ABSTRACT
Background
Patients experience falls frequently after stroke. Preserved or acquired balance skills decrease fall risk and improve independence. Feasibility of Fullerton Advanced Balance Scale (FAB) has been shown in balance assessment in some neurological diseases except stroke.
Objectives
The purpose of this study was to investigate the reliability and validity of Turkish version of FAB (FAB-T) in patients with stroke (PwS).
Methods
This cross-sectional study included 51 PwS (60.64 ± 7.66 years). Reliability analyses were conducted with Cronbach’s alpha, intraclass correlation coefficient (ICC), and Spearman correlation analysis. Intra-rater and inter-rater reliability were assessed with three raters. FAB-T, Stroke Rehabilitation Assessment of Movement (STREAM), Brunnstrom Recovery Stages (BRS), Barthel Index (BI), and 36-Item Short Form Health Survey (SF-36) were used for convergent validity. Correlations of FAB-T with Berg Balance Scale (BBS) and Mini-Balance Evaluation Systems Test (Mini-BESTest) were measured for concurrent validity. Spearman correlation analysis was used for convergent and concurrent validity. For predictive validity patients’ self-reports of falling were analyzed with ROC.
Results
Intra-rater (ICC = 0.998) and inter-rater reliability (ICCs = 0.984; 0.984; 0.990), and internal consistency (Cronbach’s alpha = 0.930) were excellent. FAB-T had good correlations with STREAM (ρ = 0.677) and BI (ρ = 0.628), moderate correlations with BRS (ρ = 0.504 and ρ = 0.579) and physical function of SF-36 (ρ = 0.436). FAB-T excellently correlated with Mini-BESTest and BBS (ρ = 0.928 and ρ = 0.942). The cutoff score of FAB-T was determined to be 21.5 points, with sensitivity of 84% and specificity of 61% (AUC = 0.749).
Conclusions
FAB-T is a reliable and valid balance assessment tool with an acceptable accuracy of fall prediction in PwS.
Acknowledgments
The authors thank all therapists, patients with stroke and their caregivers who participated in this study.
Disclosure statement
The authors conformed to the ICMJE Form for Disclosure of Potential Conflicts of Interest and reported no conflicts of interest.
Authors contribution
Concept/idea/research design: N. Köse, A. Fil-Balkan, E. Kızılkaya
Writing: E. Kızılkaya, A. Fil-Balkan
Data collection: E. Kızılkaya
Data analysis: J. Karakaya, N. Köse, A. Fil-Balkan, E. Kızılkaya
Project management: E. Kızılkaya
Providing participants: S. Ü. Delialioğlu, N. Köse, A. Fil-Balkan
Providing facilities/equipment: S. Ü. Delialioğlu,
Consultation (including review of manuscript before submitting and final approval): All authors
Ethics approval
The study was approved by Hacettepe University Non-Interventional Clinical Researches Ethics Board (2019/20–02). All participants signed the written informed consent after being elucidated by the researcher. All procedures were conducted in accordance with the Declaration of Helsinki.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/10749357.2023.2235800