Validity of the Community Balance and Mobility Scale in community-dwelling persons after stroke.

OBJECTIVES To examine the convergent validity, sensitivity to change, floor and ceiling effects of the Community Balance and Mobility Scale (CB&M) in community-dwelling stroke survivors. The secondary objective was to determine the correlations between the CB&M and lower-limb motor recovery and strength. DESIGN Validity study. SETTING Two university-based research centers. PARTICIPANTS Community-dwelling persons after stroke (N=44; 24 men, 20 women; mean age, 62.6+/-12.6y). Baseline measures were taken 3 months after the onset of stroke (98.6+/-52.6d); participants were reassessed 8 months poststroke (246.8+/-57.2d). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES CB&M, Berg Balance Scale (BBS), Timed Up & Go (TUG), Chedoke McMaster Stroke Assessment (CMSA) Impairment Inventory for leg and foot, concentric bilateral isokinetic strength of the lower-limb flexor and extensor muscle groups using a dynamometer. The magnitude of the associations and the standardized response means (SRMs) among the CB&M, BBS, and TUG were used to examine the convergent validity and sensitivity to change, respectively. RESULTS Moderate to high convergent validities (rho=.70 to .83, P<.001) were observed among the CB&M, BBS, and TUG. The CB&M was moderately correlated with the CMSA leg and foot scores (rho=.61 and .63, respectively, P<.001) and the paretic limb strength (rho=.67, P<.001). The CB&M demonstrated the greatest ability to detect change between the baseline and follow-up assessments (SRM=.83). CONCLUSIONS The CB&M is valid and sensitive to change in assessing functional balance and mobility in ambulatory stroke survivors with moderate to mild neurologic impairments.

[1]  Sarah F Tyson,et al.  Reliability and validity of functional balance tests post stroke , 2004, Clinical rehabilitation.

[2]  M. Verrier,et al.  The Community Balance and Mobility Scale-a balance measure for individuals with traumatic brain injury , 2006, Clinical rehabilitation.

[3]  M. Polkey,et al.  Quadriceps muscle weakness following acute hemiplegic stroke , 2001, Clinical rehabilitation.

[4]  C. Sherbourne,et al.  The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. , 1994 .

[5]  Richard W. Bohannon,et al.  Distribution of muscle strength impairments following stroke , 2000, Clinical rehabilitation.

[6]  M. Liang,et al.  Comparisons of Five Health Status Instruments for Orthopedic Evaluation , 1990, Medical care.

[7]  J. Judge,et al.  Strength is a major factor in balance, gait, and the occurrence of falls. , 1995, The journals of gerontology. Series A, Biological sciences and medical sciences.

[8]  C. Hui-Chan,et al.  The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. , 2005, Archives of physical medicine and rehabilitation.

[9]  A. Fugl-Meyer,et al.  The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. , 1975, Scandinavian journal of rehabilitation medicine.

[10]  D. Bartlett,et al.  Influence of Age and Gender of Healthy Adults on Scoring Patterns on the Community Balance and Mobility Scale , 2005 .

[11]  H Lanshammar,et al.  Knee joint moments in work-related situations. , 1995, Ergonomics.

[12]  Richard W. Bohannon,et al.  Reference Values for the Timed Up and Go Test: A Descriptive Meta‐Analysis , 2006, Journal of geriatric physical therapy.

[13]  B. E. Maki,et al.  Measuring balance in the elderly: validation of an instrument. , 1992, Canadian journal of public health = Revue canadienne de sante publique.

[14]  P. Stratford,et al.  Measuring Physical Impairment and Disability With the Chedoke‐McMaster Stroke Assessment , 1993, Stroke.

[15]  S. Nadeau,et al.  Frontal and sagittal plane analyses of the stair climbing task in healthy adults aged over 40 years: what are the challenges compared to level walking? , 2003, Clinical biomechanics.

[16]  P. Lachenbruch.  Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[17]  M Rousseaux,et al.  Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS). , 1999, Stroke.

[18]  Handbook of motor skills : development, impairment, and therapy , 2009 .

[19]  G. Grimby,et al.  Reliability of an interview approach to the Functional Independence Measure , 2001, Clinical rehabilitation.

[20]  Mary M Rodgers,et al.  Determinants of walking function after stroke: differences by deficit severity. , 2007, Archives of physical medicine and rehabilitation.

[21]  Diane P. Martin,et al.  A validation of the functional independence measurement and its performance among rehabilitation inpatients. , 1993, Archives of physical medicine and rehabilitation.

[22]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.

[23]  Ching-Fan Sheu,et al.  Analysis and Comparison of the Psychometric Properties of Three Balance Measures for Stroke Patients , 2002, Stroke.

[24]  C. Granger,et al.  The functional independence measure: a new tool for rehabilitation. , 1987, Advances in clinical rehabilitation.

[25]  D. Newham,et al.  Knee muscle isometric strength, voluntary activation and antagonist co-contraction in the first six months after stroke , 2001, Disability and rehabilitation.

[26]  S. Wood-Dauphinée,et al.  The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. , 1995, Scandinavian journal of rehabilitation medicine.

[27]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[28]  Nigel A. S. Taylor,et al.  Static and dynamic assessment of the Biodex dynamometer , 2004, European Journal of Applied Physiology and Occupational Physiology.

[29]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[30]  Chun-Hou Wang,et al.  Discriminative, predictive, and evaluative properties of a trunk control measure in patients with stroke. , 2005, Physical therapy.

[31]  R. Tallis,et al.  Balance disability after stroke. , 2006, Physical therapy.

[32]  Janice J Eng,et al.  Functional Walk Tests in Individuals With Stroke: Relation to Perceived Exertion and Myocardial Exertion , 2002, Stroke.

[33]  C. Richards,et al.  Responsiveness and predictability of gait speed and other disability measures in acute stroke. , 2001, Archives of physical medicine and rehabilitation.