Balance in chronic traumatic brain injury: correlations between clinical measures and a self-report measure

ABSTRACT

Objective: To assess associations among commonly used self-report and clinical measures of balance in chronic TBI.

Design: Cross-sectional analysis of balance in a convenience sample of individuals at least one year post TBI.

Main Outcome Measures: Activities-Specific Balance Confidence Scale (ABC) (self-reported balance impairment), Community Balance and Mobility Scale (CB&M) (clinical measure validated in TBI), and Balance Evaluation Systems Test (BESTest) (clinical measure not validated in TBI).

Methods: Fifty-nine individuals (64% male, mean age 48.2 years) ambulating independently within the home participated in testing. Pearson correlation coefficients were used to quantify the direction and magnitude of the relationships among the three balance impairment measures.

Results: A significant positive correlation was noted between the ABC and CB&M (r = 0.42, p = 0.0008), between the ABC and BESTest (r = 0.46, p = 0.0002), and between the CB&M and BESTest (r = 0.86, p < 0.0001).

Conclusions: This is the first study we are aware of in the chronic moderate to severe TBI population directly comparing patient’s self-reported balance impairment with clinical measures. Positive correlations were found between the self-report measure and both clinical measures. Overall, individuals with chronic TBI tend to self-report less impaired balance than clinical measures indicate. These results provide preliminary evidence to support the need for validation of the BESTest in this population.

Abbreviations: ABC: Activities-specific balance confidence scale; BESTest: balance evaluation systems test; BOS: base of support; COM: center of mass; CB&M: community balance and mobility scale; CI: confidence interval; IQR: interquartile range; PTs: physical therapists; SD: standard deviation; SE: standard error; TBI: traumatic brain injury

KEYWORDS:

• Brain injuries
• traumatic
• balance
• outcome assessment
• evidence based medicine

Disclosure Statement

This study was funded under a Traumatic Brain Injury Model Systems Center grant from the National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, Department of Health and Human Services grant number 90DP0034. The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Traumatic Brain Injury Model Systems Center grant from the National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, Department of Health and Human Services [90DP0034].