Reliability, validity, and responsiveness of three scales for measuring balance in patients with chronic stroke

Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Ga...

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Published in:	BMC neurology Vol. 18; no. 1; pp. 141 - 7
Main Authors:	Alghadir, Ahmad H., Al-Eisa, Einas S., Anwer, Shahnawaz, Sarkar, Bibhuti
Format:	Journal Article
Language:	English
Published:	London BioMed Central 13.09.2018 BioMed Central Ltd Springer Nature B.V BMC
Subjects:	Aged Balance Berg balance scale Care and treatment Cerebrovascular disease and stroke Chronic Disease Dynamic gait index Equilibrium (Physiology) Evaluation Exercise Test Female Gait Health aspects Humans Male Measurement Medical examination Medicine Medicine & Public Health Methods Middle Aged Mobility Limitation Neurochemistry Neurological tests Neurology Neurosurgery Older people Physical medicine and rehabilitation Physical therapists Postural Balance Posture Quantitative psychology Rehabilitation Reproducibility of Results Research Article Stroke Stroke - diagnosis Stroke patients Stroke Rehabilitation Studies Systematic review Timed up and go test Validity Walking Saudi Arabia Stroke Timed up and go test Berg balance scale Rehabilitation Balance Dynamic gait index
ISSN:	1471-2377, 1471-2377
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Abstract	Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke. Methods Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures. Results The reliability of the TUG (intraclass correlation coefficient [ICC 2,1 ] = 0.98), DGI (ICC 2,1 = 0.98) and BBS (ICC 2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = −.52; second reading [r] = −.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively. Conclusions The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results.
AbstractList	Abstract Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke. Methods Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures. Results The reliability of the TUG (intraclass correlation coefficient [ICC2,1] = 0.98), DGI (ICC2,1 = 0.98) and BBS (ICC2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = −.52; second reading [r] = −.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively. Conclusions The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results. Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke.BACKGROUNDVarious outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke.Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures.METHODSFifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures.The reliability of the TUG (intraclass correlation coefficient [ICC2,1] = 0.98), DGI (ICC2,1 = 0.98) and BBS (ICC2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = -.52; second reading [r] = -.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively.RESULTSThe reliability of the TUG (intraclass correlation coefficient [ICC2,1] = 0.98), DGI (ICC2,1 = 0.98) and BBS (ICC2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = -.52; second reading [r] = -.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively.The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results.CONCLUSIONSThe test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results. Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke. Methods Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures. Results The reliability of the TUG (intraclass correlation coefficient [ICC 2,1 ] = 0.98), DGI (ICC 2,1 = 0.98) and BBS (ICC 2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = −.52; second reading [r] = −.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively. Conclusions The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results. Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke. Methods Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures. Results The reliability of the TUG (intraclass correlation coefficient [ICC2,1] = 0.98), DGI (ICC2,1 = 0.98) and BBS (ICC2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = −.52; second reading [r] = −.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively. Conclusions The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results. Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke. Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures. The reliability of the TUG (intraclass correlation coefficient [ICC ] = 0.98), DGI (ICC = 0.98) and BBS (ICC = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = -.52; second reading [r] = -.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively. The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results. Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke. Methods Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures. Results The reliability of the TUG (intraclass correlation coefficient [ICC.sub.2,1] = 0.98), DGI (ICC.sub.2,1 = 0.98) and BBS (ICC.sub.2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = -.52; second reading [r] = -.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively. Conclusions The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results. Keywords: Dynamic gait index, Stroke, Balance, Berg balance scale, Rehabilitation, Timed up and go test Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke. Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures. The reliability of the TUG (intraclass correlation coefficient [ICC.sub.2,1] = 0.98), DGI (ICC.sub.2,1 = 0.98) and BBS (ICC.sub.2,1 = 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading [r] = 0.75; second reading [r] = 0.77), TUG and BBS (first reading [r] = -.52; second reading [r] = -.53), and the TUG and DGI (first reading [r] = 0.45; second reading [r] = 0.48), respectively. The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results.
ArticleNumber	141
Audience	Academic
Author	Anwer, Shahnawaz Sarkar, Bibhuti Alghadir, Ahmad H. Al-Eisa, Einas S.
Author_xml	– sequence: 1 givenname: Ahmad H. surname: Alghadir fullname: Alghadir, Ahmad H. organization: Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University – sequence: 2 givenname: Einas S. surname: Al-Eisa fullname: Al-Eisa, Einas S. organization: Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University – sequence: 3 givenname: Shahnawaz orcidid: 0000-0003-3187-8062 surname: Anwer fullname: Anwer, Shahnawaz email: anwer_shahnawazphysio@rediffmail.com, anwerphysio@gmail.com organization: Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University – sequence: 4 givenname: Bibhuti surname: Sarkar fullname: Sarkar, Bibhuti organization: National Institute for Locomotor Disabilities (Divyangjan)
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/30213258$$D View this record in MEDLINE/PubMed
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Snippet	Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to... Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine... Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to... Abstract Background Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was...
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SubjectTerms	Aged Balance Berg balance scale Care and treatment Cerebrovascular disease and stroke Chronic Disease Dynamic gait index Equilibrium (Physiology) Evaluation Exercise Test Female Gait Health aspects Humans Male Measurement Medical examination Medicine Medicine & Public Health Methods Middle Aged Mobility Limitation Neurochemistry Neurological tests Neurology Neurosurgery Older people Physical medicine and rehabilitation Physical therapists Postural Balance Posture Quantitative psychology Rehabilitation Reproducibility of Results Research Article Stroke Stroke - diagnosis Stroke patients Stroke Rehabilitation Studies Systematic review Timed up and go test Validity Walking
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Title	Reliability, validity, and responsiveness of three scales for measuring balance in patients with chronic stroke
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