Abstract

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. To determine the relative and absolute reliability, construct validity, and agreement of the short-form Activities-specific Balance Confidence scale. Test-retest with a 2-week interval. 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. 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. 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. 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.

Highlights

  • Clinicians use the Activities-specific Balance Confidence scale to understand balance confidence

  • The test-retest reliability was considered excellent for the Activities-specific Balance Confidence (ABC)-6 in the total study population (ICC = 0.92; 95% confidence interval (CI): 0.87-0.95), the TTA-nonvas group (ICC = 0.95; 95% CI: 0.87-0.98) and the TFA/bilateral group (ICC = 0.90; 95% CI: 0.76-0.96), but was considered good in the transtibial amputation of vascular etiology (TTA-vas) group (ICC = 0.88; 95% CI: 0.72-0.95)

  • This study has demonstrated the Short-form Activities-specific Balance Confidence scale (ABC-6) has good internal consistency and excellent relative reliability, yet worse absolute reliability than the ABC

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Summary

Introduction

Clinicians use the Activities-specific Balance Confidence scale to understand balance confidence. Objective: To determine the relative and absolute reliability, construct validity and agreement of the short-form Activities-specific Balance Confidence scale. Results: The short-form Activities-specific Balance Confidence scale (intraclass correlation coefficient=0.92) and Activities-specific Balance Confidence scale (intraclass correlation coefficient =0.91) had excellent relative reliability. Valid and reliable scales for measuring a concern of falling have been established; one of the most prominent is the Activities-specific Balance Confidence (ABC) Scale.[3] This scale was developed for use in community-dwelling older adults and includes 16 questions addressing balance confidence during the performance of daily activities.[4] Balance confidence is a balance specific type of self-efficacy used to measure fear of falling.[5] The validity and reliability of the ABC has been established in a number of populations,[3,6,7,8,9] including transtibial and transfemoral PLEA.[10]

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