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Abstract
Background: Fear of falling (FOF) is common among elderly individuals and can appear independently of a previous fall. FOF can start a vicious cycle by leading to a sedentary lifestyle and further FOF, with negative physical and mental consequences. The Activities-Specific Balance Confidence (ABC) scale is a popular, theoretically based, reliable and valid tool designed to assess FOF in ambulatory, community-dwelling, elderly people. A balance confidence measurement tool for Arabic-speaking ambulatory, community-dwelling, elderly individuals is lacking. The objective of the present study was to translate and culturally adapt the ABC to Arabic and to determine its psychometric properties in ambulatory, community-dwelling elderly people.
Materials and methods: This two-stage exploratory study included a forward and backward translation process and the administration of the Arabic ABC (A-ABC) via face-to-face interviews. In addition, performance-based clinical measures of balance were assessed, and two self-report physical function and disability questionnaires were administered. The study included 60 volunteers (34 women), with a mean age of 74.1±6.23 years, recruited from the Arab population of northern Israel. To determined test–retest reliability, the questionnaire was re-administered to 40 of the 60 participants twice at a 6–8-day interval.
Results: One of the 16 A-ABC scale items was modified to adjust for local climate. The main results included high internal consistency (Cronbach’s α=0.97), good to excellent structural coherence (corrected item-total correlation: 0.77–0.92); excellent test–retest reliability (ICC=0.98, confidence interval =0.08−3.05); low standard error of measure and low smallest real difference (3.5% and 9.64%, respectively); strong-to-moderate correlations with performance-based clinical measures of balance and self-report physical function and disability questionnaires; and a ceiling effect. A significant difference between genders and between fallers and non-fallers was demonstrated.
Conclusions: The A-ABC demonstrated excellent psychometric properties in elderly, Arabic-speaking, independently living individuals and can be used as a balance confidence measurement tool in research and clinical settings.
Acknowledgments
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Abbreviations list
FOF, fear of falling; ABC, Activities-Specific Balance Confidence scale; A-ABC, Arabic translation of the Activities-Specific Balance Confidence scale; LLFDI, Late-Life Function and Disability Instrument; MEG, Michal Elboim-Gabyzon; MA, Maayan Agmon; PF, Arabic version of the Physical Function component of the Short Form General Health Survey questionnaire; PCS, Physical Component of the Short Form General Health Survey questionnaire; SF-36, Short Form General Health Survey questionnaire; TUG, Timed Up and Go test; BBS, Berg Balance Scale; SD, standard deviations; ICC, intra-class correlation coefficient; SEM, standard error of measure; SRD, smallest real difference; CI, confidence interval; n, number; cm, centimeter; kg, kilograms; BMI, body mass index.
Data sharing statement
The dataset used and analyzed during the current study is available from the corresponding author on reasonable request.
Author Contributions
All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.