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

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.

KEYWORDS:

• ABC Scale
• balance confidence
• COPD
• fall status
• validity

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).