Reliability, validity, and agreement of the short-form Activities-specific Balance Confidence Scale in people with lower extremity amputations

Abstract

Background: Clinicians use the Activities-specific Balance Confidence Scale to understand balance confidence. A short-form Activities-specific Balance Confidence scale, was developed using the six most difficult tasks from the original Activities-specific Balance Confidence scale; however, short-form the short-form scale psychometrics and agreement with the original scale have yet to be explored in people with lower extremity amputations. Objective: To determine the relative and absolute reliability, construct validity, and agreement of the short-form Activities-specific Balance Confidence scale. Study design: Test–retest with a 2-week interval. Methods: Analysis for relative reliability and internal consistency was intraclass correlation coefficient and Cronbach’s α, respectively. Absolute reliability was measured using standard error of measurement and minimal detectable change. Bland–Altman plots measured agreement between scales. Construct validity was evaluated against the L Test using a Pearson-product moment correlation. Results: The short-form Activities-specific Balance Confidence (intraclass correlation coefficient = 0.92) and Activities-specific Balance Confidence (intraclass correlation coefficient = 0.91) scales had excellent relative reliability. Both scales demonstrated good internal consistency. Worse absolute reliability was observed in the short-form Activities-specific Balance Confidence scale. Construct validity against the L Test was confirmed. Bland–Altman plots indicated poor agreement between scales. Conclusion: Both scales exhibit excellent relative reliability and good internal consistency and construct validity. Poor agreement between short-form Activities-specific Balance Confidence and Activities-specific Balance Confidence indicates the scales should not be used interchangeably. Inadequate absolute reliability of the short-form Activities-specific Balance Confidence scale suggests the Activities-specific Balance Confidence should be the balance confidence scale of choice. Clinical relevance: Balance confidence is an important metric for our understanding of rehabilitation and community re-integration in people with lower extremity amputations. Due to inferior absolute reliability and a lack of appropriate items composing the short-form Activities-specific Balance Confidence scale, the full-scale Activities-specific Balance Confidence is recommended for the assessment of balance confidence in this population.

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

“…In the diabetic population, the ABC-6 was more sensitive than the ABC-16 for detecting subtle differences in balance confidence. 41 On the contrary, in patients with a lower extremity amputation, the ABC-16 was recommended 42 and the ABC-16 with 5-option response format was also found an effective measure of balance confidence. 43 In addition, because ABC-6 contains six of the most balancechallenging activities, its scores were significantly lower than that of the ABC-16.…”

The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

“…Alternatively, and if applied to dual‐task cost, pairwise comparisons may be sufficient to assess if a greater magnitude of change in performance between single‐task and dual‐task conditions is observed in PLLA relative to CN. To avoid underpowered studies that minimize the ability to observe a true effect, a priori sample size calculations should be reported and be based on effect sizes from similar published research or be informed by a protocol pilot. Although a demand exists for the assessment of balance and gait using instrumented technology, future research on dual‐task testing using clinical tests is also important because of its clinical applicability. Currently, many clinical tests of mobility are available 13,14 ; however, the L Test of Functional Mobility remains the only test specifically designed for PLLA and for which a condition of dual‐task has been shown to be valid and reliable 24,29,30,62 . Dual‐task testing assesses cognitive‐motor capacity, and offers healthcare professionals the ability to examine situations resembling real life 22,23 that are often associated with experiences of falls 63 .…”

“…Currently, many clinical tests of mobility are available 13,14 ; however, the L Test of Functional Mobility remains the only test specifically designed for PLLA and for which a condition of dual-task has been shown to be valid and reliable. 24,29,30,62 Dual-task testing assesses cognitivemotor capacity, and offers healthcare professionals the ability to examine situations resembling real life 22,23 that are often associated with experiences of falls. 63 In spite of this, the falls-related predictive validity for dualtask tests of balance or gait remains unexplored in this population.…”

The number of falls recalled in the past year and balance confidence predict the frequency of injurious falls by unilateral lower limb prosthesis users

“…27 The Patient-Reported Outcomes Measurement Information System (PROMIS) four-item fatigue short form was used to assess participants' degree of overall fatigue. 28,29 Several of these self-report measures, specifically those assessing perceived mobility and balance confidence, have been used to assess fall risk in LLP users, 9,30 and possess evidence of validity 25,31,32 and reliability [31][32][33] in unilateral LLP users.…”