Article

OBJECTIVES: To assess, within the context of Rasch analysis, (1) the internal
validity and reliability of the Berg Balance Scale (BBS) in a sample of
rehabilitation patients with varied balance abilities; and (2) the comparability
of the BBS measures across different neurologic diseases. DESIGN: Observational
prospective study. SETTING: Rehabilitation ward of an Italian district hospital.
PARTICIPANTS: Consecutively admitted inpatients and outpatients (N=217); for 85
participants, data were collected both on admission and discharge, giving a total
sample of 302 observations. INTERVENTION: Not applicable. MAIN OUTCOME MEASURE:
BBS. RESULTS: Most of the BBS items had to be rescored,
and 2 items (static
sitting and standing balance) had to be deleted, to attain adequate internal
construct validity (chi(2)(24)=35.68; P=.059).
The reliability of the
Rasch-modified BBS (BBS-12) (total score, 0-35) was high (.957), indicating
precision of measurement at the individual level. The analysis of differential
item functioning (DIF) showed invariance of the item calibrations across
patients' sex, age, and etiology. After adjusting for the possible effect of
repeated measurements on person estimates, the analysis of DIF by timing of
assessment confirmed the stability of the item hierarchy across time. A practical
ruler was provided to convert item raw scores into Rasch estimates of balance
ability. CONCLUSIONS:
This study supports the internal validity and reliability
of the BBS-12 as a measurement tool independent of the etiology of the neurologic
disease causing the balance impairment. In view of some sample-related issues and
that not all possible etiologies encountered in the neurorehabilitation settings
were tested, a larger multicenter study is warranted to confirm these findings.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS