Sage Journals: Discover world-class research

Abstract

Background

The Activities-specific Balance Confidence (ABC) scale lacks sufficient psychometric evidence for use in patients with subacute stroke.

Objective

To investigate the floor and ceiling effects, construct validity, responsiveness, and the minimal important change (MIC) of the ABC scale in patients with subacute stroke.

Methods

The cases of patients with subacute stroke (n = 62) were analyzed for floor/ceiling effects and construct validity at baseline; those of 39 of the patients were analyzed for responsiveness and MIC at baseline and after 4 weeks. Outcome measures included the ABC scale, Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go test (TUG), comfortable walking speed (CWS), and maximal walking speed (MWS) measured at both baseline and 4-week follow-up. The MIC was calculated using a ≥ 4-point improvement on the Mini-BESTest as the anchor.

Results

The ABC scale's total score did not exhibit any floor or ceiling effects. The ABC scale was correlated with the Mini-BESTest (ρ = 0.74), TUG (ρ = −0.56), CWS (ρ = 0.60), and MWS (ρ = 0.64). The correlation of change score between the ABC scale and Mini-BESTest was ρ = 0.39. The MIC for the ABC scale was 15.6% (95%CI: 10.4%–21.1%).

Conclusions

The ABC scale may help assess self-efficacy in patients with subacute stroke.

Keywords

cerebrovascular disorder outcome measure patient reported outcome measure postural balance self-efficacy

Get full access to this article

View all access options for this article.

References

Basch

(2010). The missing voice of patients in drug-safety reporting. The New England Journal of Medicine, 362(10), 865–869. https://doi.org/10.1056/NEJMp0911494

Beauchamp

M. K.

Harrison

S. L.

Goldstein

R. S.

Brooks

(2016). Interpretability of change scores in measures of balance in people with COPD. Chest, 149(3), 696–703. https://doi.org/10.1378/chest.15-0717

Beghi

Gervasoni

Pupillo

Bianchi

Montesano

Aprile

Agostini

Rovaris

Cattaneo

, & NEUROFALL Group. (2018). Prediction of falls in subjects suffering from Parkinson disease, multiple sclerosis, and stroke. Archives of Physical Medicine and Rehabilitation, 99(4), 641–651. https://doi.org/10.1016/j.apmr.2017.10.009

Bernhardt

Hayward

K. S.

Kwakkel

Ward

N. S.

Wolf

S. L.

Borschmann

Krakauer

J. W.

Boyd

L. A.

Carmichael

S. T.

Corbett

Cramer

S. C.

(2017). Agreed definitions and a shared vision for new standards in stroke recovery research: The Stroke Recovery and Rehabilitation Roundtable taskforce. International Journal of Stroke: Official Journal of the International Stroke Society, 12(5), 444–450. https://doi.org/10.1177/1747493017711816

Botner

E. M.

Miller

W. C.

Eng

J. J.

(2005). Measurement properties of the Activities-specific Balance Confidence Scale among individuals with stroke. Disability and Rehabilitation, 27(4), 156–163. https://doi.org/10.1080/09638280400008982

Brunnstrom

(1966). Motor testing procedures in hemiplegia: Based on sequential recovery stages. Physical Therapy, 46(4), 357–375. https://doi.org/10.1093/ptj/46.4.357

Chiu

C. Y.

M. Y.-H.

Lam

S. C.

Hui

K. Y.

Keung

C. H.

Ouyang

Pang

M. Y.-C.

(2023). Effect of physical exercise on fear of falling in patients with stroke: A systematic review and meta-analysis. Clinical Rehabilitation, 37(3), 294–311. https://doi.org/10.1177/02692155221135028

Corrini

Torchio

Anastasi

Parelli

Meotti

Spedicato

Groppo

D’Arma

Grosso

Montesano

Cattaneo

Gervasoni

(2021). Minimal clinically important difference of modified dynamic gait index in people with neurological disorders. Gait & Posture, 90, 210–214. https://doi.org/10.1016/j.gaitpost.2021.08.024

Di Carlo

Bravini

Vercelli

Massazza

Ferriero

(2016). The Mini-BESTest: A review of psychometric properties. International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung. Revue Internationale de Recherches de Readaptation, 39(2), 97–105. https://doi.org/10.1097/MRR.0000000000000153

10.

Dodds

T. A.

Martin

D. P.

Stolov

W. C.

Deyo

R. A.

(1993). A validation of the functional independence measurement and its performance among rehabilitation inpatients. Archives of Physical Medicine and Rehabilitation, 74(5), 531–536. https://doi.org/10.1016/0003-9993(93)90119-U

11.

Flansbjer

U.-B.

Holmbäck

A. M.

Downham

Patten

Lexell

(2005). Reliability of gait performance tests in men and women with hemiparesis after stroke. Journal of Rehabilitation Medicine, 37(2), 75–82. https://doi.org/10.1080/16501970410017215

12.

Forsberg

Nilsagård

(2013). Validity and reliability of the Swedish version of the activities-specific balance confidence scale in people with chronic stroke. Physiotherapy Canada. Physiotherapie Canada, 65(2), 141–147. https://doi.org/10.3138/ptc.2011-54

13.

Franchignoni

Horak

Godi

Nardone

Giordano

(2010). Using psychometric techniques to improve the balance evaluation systems test: The mini-BESTest. Journal of Rehabilitation Medicine, 42(4), 323–331. https://doi.org/10.2340/16501977-0537

14.

French

M. A.

Moore

M. F.

Pohlig

Reisman

(2016). Self-efficacy mediates the relationship between balance/walking performance, activity, and participation after stroke. Topics in Stroke Rehabilitation, 23(2), 77–83. https://doi.org/10.1080/10749357.2015.1110306

15.

Gervasoni

Jonsdottir

Montesano

Cattaneo

(2017). Minimal clinically important difference of berg balance scale in people with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 98(2), 337–340.e2. https://doi.org/10.1016/j.apmr.2016.09.128

16.

Godi

Arcolin

Giardini

Corna

Schieppati

(2020). Responsiveness and minimal clinically important difference of the Mini-BESTest in patients with Parkinson’s disease. Gait & Posture, 80, 14–19. https://doi.org/10.1016/j.gaitpost.2020.05.004

17.

Ishige

Wakui

Miyazawa

Naito

(2019). Reliability and validity of the Activities-specific Balance Confidence scale-Japanese (ABC-J) in community-dwelling stroke survivors. Physical Therapy Research, 10(1), 15–22. https://doi.org/10.1298/ptr.E9982

18.

Mokkink

L. B.

Prinsen

C. A. C.

Patrick

D. L.

Alonso

Bouter

L. M.

de Vet Henrica

C. W.

Terwee

C. B.

(2019, July). COSMIN Study Design checklist for Patient-reported outcome measurement instruments. https://www.cosmin.nl/

19.

Moore

J. L.

Potter

Blankshain

Kaplan

S. L.

O'Dwyer

L. C.

Sullivan

J. E.

(2018). A core set of outcome measures for adults with neurologic conditions undergoing rehabilitation: A CLINICAL PRACTICE GUIDELINE. Journal of Neurologic Physical Therapy: JNPT, 42(3), 174–220. https://doi.org/10.1097/NPT.0000000000000229

20.

Nakazono

Takahashi

Suzuki

Mizuno

Nomura

Hiraga

Matsumoto

Nishiyama

Fukuda

(2022). Reliability and validity of Japanese version of fugl-Meyer assessment for the lower extremities. Topics in Stroke Rehabilitation, 29(2), 125–132. https://doi.org/10.1080/10749357.2021.1899700

21.

Podsiadlo

Richardson

(1991). The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

22.

Powell

L. E.

Myers

A. M.

(1995). The activities-specific balance confidence (ABC) scale. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 50A(1), M28–M34. https://doi.org/10.1093/gerona/50A.1.M28

23.

Prinsen

C. A. C.

Mokkink

L. B.

Bouter

L. M.

Alonso

Patrick

D. L.

de Vet

H. C. W.

Terwee

C. B.

(2018). COSMIN Guideline for systematic reviews of patient-reported outcome measures. Quality of Life Research, 27(5), 1147–1157. https://doi.org/10.1007/s11136-018-1798-3

24.

Rodrigues

L. C.

Marques

A. P.

Barros

P. B.

Michaelsen

S. M.

(2014). Reliability of the Balance Evaluation Systems Test (BESTest) and BESTest sections for adults with hemiparesis. Brazilian Journal of Physical Therapy, 18(3), 276–281. https://doi.org/10.1590/bjpt-rbf.2014.0033

25.

Roelofs

J. M. B.

Zandvliet

S. B.

Schut

I. M.

Huisinga

A. C. M.

Schouten

A. C.

Hendricks

H. T.

de Kam

Aerden

L. A. M.

Bussmann

J. B. J.

Geurts

A. C. H.

Weerdesteyn

(2023). Mild stroke, serious problems: Limitations in balance and gait capacity and the impact on fall rate, and physical activity. Neurorehabilitation and Neural Repair, 37(11–12), 786–798. https://doi.org/10.1177/15459683231207360

26.

Salbach

N. M.

Mayo

N. E.

Hanley

J. A.

Richards

C. L.

Wood-Dauphinee

(2006). Psychometric evaluation of the original and Canadian French version of the activities-specific balance confidence scale among people with stroke. Archives of Physical Medicine and Rehabilitation, 87(12), 1597–1604. https://doi.org/10.1016/j.apmr.2006.08.336

27.

Salot

Patel

Bhatt

(2016). Reactive balance in individuals with chronic stroke: Biomechanical factors related to perturbation-induced backward falling. Physical Therapy, 96(3), 338–347. https://doi.org/10.2522/ptj.20150197

28.

Seamon

B. A.

Kautz

S. A.

Velozo

C. A.

(2019). Rasch analysis of the activities-specific balance confidence scale in individuals poststroke. Archives of Rehabilitation Research and Clinical Translation, 1(3–4), 100028. https://doi.org/10.1016/j.arrct.2019.100028

29.

Sullivan

J. E.

Crowner

B. E.

Kluding

P. M.

Nichols

Rose

D. K.

Yoshida

Pinto Zipp

(2013). Outcome measures for individuals with stroke: Process and recommendations from the American physical therapy association neurology section task force. Physical Therapy, 93(10), 1383–1396. https://doi.org/10.2522/ptj.20120492

30.

Tamura

Miyata

Hasegawa

Kobayashi

Shioura

Usuda

(2024). Pooled minimal clinically important differences of the mini-balance evaluation systems test in patients with early subacute stroke: A multicenter prospective observational study. physical therapy, 104(4), pzae017. https://doi.org/10.1093/ptj/pzae017

31.

Terluin

Eekhout

Terwee

C. B.

de Vet

H. C. W.

(2015). Minimal important change (MIC) based on a predictive modeling approach was more precise than MIC based on ROC analysis. Journal of Clinical Epidemiology, 68(12), 1388–1396. https://doi.org/10.1016/j.jclinepi.2015.03.015

32.

Terwee

C. B.

Bot

S. D. M.

de Boer

M. R.

van der Windt

D. A. W. M.

Knol

D. L.

Dekker

Bouter

L. M.

de Vet

H. C. W.

(2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60(1), 34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012

33.

Terwee

C. B.

Peipert

J. D.

Chapman

Lai

J.-S.

Terluin

Cella

Griffith

Mokkink

L. B.

(2021). Minimal important change (MIC): A conceptual clarification and systematic review of MIC estimates of PROMIS measures. Quality of Life Research, 30(10), 2729–2754. https://doi.org/10.1007/s11136-021-02925-y

34.

Thilarajah

Mentiplay

B. F.

Bower

K. J.

Tan

Pua

Y. H.

Williams

Koh

Clark

R. A.

(2018). Factors associated with post-stroke physical activity: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 99(9), 1876–1889. https://doi.org/10.1016/j.apmr.2017.09.117

35.

Wellons

R. D.

Duhe

S. E.

MacDowell

S. G.

Hodge

Oxborough

Levitzky

E. E.

(2022). Estimating the minimal clinically important difference for balance and gait outcome measures in individuals with vestibular disorders. Journal of Vestibular Research: Equilibrium & Orientation, 32(3), 223–233. https://doi.org/10.3233/VES-201630

36.

Winairuk

Pang

M. Y. C.

Saengsirisuwan

Horak

F. B.

Boonsinsukh

(2019). Comparison of measurement properties of three shortened versions of the balance evaluation system test (BESTest) in people with subacute stroke. Journal of Rehabilitation Medicine: Official Journal of the UEMS European Board of Physical and Rehabilitation Medicine, 51(9), 683–691. https://doi.org/10.2340/16501977-2589

37.

Ylva

Anette

(2012). Psychometric properties of the Activities-Specific Balance Confidence Scale in persons 0-14 days and 3 months post stroke. Disability and Rehabilitation, 34(14), 1186–1191. https://doi.org/10.3109/09638288.2011.637604

The Validity,Responsiveness,and Interpretability of the Activities-specific Balance Confidence Scale in Patients with Subacute Stroke: A Preliminary Investigation

Abstract

Background

Objective

Methods

Results

Conclusions

Keywords

Get full access to this article

References