Background: The Pediatric Balance Scale (PBS) and the Fullerton Advanced Balance (FAB) scale were used to assess balance function in patients with balance problem. These multidimensional clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate and compare the predictive properties of the PBS and FAB scales relative to fall risk in children with cerebral palsy (CP) using a receiver operating characteristic analysis. Methods: In total, 49 children with CP (boy=21, girl=28) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS and FAB were performed, and verified cut-off score, sensitivity, specificity, and the area of under the curve (AUC). Results: In this study, the PBS scale was as a predictive measure of fall risk, but the FAB was not significant in children with CP. A cut-off score of 45.5 points provided optimal sensitivity of .90 and specificity of .69 on the PBS, and a cut-off score of 21.5 points provided optimal sensitivity of .90 and specificity of .62 on the FAB. Both scales showed moderately accurate of AUC with .79 and .76, respectively. Conclusion: The PBS is a useful screening tool for predicting fall risk in children with cerebral palsy, and those who score 45.5 or lower indicate a high risk for falls and are in need of balance intervention.
Background: Rasch analysis has the advantage of placing both the items and the person along a single ratio scale and calibrates person ability and item difficulty onto an interval scale by logits. Therefore, Rasch analysis has been recommended as a better method for evaluating functional outcome questionnaires than traditional analyses. Objects: The aim of current study was to investigate item fit, item difficulty, rating scale, and separation index of the Korean version of the Fullerton Advanced Balance (KFAB) scale using Rasch analysis. Methods: In total, 93 patients with stroke (male=58, female=35) participated in this study. To investigate the item fit, difficulty, rating scale, and separation index of the KFAB scale, Rasch analysis was completed by the Winsteps software program. Results: In this study, all items of the KFAB scale were included in the Rasch model. The most difficult item was 'standing with feet together and eyes closed', and the easiest item was 'two-footed jump'. The rating scale was a 4-point scale instead of the original 5-point scale. Person and item separation indices showed high values that can identify a person with a wide range of balance ability. Conclusion: The KFAB scale appears to be a reliable and valid tool to assess balance function in patients with stroke. Furthermore, the scale was found to discriminate among stroke patients of varying balance abilities.
The purpose of this study were to translate the Fullerton Advanced Balance (FAB) scale into Korean and to verify the content validity by utilizing a back-translation method with a view to assessing balance function and the risk of falling in a clinical research setting. This research was conducted in six steps. First, three Korean physical therapists translated the FAB scale into Korean. Second, two bilingual professors of physical therapy and a physical therapist evaluated translation conformity of Korean-translated FAB scale. In the third and fourth steps, twelve physical therapists evaluated the degree of translation comprehension, and a translator back-translated the Korean FAB scale into the original language. Fifth, a bilingual professor of physical therapy and two native speakers evaluated the technical and conceptual equivalence between the original and translation versions. In this process, inappropriate translated items were revised using recommended substitute words or sentences, and all items were evaluated on the basis of three points or more on a rating scale in terms of translation comprehension, and the technical and conceptual equivalence of the back-translation. In the sixth and last step, the translation verification committee completed the final Korean version. The above process indicated that the content validity of the Korean-translated FAB scale was established by means of systematic translation methods, and it can therefore be used to assess balance function and the risk of falls in a clinical research setting.
Background: The assessment tool developed in other countries should be translated into Korean language using rigorous methodological approaches in order to be used in Korea. Because these procedures are insufficient for establishing the cross-cultural and linguistic equivalence, the need for statistical methods is raised. The Fullerton Advanced Balance Scale was translated into Korean and the content validity was verified through the back translation method, but the reliability and validity have not yet been proven by statistical methods. Objects: The purpose of this study was to investigate the reliability and validity of the Korean version of the Fullerton Advanced Balance Scale (KFAB) by statistical methods in elderly people. Methods: A total of 97 elderly adults (39 males and 58 females) participated in this study. Internal consistency of the KFAB was measured using Cronbach's alpha and an intraclass correlation coefficient (ICC) was used to assess test-retest reliability between the two measurement sessions. Concurrent validity was measured by comparing the KFAB responses with the Korean version of the Berg Balance Scale (KBBS) using the Spearman correlation coefficient. Construct validity of the KFAB was measured using the exploratory factor analysis to evaluate the unidimensionality of the questionnaire. The significance level was set at ${\alpha}=.05$. Results: The internal consistency of the KFAB was found be adequate with Cronbach's alpha (.96), and test-retest reliability was excellent as evidenced by the high ICC (r=.996). Concurrent validity showed high correlation between the KFAB and KBBS (r=.89, p<.001). Construct validity was evaluated using exploratory factor analysis. The result from Bartlett test of sphericity was statistically significant (p<.001), and the value of Kaiser-Meyer-Olkin measure of sampling adequacy was .93. Exploratory factor analysis revealed the existence of only one dominant factor that explained 76.43% of the variance. Conclusion: The KFAB is a reliable, valid and appropriate tool for measuring the balance functions in elderly people.
Kim, In-seop;Nam, Taek-gil;Kim, Gyoung-mo;Kim, Jun-seop;Kim, So-jeong;Kang, Jeong-ha
Physical Therapy Korea
/
v.25
no.1
/
pp.39-46
/
2018
Background: The Berg Balance Scale (BBS) and the Fullerton Advanced Balance (FAB) scale have been used to assess balance function in patients with chronic stroke. These clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate the incidence of and risk factors of falls and compare the predictive values of the BBS and FAB scale relative to fall risk in patients with stroke through receiver operating characteristic analysis. Methods: Sixty-three patients with stroke (faller=34, non-faller=29) who could walk independently for 10 meters participated in this study. The BBS and FAB scale were administered. Then, we verified the cut-off score, sensitivity, specificity, and the area of under the curve. Results: In this study, the BBS and FAB scale did not predict fall risk in patients with stroke in the receiver operator characteristic curve analysis. A cut-off score of 37.5 points provided sensitivity of .47 and specificity of .35 on the BBS, and a cut-off score of 20.5 points provided sensitivity of .44 and specificity of .45 on the FAB scale. Conclusion: The BBS and FAB scale were not useful screening tools for predicting fall risk in patients with stroke in this study, but those who scored 37.5 or lower on the BBS and 20.5 or lower on the FAB scale had a high risk for falls.
Background: Rasch analysis estimates the probability that a respondent will endorse an item and select a particular rating for that item. It has the advantage of placing both the items and the person along a single ration scale and calibrates person ability and item difficulty onto an interval scale by logits. In addition, Rasch analysis is a useful tool for exploring the validity of questionnaires that have been developed using traditional methods. Therefore, it has been recommended as a method for developing and evaluating functional outcome measures. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of the Fullerton Advanced Balance Scale (KFAB) using Rasch analysis. Methods: Total 97 subjects (39 males and 58 females) with dwelling elderly adults were participated, but 3 people were excluded for misfit persons. Rasch analysis was then done by means of the Winsteps program to determine the item fit, item difficulty, rating scale, and reliability of the KFAB. Results: In this study, the 'standing with feet together and eyes closed', 'two-footed jump', 'walk with head turns', and 'stand on foam, eyes closed' items shown misfit statistics. The most difficult item was 'stand on one leg', whereas the easiest item was 'turn in full circle'. The rating scale was acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. This would indicated that each domain covers a useful range of item difficulty that is appropriate for measuring a person with a wide range of functional ability. Conclusion: The KFAB has been proven reliable, valid and an appropriate tool with which to evaluate the balance of the elderly people.
Purpose: The aim of this study was to determine the effect of side walking on balance confidence, falls efficacy and fall risk in acute stroke patients. Methods: The study included 14 patients with acute stroke who were randomly allocated to a side walking group (Experimental group, N=7) and a forward walking group (Control group, N=7). Both groups performed the exercise 5 times a week for 2 weeks. Outcomes were assessed using Korean-Activities-specific Balance Confidence Scale (K-ABC), Korean-Fall Efficacy Scale (K-FES), Korean-Fullerton Advanced Balance Scale (K-FAB). Results: After 2 weeks of training, both groups showed significantly improved ABC, FES, FAB (p<.05 in both groups). However, the ABC, FES, FAB in the experimental group was significantly better than in the control group (p<.05). Conclusion: These findings indicate that side walking training may be effective at improving balance confidence and decreasing fall down risk in early stroke patients. Therefore, side walking training may be recommended as an intervention in reducing the incidence of falls in acute stroke patient.
Journal of the Korean Society of Physical Medicine
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v.12
no.4
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pp.139-146
/
2017
PURPOSE: The purpose of this study was to systematically analyze the reliability and validity of the Korean-version of the balance assessment tools. METHODS: Two reviewers of this study independently evaluated the titles of articles and abstracts of studies published until December 2016 through electronic databases (RISS, NDSL, KISS, DBpia) using the keywords "Balance or posture or postural control or postural stability", "Test or assessment or measurement or outcome measure or assessment tool or measurement tool", "Korean version", "Reliability" and "Validity". Regarding the questions considered suitable for the purpose of this study, consensus was reached after reading the full text. Selecting journals suitable for the purpose of the study, they were analyzed as data. RESULTS: The reviewers selected nine papers suitable for the purpose of this study, and Korean-version of the balance assessment tools, included the Berg Balance Scale (BBS), Activities-specific Balance Confidence (ABC) scale, Postural Assessment Scale for Stroke (PASS), Motor Assessment Scale (MAS), Trunk Impairment Scale (TIS), Falls Efficacy Scale (FES), Tinetti-Balance scale, Fullerton Advanced Balance (FAB) scale, and Function In Sitting Test (FIST). Our study showed that the reliability and validity of the Korean-version of the balance assessment tools were high. CONCLUSION: The Korean-version of the balance assessment tools with high reliability and validity would enable physical therapists to make a more accurate evaluation of balance.
Objective: The purpose of this study was to investigate the effects of anon-contact complex exercise program on muscle strength, fall efficacy, quality of life, and balance ability in older over 65 years of age. Design: A randomized controlled trial Methods: A total of 37 people in older over 65 years of age participated in the study. Random program was conducted and assigned to the experimental group (n=19) and the control group (n=18). Both groups performed the older people welfare center program. In addition, in the experimental group, a non-contact complex exercise program for muscle and balance exercise was performed. All interventions were performed 2 times a week, for a total of 6 weeks. chair stand test (CST), fall efficacy scale (FES), Euro quality of life 5 dimension (EQ-5D), Berg balance scale (BBS), timed up and go test (TUG), Fullerton advanced balance scale (FAB) were measured before and after the intervention to compare their effectiveness. Results: Both groups showed significant differences in CST, FES, EQ-5D, BBS, and TUG before and after intervention (p<0.05). FAB showed significant differences before and after intervention in all items except for FAB 8 and 9 items in the experimental group. In addition, the experimental group showed significant differences in CST, FES, BBS, TUG, FAB (except 1, 7, 8, 9) compared to the control group (p<0.05). Conclusions: The non-contact complex exercise program is an effective intervention method that has clinical significance in improving muscle strength, fall efficacy and static and dynamic balance abilities for the older over 65 years of age.
Journal of the Korean Society of Physical Medicine
/
v.19
no.1
/
pp.81-94
/
2024
PURPOSE: This study aimed to investigate the effect of a progressive balance training program with whole-body vibration stimulation on knee joint pain, dysfunction, psychosocial status, and balance ability in individuals aged ≥ 65 years with knee osteoarthritis. METHODS: A total of 40 individuals aged ≥ 65 years with osteoarthritis of the knees participated in the study. Using a randomization program, participants were assigned to an experimental group (n = 20) or a control group (n = 20). Both groups were assigned a knee strength training program, and a progressive balance training program with whole-body vibration stimulation was assigned to the experimental group. All interventions were conducted three times a week for four weeks. Participants were evaluated for the following: pain (numeric rating scale, NRS), knee dysfunction (Korean version of the Western Ontario and McMaster Universities Arthritis Index, K-WOMAC), fall efficacy (Korean Version Falls Efficacy Scale, K-FES), quality of life (Euro Quality of life 5 Dimension, EQ-5D), and advanced balance scale score (Fullerton advanced balance scale, FAB) before and after the intervention, and the effects of the intervention were compared accordingly between groups. RESULTS: Both groups showed significant differences in the results of the NRS, K-WOMAC, K-FES, and EQ-5D assessments before and after the intervention, and there was a significant difference in the amount of change between the two groups (p < .05). There was a significant improvement in FAB in all but items FAB 8 and FAB 9 after the intervention in the experimental group. In the control group, there was a significant improvement in FAB 1, FAB 2, FAB 7, and FAB total after the intervention (p < .05). In addition, there was a significant difference in the amount of change between the two groups in all items except FAB 8 and FAB 9 (p < .05). CONCLUSION: The progressive balance training program with whole body vibration stimulation is an effective intervention method with clinical significance in improving knee joint pain, knee disability index, psychosocial level, and balance ability in adults aged ≥ 65 with osteoarthritis of the knees.
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