Unified Balance Scale: An activity-based, bed to community, and aetiology-independent measure of balance calibrated with Rasch analysis
Fabio La Porta, Marco Franceschini, Serena Caselli, Paola Cavallini, Sonia Susassi, Alan Tennant
Objective: To build a new activity-based, “bed to community”, aetiology-independent measure of balance within the neurological rehabilitation setting by merging some existing scales.
Methods: Balance scales were selected using a conceptual framework and subsequently administered to a convenience sample of adult patients with balance problems due to different neurological aetiologies. Data were then processed using classical psychometric analyses and Rasch analysis in order to construct a new balance measurement tool.
Results: The Berg Balance Scale, the Tinetti Scales and the Fullerton Advanced Balance Scale were selected and administered to a sample of patients, giving 302 observations. Classical psychometric analyses (item and scale analysis; confirmatory factor analysis) were undertaken on the pooled 40-item set with confirmation of unidimensionality. The subsequent Rasch analysis allowed the identification of a 27-item set satisfying the Rasch Model’s requirements for fundamental measurement, with further confirmation of unidimensionality by post-hoc confirmatory factor analysis.
Conclusion: The new scale (Unified Balance Scale) holds proven measurement properties and may be a candidate tool for “bed to community” balance measurement for
patients with balance problems within the neuro-rehabilitation setting. Future studies are warranted to explore further its external validity and other clinical properties, as well as to improve its usability.
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