Test-retest reliability and minimal detectable change of two simplified 3-point balance measures in patients with stroke

Eur J Phys Rehabil Med. 2017 Oct;53(5):719-724. doi: 10.23736/S1973-9087.17.04463-X. Epub 2017 Jan 12.

Abstract

Background: The 3-point Berg Balance Scale (BBS-3P) and 3-point Postural Assessment Scale for Stroke Patients (PASS-3P) were simplified from the BBS and PASS to overcome the complex scoring systems. The BBS-3P and PASS-3P were more feasible in busy clinical practice and showed similarly sound validity and responsiveness to the original measures. However, the reliability of the BBS-3P and PASS-3P is unknown limiting their utility and the interpretability of scores.

Aim: We aimed to examine the test-retest reliability and minimal detectable change (MDC) of the BBS-3P and PASS-3P in patients with stroke.

Design: Cross-sectional study.

Setting: The rehabilitation departments of a medical center and a community hospital.

Population: A total of 51 chronic stroke patients (64.7% male).

Methods: Both balance measures were administered twice 7 days apart. The test-retest reliability of both the BBS-3P and PASS-3P were examined by intraclass correlation coefficients (ICC). The MDC and its percentage over the total score (MDC%) of each measure was calculated for examining the random measurement errors.

Results: The ICC values of the BBS-3P and PASS-3P were 0.99 and 0.97, respectively. The MDC% (MDC) of the BBS-3P and PASS-3P were 9.1% (5.1 points) and 8.4% (3.0 points), respectively, indicating that both measures had small and acceptable random measurement errors.

Conclusions: Our results showed that both the BBS-3P and the PASS-3P had good test-retest reliability, with small and acceptable random measurement error. These two simplified 3-level balance measures can provide reliable results over time.

Clinical rehabilitation impact: Our findings support the repeated administration of the BBS-3P and PASS-3P to monitor the balance of patients with stroke. The MDC values can help clinicians and researchers interpret the change scores more precisely.

Publication types

  • Comparative Study

MeSH terms

  • Academic Medical Centers
  • Accidental Falls / prevention & control*
  • Activities of Daily Living / psychology*
  • Age Factors
  • Aged
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Hospitals, Community
  • Humans
  • Male
  • Middle Aged
  • Postural Balance / physiology*
  • Prognosis
  • Psychometrics
  • Reproducibility of Results
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Stroke / diagnosis*
  • Stroke / therapy
  • Stroke Rehabilitation / methods*
  • Treatment Outcome