Reliability, validity, and responsiveness of three scales for measuring balance in patients with chronic stroke

Ahmad H Alghadir, Einas S Al-Eisa, Shahnawaz Anwer, Bibhuti Sarkar, Ahmad H Alghadir, Einas S Al-Eisa, Shahnawaz Anwer, Bibhuti Sarkar

Abstract

Background: Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke.

Methods: Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures.

Results: The reliability of the TUG (intraclass correlation coefficient [ICC2,1] = 0.98), DGI (ICC2,1 = 0.98) and BBS (ICC2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = -.52; second reading [r] = -.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively.

Conclusions: The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results.

Keywords: Balance; Berg balance scale; Dynamic gait index; Rehabilitation; Stroke; Timed up and go test.

Conflict of interest statement

Ethics approval and consent to participate

The institutional ethics committee, Rehabilitation Research Chair, King Saud University, Riyadh, Saudi Arabia, approved this study. An informed consent form was signed by each participant.

Consent for publication

Not applicable.

Competing interests

There are no competing interests reported by any authors.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Bland-Altman plot showing reliability of the Timed up and go test (TUG)
Fig. 2
Fig. 2
Bland-Altman plot showing reliability of the Dynamic gait index (DGI)
Fig. 3
Fig. 3
Bland-Altman plot showing reliability of the Berg balance scale (BBS)

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