Psychometric properties of Fullerton Advanced Balance Scale in patients with stroke

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.

KEYWORDS:

• Fullerton Advanced Balance Scale
• stroke
• reliability
• validity
• rehabilitation

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

Additional information

Funding

The authors reported there is no funding associated with the work featured in this article.