Abstract
BackgroundWith the growing number of young-older adults (baby-boomers), there is an increasing demand for assessment tools specific for this population, which are able to detect subtle balance and mobility deficits. Various balance and mobility tests already exist, but suffer from ceiling effects in higher functioning older adults. A reliable and valid challenging balance and mobility test is critical to determine a young-older adult’s balance and mobility performance and to timely initiate preventive interventions. The aim was to evaluate the concurrent validity, inter- and intrarater reliability, internal consistency, and ceiling effects of a challenging balance and mobility scale, the Community Balance and Mobility Scale (CBM), in young-older adults aged 60 to 70 years.MethodsFifty-one participants aged 66.4 ± 2.7 years (range, 60–70 years) were assessed with the CBM. The Fullerton Advanced Balance scale (FAB), 3-Meter Tandem Walk (3MTW), 8-level balance scale, Timed-Up-and-Go (TUG), and 7-m habitual gait speed were used to estimate concurrent validity, examined by Spearman correlation coefficient (ρ). Inter- and intrarater reliability were calculated as Intra-class-correlations (ICC), and internal consistency by Cronbach alpha and item-total correlations (ρ). Ceiling effects were determined by obtaining the percentage of participants reaching the highest possible score.ResultsThe CBM significantly correlated with the FAB (ρ = 0.75; p < .001), 3MTW errors (ρ = − 0.61; p < .001), 3MTW time (ρ = − 0.35; p = .05), the 8-level balance scale (ρ = 0.35; p < .05), the TUG (ρ = − 0.42; p < .01), and 7-m habitual gait speed (ρ = 0.46, p < .001). Inter- (ICC2,k = 0.97), intrarater reliability (ICC3,k = 1.00) were excellent, and internal consistency (α = 0.88; ρ = 0.28–0.81) was good to satisfactory. The CBM did not show ceiling effects in contrast to other scales.ConclusionsConcurrent validity of the CBM was good when compared to the FAB and moderate to good when compared to other measures of balance and mobility. Based on this study, the CBM can be recommended to measure balance and mobility performance in the specific population of young-older adults.Trial registrationTrial number: ISRCTN37750605. (Registered on 21/04/2016).
Highlights
With the growing number of young-older adults, there is an increasing demand for assessment tools specific for this population, which are able to detect subtle balance and mobility deficits
The Community Balance and Mobility Scale (CBM) showed no ceiling effects as compared to Berg Balance Scale (BBS) (23%) and Short Physical Performance Battery (SPPB) (33%) [26]. While these findings suggest that the CBM has added value in the assessment of community-dwelling older adults, the measurement properties in the specific population of young-older adults aged 60–70 years are yet to be evaluated
For the participants in Heidelberg (n = 16), 3-Meter Tandem Walk (3MTW) performance was rated only by errors, but not by time. These participants were excluded from statistical analysis on the 3MTW test, resulting in a subsample of 31 participants for which information on time and errors was available
Summary
With the growing number of young-older adults (baby-boomers), there is an increasing demand for assessment tools specific for this population, which are able to detect subtle balance and mobility deficits. The aim was to evaluate the concurrent validity, inter- and intrarater reliability, internal consistency, and ceiling effects of a challenging balance and mobility scale, the Community Balance and Mobility Scale (CBM), in young-older adults aged 60 to 70 years. Young-older adults of retirement age (60–69 years [5]) generally function at a higher level compared to (old-) older adults. Their more active lifestyle potentially exposes them to more high-risk balance-challenging situations. With a dramatic increase in the proportion of young-older adults (baby boomer generation), a paradigm shift is requested towards early stage innovative population-level efforts to prevent loss of balance [7]
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