Cross-cultural validation of the Berg balance scale to assess balance among Hungarian institutionalised older adults

Abstract

Purpose To translate the Berg Balance Scale (BBS) to Hungarian and to evaluate the psychometric characteristics of the Hungarian version (HU-BBS). Methods In total, 150 institutionalised older adults were recruited for the study. Eighty-one participants completed the retesting. Internal consistency, intra- and inter-rater reliability, and 95% limits of agreement of the HU-BBS were examined. Construct validity was assessed through convergent, discriminant, and known-group validity. Results The overall Cronbach’s alpha was 0.943. The intra- and inter-rater reliability was excellent (intraclass correlation coefficient > 0.92). The Bland–Altman analysis revealed a mean inter-rater difference of 0.284 [−2.193–2.744] and a mean intra-rater difference of 0.259 [−2.657–3.162]. Regarding convergent validity, the HU-BBS was correlated with the functional status (r = 0.833), Timed Up and Go test (r= −0.824), and age (r= −0.606). The HU-BBS scores of women were similar to those of men (p = 0.104), showing discriminant validity. Additionally, the HU-BBS scores were lower among faller than among non-faller participants (p ˂ 0.0001), establishing known-group validity. Conclusions Translation and cultural adaptation of the original scale was successful. The HU-BBS proved to be a reliable, valid tool confirming that it can be used in future clinical and scientific work on Hungarian older adults. Implications for rehabilitation Institutionalised older adults are vulnerable and at a high risk of developing further decline in postural control, contributing to an increase in limited functional mobility and risk for falls. The Berg Balance Scale is a widely used tool originally developed to measure postural control in older adults. The Hungarian version of the Berg Balance Scale tested on institutionalised older adults shows excellent test-retest reliability, good internal consistency, and acceptable convergent construct validity. The Hungarian version of the Berg Balance Scale is a valid and reliable tool for measuring postural control among Hungarian-speaking institutionalised older adults both in clinical practice and scientific studies.