Discriminative ability of the original and short form of the Activities-specific Balance Confidence scale and its individual items for falls in people with multiple sclerosis

Zuhal Abasıyanık; Turhan Kahraman; Cavid Baba; Özge Sağıcı; Özge Ertekin; Serkan Özakbaş; Multiple Sclerosis Research Group

doi:10.1007/s13760-024-02515-y

Discriminative ability of the original and short form of the Activities-specific Balance Confidence scale and its individual items for falls in people with multiple sclerosis

Acta Neurol Belg. 2024 Mar 14. doi: 10.1007/s13760-024-02515-y. Online ahead of print.

Authors

Zuhal Abasıyanık^{1

2}, Turhan Kahraman^{3

4}, Cavid Baba⁵, Özge Sağıcı⁵, Özge Ertekin⁶, Serkan Özakbaş⁷; Multiple Sclerosis Research Group

Affiliations

¹ Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey. zuhalabasiyanik@gmail.com.
² Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey. zuhalabasiyanik@gmail.com.
³ Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
⁴ Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK.
⁵ Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey.
⁶ Department of Neurological Physiotherapy-Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
⁷ Izmir University of Economics, Medical Point Hospital, Izmir, Turkey.

PMID: 38483733
DOI: 10.1007/s13760-024-02515-y

Abstract

Background: Balance confidence is an essential component of fall risk assessment in persons with multiple sclerosis (pwMS).

Aims: The aims of this cross-sectional study were to 1) investigate the ability of the 16-item Activities-specific Balance Confidence scale (ABC-16), 6-item Activities-specific Balance Confidence scale (ABC-6), and each item of the ABC-16 for distinguishing fallers and 2) determine cutoff scores for these scales to discriminate fallers and non-fallers in pwMS.

Methods: One hundred and fifty-six participants [fallers/non-fallers: 60 (38.5%)/96 (61.5%), median EDSS: 1.5] were enrolled. Balance confidence was assessed using the ABC-16 and ABC-6. The self-reported number of falls in the past three months was recorded. Descriptive assessments, including walking, balance, and cognition were performed. Logistic regression and receiver operating characteristic analyses were conducted to estimate the sensitivities and specificities of the ABC-16 and ABC-6.

Results: Both the ABC-16 (AUC: 0.85) and ABC-6 (AUC: 0.84) had the discriminative ability for falls. Each item of the ABC-16 scale was a significantly related to falls [odds ratio (OR) range: 1.38 to 1.89]. Items 8 and 10 had the highest odds ratio (OR: 1.85; 95%CI: 1.47-2.33, OR: 1.89; 95%CI: 1.49-2.40; respectively). We found cutoff scores of ≤ 70 of 100 (sensitivity: 71.67, specificity: 86.46) and ≤ 65/100 (sensitivity: 76.67, specificity: 79.17) in discrimination between fallers and non-fallers for the ABC-16 and ABC-6, respectively.

Conclusion: Both original and short forms of the ABC scale are an efficient tool for discriminating fallers and non-fallers in pwMS. Although all items are related to falls, outdoor walking activities have the strongest associations with falls than other items.

Keywords: Activities-specific Balance Confidence scale; Balance confidence; Falls; Multiple sclerosis; Sensitivity; Specificity.