Group- and Individual-Level Responsiveness of the 3-Point Berg Balance Scale and 3-Point Postural Assessment Scale for Stroke Patients

Yi-Jing Huang; Gong-Hong Lin; Shih-Chieh Lee; Yi-Miau Chen; Sheau-Ling Huang; Ching-Lin Hsieh

doi:10.1016/j.apmr.2017.08.472

Group- and Individual-Level Responsiveness of the 3-Point Berg Balance Scale and 3-Point Postural Assessment Scale for Stroke Patients

Arch Phys Med Rehabil. 2018 Mar;99(3):529-533. doi: 10.1016/j.apmr.2017.08.472. Epub 2017 Sep 9.

Authors

Yi-Jing Huang¹, Gong-Hong Lin¹, Shih-Chieh Lee¹, Yi-Miau Chen², Sheau-Ling Huang³, Ching-Lin Hsieh⁴

Affiliations

¹ School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
³ School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: cathy@ntu.edu.tw.
⁴ School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan.

PMID: 28899824
DOI: 10.1016/j.apmr.2017.08.472

Abstract

Objectives: To examine both group- and individual-level responsiveness of the 3-point Berg Balance Scale (BBS-3P) and 3-point Postural Assessment Scale for Stroke Patients (PASS-3P) in patients with stroke, and to compare the responsiveness of both 3-point measures versus their original measures (Berg Balance Scale [BBS] and Postural Assessment Scale for Stroke Patients [PASS]) and their short forms (short-form Berg Balance Scale [SFBBS] and short-form Postural Assessment Scale for Stroke Patients [SFPASS]) and between the BBS-3P and PASS-3P.

Design: Data were retrieved from a previous study wherein 212 patients were assessed at 14 and 30 days after stroke with the BBS and PASS.

Setting: Medical center.

Participants: Patients (N=212) with first onset of stroke within 14 days before hospitalization.

Interventions: Not applicable.

Main outcome measures: Group-level responsiveness was examined by the standardized response mean (SRM), and individual-level responsiveness was examined by the proportion of patients whose change scores exceeded the minimal detectable change of each measure. The responsiveness was compared using the bootstrap approach.

Results: The BBS-3P and PASS-3P had good group-level (SRM, .60 and SRM, .56, respectively) and individual-level (48.1% and 44.8% of the patients with significant improvement, respectively) responsiveness. Bootstrap analyses showed that the BBS-3P generally had superior responsiveness to the BBS and SFBBS, and the PASS-3P had similar responsiveness to the PASS and SFPASS. The BBS-3P and PASS-3P were equally responsive to both group and individual change.

Conclusions: The responsiveness of the BBS-3P and PASS-3P was comparable or superior to those of the original and short-form measures. We recommend the BBS-3P and PASS-3P as responsive outcome measures of balance for individuals with stroke.

Keywords: Outcome assessment (health care); Postural balance; Psychometrics; Rehabilitation; Stroke.

Publication types

Validation Study

MeSH terms

Aged
Disability Evaluation*
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Outcome Assessment, Health Care / methods*
Postural Balance / physiology*
Psychometrics
Reproducibility of Results
Stroke / physiopathology*
Stroke Rehabilitation*
Treatment Outcome