Interrater and Intrarater Reliability of the Balance Computerized Adaptive Test in Patients With Stroke

Abstract

Objective: To examine the interrater and intrarater reliability of the Balance Computerized Adaptive Test (Balance CAT) in patients with chronic stroke having a wide range of balance functions.

Design: Repeated assessments design (1wk apart).

Setting: Seven teaching hospitals.

Participants: A pooled sample (N=102) including 2 independent groups of outpatients (n=50 for the interrater reliability study; n=52 for the intrarater reliability study) with chronic stroke.

Interventions: Not applicable.

Main outcome measures: Balance CAT.

Results: For the interrater reliability study, the values of intraclass correlation coefficient, minimal detectable change (MDC), and percentage of MDC (MDC%) for the Balance CAT were .84, 1.90, and 31.0%, respectively. For the intrarater reliability study, the values of intraclass correlation coefficient, MDC, and MDC% ranged from .89 to .91, from 1.14 to 1.26, and from 17.1% to 18.6%, respectively.

Conclusions: The Balance CAT showed sufficient intrarater reliability in patients with chronic stroke having balance functions ranging from sitting with support to independent walking. Although the Balance CAT may have good interrater reliability, we found substantial random measurement error between different raters. Accordingly, if the Balance CAT is used as an outcome measure in clinical or research settings, same raters are suggested over different time points to ensure reliable assessments.

Keywords: Postural balance; Rehabilitation; Reproducibility of results; Stroke.