Cross-Cultural Adaptation and Psychometric Analysis of the Hindi-Translated Activities-Specific Balance Confidence Scale

Abstract

Background: Falls are very common in older adults. The activities-specific balance confidence (ABC) scale is an instrument used to measure confidence in balance, hitherto available only in the English language. There is a need for a Hindi version of the ABC scale for subjects whose primary language is Hindi, as the availability of a self-administered scale in subjects’ native language will make clinical management and research more effective. Objectives: The aim of this study was to translate the activities-specific balance confidence scale into a Hindi version (ABC-H), crossculturally adapt it, assess its psychometric properties, and establish the normative value of self-perceived balance confidence scores of Indian older adults. Materials and Methods: One hundred community-dwelling, Indian older adults participated in the study. ABC-H was developed through a standard cross-cultural adaptation procedure. Eight items from the original ABC scale were modified. A subsample of 50 subjects was re-assessed for test-retest reliability, standard error of measurement (SEM), minimum detectable change (MDC), and concurrent validity, using the fall efficacy scale (FES-I) to analyze the psychometric properties. Results: The normative value of ABC-H total score observed in the Indian older population (n = 100) was 71%, ranging from 41.25 to 95.63. In the subsample of 50 subjects, test-retest reliability was excellent (ICC = 0.97). All 16 items had excellent to good internal consistency (Cronbach’s α = 0.97 - 0.88); SEM was 2.45, MDC 95 was 6.9%, with excellent concurrent validity (r = -0.85, P < 0.0001). Conclusions: The Hindi version of the ABC scale demonstrated acceptable measurement properties, showing that ABC-H can be used for assessing balance confidence in Hindi-speaking, community-dwelling Indian older adults. It can be an assessment tool either for clinical management or research.