Psychometric properties of Fullerton Advanced Balance Scale in patients with stroke


Kızılkaya E., KÖSE N., Ünsal Delialioğlu S., Karakaya J., FİL BALKAN A.

Topics in Stroke Rehabilitation, vol.31, no.2, pp.145-156, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 2
  • Publication Date: 2024
  • Doi Number: 10.1080/10749357.2023.2235800
  • Journal Name: Topics in Stroke Rehabilitation
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.145-156
  • Keywords: Fullerton Advanced Balance Scale, rehabilitation, reliability, stroke, validity
  • Hacettepe University Affiliated: Yes

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.