-309. [PMID: 35191344 DOI: 10.1080/09638288.2022.2028020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To investigate: (1) the interrater, and test-retest reliability of the figure-of-eight walk test (F8WT) in people with Parkinson's disease (PwPD); (2) the minimum detectable change in the F8WT times; (3) the concurrent and known-groups validity of the F8WT times; and (4) the cut-off times that best discriminate PwPD from healthy people and fallers from non-fallers with PD. METHODS This was a cross-sectional study. Forty-three PwPD and 34 healthy people were recruited. The F8WT was performed along with the timed up and go test, 10 m walk test, Berg Balance Scale, Activities-Specific Balance Confidence Scale, Unified Parkinson's disease Rating Scale, and Hoehn and Yahr Scale. RESULTS The F8WT showed good interrater and test-retest reliability (ICC = 0.964-0.978 and ICC = 0.905-0.920, respectively). The MDC was 2.77 s. The F8WT was correlated with other outcome measures. Significant differences in the F8WT times were found between PwPD and healthy people and between fallers and non-fallers with PD (p < 0.001 and p < 0.001, respectively). The cut-off times of 8.43 s best discriminated PwPD from healthy people, while 11.19 s best discriminated fallers from non-fallers with PD. CONCLUSIONS The F8WT is a reliable, valid, and easy-to-administer tool in assessing the walking skill of PwPD.Implications for rehabilitationThe figure-of-eight walk test (F8WT) is a reliable, valid, and clinically available tool for assessing walking skill in Parkinson's disease (PD).The minimal detectable change of the F8WT is 2.77 s, which may help to determine any real change in walking skill after any intervention.The F8WT correlated with functional mobility, gait speed, balance, balance confidence, and severity and stage of PD.The F8WT times may detect impaired walking skill between people with PD and healthy people, and between fallers and non-fallers with PD.
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Affiliation(s)
- Fatih Soke
- Department of Physiotherapy and Rehabilitation, Gulhane Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | | | - Elvan Ozcan Gulsen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yuksek Ihtisas University, Ankara, Turkey
| | - Oznur Yilmaz
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cagri Gulsen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Bilge Kocer
- Department of Neurology, Diskapi Yildirim Beyazit Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Fatos Kirteke
- Department of Ergotherapy, Faculty of Health Sciences, Fenerbahce University, Istanbul, Turkey
| | - Sultan Basturk
- Kanalboyu Physical Therapy and Rehabilitation Medical Center, Malatya, Turkey
| | - Selim Selcuk Comoglu
- Department of Neurology, Diskapi Yildirim Beyazit Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ayse Bora Tokcaer
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Zhang D, Tian F, Gao W, Huang Y, Huang H, Tan L. The Chinese Short Version of the Activities-Specific Balance Confidence Scale: Its Validity, Reliability, and Predictive Value for Future Falls in Community-Dwelling Older Adults. Clin Interv Aging 2022; 17:1483-1491. [PMID: 36212511 PMCID: PMC9541673 DOI: 10.2147/cia.s380921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/24/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose To examine the reliability and validity of the Chinese short version of the Activities-specific Balance Confidence scale (ABC-6), and its predictive value for prospective falls in community-dwelling older adults. Patients and Methods A total of 391 community older adults completed the prospective study. Internal consistency reliability, test-retest reliability, structural validity and discriminant validity were analyzed. To determine the accuracy of ABC-6 total score in predicting falls, a receiver operating characteristic curve analysis was performed, and comparisons with the Activities-specific Balance Confidence scale (ABC-16) and Berg Balance Scale (BBS) were made. Results Excellent internal consistency (Cronbach’s α = 0.938) and test-retest reliability (ICC=0.964, 95% CI: 0.947–0.977) were found for the ABC-6. Exploratory factor analysis suggested that ABC-6 had a one-factor structure (explained variance, 68.30%). The optimal cutoff value, sensitivity and specificity of ABC-6 to distinguish fallers from non-fallers was ≤ 60.00%, 70.83% and 84.26%, respectively, and there was no significant difference in the predictive value among the ABC-6, ABC-16, and BBS. Conclusion The Chinese version of the ABC-6 scale was a valid and reliable tool for measuring self-perceived balance confidence in community-dwelling older adults, and can be used as an effective assessment tool to predict future falls.
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Affiliation(s)
- Dongting Zhang
- Department of Nursing, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Fengmei Tian
- Department of Nursing, the Second Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Wenjun Gao
- Department of Nursing, the Second Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Yvfeng Huang
- School of Nursing, Soochow University, Suzhou, People’s Republic of China
| | - Hui Huang
- Department of Nursing, the Second Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China,Correspondence: Hui Huang; Liping Tan, Department of Nursing, the Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, 215004, People’s Republic of China, Tel +86-15312187852; +86-13962514643, Email ;
| | - Liping Tan
- Department of Nursing, the Second Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
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Misaghi E, Miller WC, Imam B, Payne MWC, Lindstrom H. Walking while talking: validation in older adults with lower-limb amputation. Prosthet Orthot Int 2021; 45:457-462. [PMID: 34772867 DOI: 10.1097/pxr.0000000000000063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 08/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Walking while talking (WWT) is a dual-task (cognitive and motor) performance test that has not yet been validated in older adults with lower-limb amputation (LLA). WWT is composed of two sections: WWT-simple (walking while reciting every letter of the alphabet) and WWT-complex (walking while reciting every other letter of the alphabet). OBJECTIVE To determine the validity, and provide normative data and a new scoring system for the WWT test in older adults with LLA. STUDY DESIGN Baseline cross-sectional data were collected from 56 community-living older adults (≥50 years old) with LLA at rehabilitation hospitals in Vancouver, BC, London, ON, and Edmonton, AB, Canada. METHODS Time and number of recited letters and errors during both sections were recorded. A new score was developed based on all these variables. Correlations of the recorded times with the Activities-specific Balance Confidence (ABC) scale and the 2-Minute Walk Test (2MWT) score were used to evaluate the validity of the WWT test. RESULTS As hypothesized, the times for both sections of the WWT were negatively correlated with both the ABC and 2MWT scores. Positive correlations were observed between the scores developed for both WWT sections with the 2MWT score. CONCLUSION Times taken to complete each section of the WWT test were correlated with the 2MWT and the ABC scale scores, providing evidence for the validity of the WWT test. We also provided a scoring method that is more objective and in line with the dual-task nature of the test.
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Affiliation(s)
- Ehsan Misaghi
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - William C Miller
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Bita Imam
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Michael W C Payne
- Department of Physical Medicine and Rehabilitation, Western University, London, ON, Canada
| | - Heather Lindstrom
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Task-oriented circuit training combined with aerobic training improves motor performance and balance in people with Parkinson's Disease. Acta Neurol Belg 2021; 121:535-543. [PMID: 31741209 DOI: 10.1007/s13760-019-01247-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/12/2019] [Indexed: 12/19/2022]
Abstract
Goal-based training such as task practice combined with aerobic training (AT) has been suggested to improve motor performance and neuroplasticity for people with Parkinson's Disease (PwPD); however, its effect on clinical outcomes is unclear. Therefore, the main aim was to investigate the effects of task-oriented circuit training combined with AT (TOCT-AT) on balance and gait in PwPD. The secondary aim was to investigate the effects of TOCT-AT on functional mobility, balance confidence, disease severity, and quality of life. Twenty-six PwPD were randomly assigned to either to the experimental group (n = 14) or the control group (n = 12). The control group received AT, while the experimental group received TOCT-AT three times a week for 8 weeks. The main outcomes were the Berg Balance Scale (BBS), Postural Stability Test (PST), Limits of Stability Test (LOS), Pull Test (PT), Six Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Activities-specific Balance Confidence Scale (ABC), Unified Parkinson's Disease Rating Scale (UPDRS), and eight-item Parkinson's Disease Questionnaire (PDQ-8) were secondary outcomes. After intervention, between-group comparisons showed that the experimental group significantly improved more than the control group in all outcomes (p < 0.05). Additionally, both groups significantly improved in BBS, 6MWT, TUG, ABC, UPDRS-II, UPDRS-III, UPDRS total, and PDQ-8 (p < 0.05), while only the experimental group significantly improved in PST, LOS, and PT (p < 0.001). This study suggest that TOCT-AT could improve balance and gait performance, which could also be positively translated into functional mobility, balance confidence, disease severity, and quality of life in PwPD.
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Atay F, Bayramlar K, Sarac ET. Effects of Craniosacral Osteopathy in Patients with Peripheral Vestibular Pathology. ORL J Otorhinolaryngol Relat Spec 2020; 83:7-13. [PMID: 32906128 DOI: 10.1159/000509486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/15/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Vertigo appears as a result of a sudden neural activity imbalance of the vestibular system. The vertigo prevalence is higher in patients over 60 years of age compared to patients under 40 years of age. OBJECTIVES The purpose of this study was to analyze the effect of craniosacral osteopathy on dizziness and balance in individuals who have peripheral vestibular pathology. METHODS A total of 30 individuals, aged 24-50 years, participated in this study. Twenty-four of the participants were female (80%) and 6 were male (20%). The participants were separated into 2 groups, with 15 patients included in the cranial osteopathy treatment group (study group) and 15 patients included in the group that used dimenhydrinate (control group). The individuals were evaluated in terms of dizziness and balance. A visual analog scale was used to evaluate dizziness. Balance was evaluated using the Berg balance scale and the Activities-Specific Balance Confidence scale. The craniosacral treatment program was applied once per week for 6 sessions. All of the individuals included in this study were evaluated 3 times, i.e., prior to treatment, on the third week of treatment, and on the sixth week of treatment. RESULTS Significant improvement was noted within each group in terms of dizziness and balance (p < 0.05). When the groups were compared with each other, it was observed that craniosacral osteopathy was more effective than dimenhydrinate treatment for dizziness and balance (p < 0.05). CONCLUSION Craniosacral osteopathy is an effective treatment choice in individuals who have chronic peripheral vestibular pathology. In individuals who have resistant and chronic vestibular pathology, craniosacral osteopathy should be evaluated among the treatment choices.
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Affiliation(s)
- Feride Atay
- Department of Physical Therapy, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Kezban Bayramlar
- Department of Physical Therapy, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Elif Tugba Sarac
- Department of Audiology, Ear-Nose-Throat Department, Mustafa Kemal University Medicine Faculty, Hatay, Turkey,
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Innovative Exercise as an Intervention for Older Adults with Knee Osteoarthritis: A Pilot Feasibility Study. Can J Aging 2018; 38:111-121. [DOI: 10.1017/s0714980818000454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
RÉSUMÉL’exercice peut diminuer la morbidité associée à l’arthrose du genou. Nous avons réalisé une étude auprès de 22 participants avec arthrose du genou (68 % de femmes) ayant en moyenne 69,5 ans (ÉT : 7,4). Les participants ont été aléatoirement assignés à un groupe d’exercice de marche carrée (square-stepping exercise; SSE; 2 fois/semaine pour 24 semaines) ou à un groupe contrôle. Nous avons évalué la faisabilité (recrutement et présence) du SSE et son efficacité en lien avec les symptômes (WOMAC), l’équilibre (Fullerton), la mobilité (test de la chaise de 30 secondes) et la vitesse de marche après 12 et 24 semaines. Le groupe SSE avait un taux de présence de 49,3% et sa performance au test de la chaise de 30 secondes tendait à s’améliorer après 12 semaines (F=1,8, p=0,12, ηp2=0,16) et 24 semaines (F=3,4, p=0,09, ηp2=0,18), tout comme sa vitesse de marche à 24 semaines (F=2,4, p=0,14, ηp2=0,14), comparativement au groupe contrôle, en contrôlant pour les données de base. Aucune différence n’a été observée sur le plan des symptômes ou de l’équilibre. Les taux de présence et de recrutement faibles indiquent une faisabilité limitée du SSE chez les personnes âgées avec arthrose du genou. Les tendances observées suggèrent que le SSE peut améliorer la fonction du membre inférieur et la vitesse de marche. Les études futures sur le programme SSE devraient se pencher sur son efficacité en lien avec les symptômes et l’équilibre, et viser l’amélioration de sa faisabilité.
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Rasch Analysis of the Activities-Specific Balance Confidence Scale in Older Adults Seeking Outpatient Rehabilitation Services. J Orthop Sports Phys Ther 2018; 48:574-583. [PMID: 29602305 DOI: 10.2519/jospt.2018.8023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background The Activities-specific Balance Confidence (ABC) scale measures confidence in performing various ambulatory activities without falling or experiencing a sense of unsteadiness. Objectives This study (1) examined the ABC scale (0-100) using Rasch analysis, (2) assessed statistically reliable change, and (3) developed a functional staging to guide clinical interpretation of a patient's improvement. Methods The authors examined rating-scale structure, item difficulty hierarchy, item fit, person-item match, separation index, differential item functioning, test precision, and unidimensionality. Additionally, this cross-sectional study of 5012 older patients seeking outpatient rehabilitation therapy in 123 clinics estimated the minimal detectable change and developed a functional staging. Results The item "walk outside on icy sidewalks" was the most difficult item, while the item "reach for a small can off a shelf at eye level" was the easiest item. Overall, average patient ability estimates of 56.2 ± 20.3 were slightly higher than the average item difficulty estimates of 45.9 ± 7.8. With a separation index equal to 3.65, the ABC scale items can differentiate individuals into 5.2 statistically distinct strata. Most ABC scale items were free of differential item functioning. For example, "walk outside on icy sidewalks" was easier for patients who were underweight. Results supported unidimensionality of the ABC scale, with the first factor explaining 77% of the total variance. The estimated minimal detectable change was 15 points. The authors provided an example of functional staging application. Conclusion Results supported sound psychometric properties and clinical usage of the ABC scale for older adults seeking outpatient rehabilitation therapy. J Orthop Sports Phys Ther 2018;48(7):574-583. Epub 30 Mar 2018. doi:10.2519/jospt.2018.8023.
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