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Expert Review of Respiratory Medicine Volume 16, 2022 - Issue 6
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Original Research

Validity of the Activities-specific Balance Confidence Scale in individuals with chronic obstructive pulmonary disease

Sanaa A. Alsubheena School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, CanadaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-9841-7522View further author information
ORCID Icon,
Marla K. Beauchampa School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada;b Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, CanadaORCID Iconhttps://orcid.org/0000-0003-2843-388XView further author information
ORCID Icon,
Cindy Ellertonb Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada;c Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaView further author information
,
Roger Goldsteinb Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada;c Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;d Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada;e Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaView further author information
,
Jennifer A. Alisonf School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia;g Allied Health, Sydney Local Health District, Sydney, AustraliaORCID Iconhttps://orcid.org/0000-0002-2011-4756View further author information
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Gail Dechmanh School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada;i Department of Medicine, Respirology, Dalhousie University and Nova Scotia Health Authority, Halifax, NS, CanadaView further author information
,
Kimberley J. Hainesj Physiotherapy Department, Western Health, Melbourne, AustraliaView further author information
,
Samantha L. Harrisonk School of Health and Life Sciences, Teesside University, Middlesbrough, UKView further author information
,
Anne E. Hollandl Department of Physiotherapy, Alfred Health, Melbourne, Australia;m Respiratory Research, Monash University, Melbourne, Australia;n Institute for Breathing and Sleep, Melbourne, AustraliaORCID Iconhttps://orcid.org/0000-0003-2061-845XView further author information
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Annemarie L. Leen Institute for Breathing and Sleep, Melbourne, Australia;o Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia;p Department of Allied Health Research, Cabrini Health, Malvern, AustraliaView further author information
,
Alda Marquesq Research and Rehabilitation Laboratory, School of Health Sciences, ESSUA) and Institute of Biomedicine, iBiMED), University of AveiroLab3R-Respiratory, Aveiro, PortugalView further author information
,
Lissa Spencerf School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia;r Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, AustraliaORCID Iconhttps://orcid.org/0000-0002-2358-0736View further author information
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Michael Sticklands Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;t G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, CanadaView further author information
,
Elizabeth H. Skinnerj Physiotherapy Department, Western Health, Melbourne, Australia;o Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, AustraliaORCID Iconhttps://orcid.org/0000-0003-0268-7160View further author information
ORCID Icon &
Dina Brooksc Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;d Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada;e Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;m Respiratory Research, Monash University, Melbourne, AustraliaORCID Iconhttps://orcid.org/0000-0001-6080-5052View further author information
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Pages 689-696 | Received 21 Dec 2021, Accepted 09 Jun 2022, Published online: 12 Jul 2022
 
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ABSTRACT

Background

Limited research assessed the validity of the Activities-specific Balance Confidence, ABC) Scale in individuals with chronic obstructive pulmonary disease, COPD) at risk of falls. We report on the scale’s construct and criterion validity.

Methods

Construct validity was established by assessing known groups, convergent, and divergent validity. A receiver operating characteristic, (ROC) curve and logistic regression examined the criterion validity of the scale.

Results

In 223 individuals with COPD, the ABC Scale significantly, (p < 0.001) discriminated between groups, with lower scores for females [Mean difference (MD) = 10%], rollator use [MD = 13%], and fallers [MD = 12%], and had a strong association [r = 0.58, p < 0.001] with Berg Balance Scale. The scale distinguished fallers from non-fallers with a cutoff value of 58% [Area Under the Curve = 0.64, 95% CI = 0.57–0.72, p < 0.001] and significantly identified fall status [B, SE = −0.03, 0.01, p < 0.001] with an odds ratio of 0.97 [95%CI = 0.96–0.99]. The sensitivity, specificity, and test accuracy were: 61, 58, and 60%, respectively.

Conclusion

The ABC Scale showed evidence for known groups, convergent, and divergent validity and can assist in identifying fall status in individuals with COPD.

Article highlights

  • Individuals with COPD are at high risk of falls

  • The ABC Scale is a valid tool for assessing balance confidence and fall status in individuals with COPD

  • Assessing balance confidence in COPD can guide clinicians in managing the risk of falls in individuals with COPD

Acknowledgments

Dr. Dina Brooks holds the National Sanitarium Association, (NSA) Chair in Respiratory Rehabilitation Research. Dr. Marla Beauchamp holds a Tier 2 Canada Research Chair in Mobility, Aging, and Chronic Disease. Dr. Samantha Harrison, Advanced Fellow (NIHR300856) is funded by the National Institute for Health Research.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

S.A. Alsubheen: Conceptualization, Formal analysis, Methodology, Writing - original draft, Writing - review & editing, & approval of final version. M. Beauchamp: Conceptualization, Data curation, Formal analysis, Methodology, Writing - review & editing, & approval of final version. C. Ellerton: Data curation, Methodology, Writing - review & editing, & approval of final version. R. Goldstein: Supervision, Writing - review & editing, & approval of final version. J.A. Alison: Data curation, Writing - review & editing, & approval of final version. G. Dechman: Data curation, Writing - review & editing, & approval of final version. K.J. Haines: Data curation, Writing - review & editing, & approval of final version. S.L. Harrison: Data curation, Writing - review & editing, & approval of final version. A.E. Holland: Data curation, Writing - review & editing, & approval of final version. A.L. Lee: Data curation, Writing - review & editing, & approval of final version. A. Marques: Data curation, Writing - review & editing, & approval of final version. L. Spencer: Data curation, Writing - review & editing, & approval of final version. M. Stickland: Data curation, Writing - review & editing, & approval of final version. E.H. Skinner: Data curation, Writing - review & editing, & approval of final version. D. Brooks: Conceptualization, Formal analysis, Funding acquisition, Methodology, Writing - review & editing, & approval of final version.

All authors agree to be accountable for all aspects of the work

Additional information

Funding

This study was funded by the Canadian Institute of Health Research, (CIHR). Funding Reference Number (FRN-CIHR: 363312).

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