Construct validity and reliability of the modified gait efficacy scale for older adults

Abstract

Purpose

To perform a cross-cultural adaptation of the mGES into Dutch and investigate its construct validity, internal consistency, test-retest reliability and floor and ceiling effects in a large cohort of community-dwelling older adults.

Materials and methods

We translated the British version of the mGES into Dutch, back into English, and had a native English speaker review the final version. Next, we included 223 community-dwelling older adults from the ‘Veilig in Beweging Blijven’ (VIBE) cohort (69.8 [67.6–74.3] years old, 155 (69.5%) female), who filled out both the mGES and the Falls Efficacy Scale-International (FES-I) twice, with a month in between. Construct validity was assessed by Spearman’s correlation between the scores on the mGES and the FES-I. Internal consistency was assessed with Cronbach’s alpha and test-retest reliability was assessed with the intra class correlation coefficient (ICC(2,1)).

Results

Construct validity (rho = −0.81, p < 0.001), internal consistency (α = 0.95), and test-retest reliability (ICC(2,1)=0.90, 95%CI = [0.87–0.92]) were all excellent. Ceiling effect was observed in 44 (19.7%) participants which suggest caution when evaluating the mGES for fit and confident older adults.

Conclusion

The Dutch mGES is a valid and reliable tool to assess confidence in walking and is suggested as a tool for evaluating self-efficacy after interventions aimed at improving gait.

IMPLICATIONS FOR REHABILITATION

• Assessment and rehabilitation of gait may be affected by self-efficacy of walking performance.

• We show that the Dutch translation of the modified gait efficacy scale is a valid and reliable tool for assessing self-efficacy of walking.

• A ceiling effect was observed that was associated with muscle strength and symptoms of depression.

• The results of the present study underline the use of the modified gait efficacy scale in the assessment and evaluation of self-efficacy of walking in rehabilitation.

Keywords:

• Self efficacy
• elderly
• questionnaires
• walking
• accidental falls

Acknowledgments

We thank Mark Melman and Martine Rog who helped during data collection. We also thank Eli Brenner, Axel Koopman and Naomi Weijer-Schouten for their contribution to the translation process. This research was funded by a VIDI grant [no. 91714344] from the Dutch Organization for Scientific Research (NWO). The mGES has been translated and reprinted by permission of Oxford University Press on behalf of APTA. OUP and APTA are not responsible or in any way liable for the accuracy of the translation. The translators are solely responsible for the translation in this publication.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data will be made available on request.

Additional information

Funding

This research was funded by a VIDI grant [no. 91714344] from the Dutch Organization for Scientific Research (NWO).