This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mao, H.-F. Articles by Hsieh, C.-L. Search for Related Content PubMed PubMed Citation Articles by Mao, H.-F. Articles by Hsieh, C.-L. Related Collections Rehabilitation, Stroke

(Stroke. 2002;33:1022.)
© 2002 American Heart Association, Inc.

Original Contributions

Analysis and Comparison of the Psychometric Properties of Three Balance Measures for Stroke Patients

Hui-Fen Mao, MS; I-Ping Hsueh, MA; Pei-Fang Tang, PhD; Ching-Fan Sheu, PhD Ching-Lin Hsieh, PhD

From the School of Occupational Therapy (H.-F.M., I.-P.H., C.-L.H.) and the School and Graduate Institute of Physical Therapy (P.-F.T.), College of Medicine, National Taiwan University, Taipei, Taiwan, and Department of Psychology, DePaul University, Chicago, Ill (C.-F.S.).

Correspondence to Ching-Lin Hsieh, School of Occupational Therapy, College of Medicine, National Taiwan University, No 7, Chung-Shan S Rd, Taipei 100, Taiwan, ROC. E-mail mike26{at}ha.mc.ntu.edu.tw

Background and Purpose— This study compared the psychometric properties of 3 clinical balance measures, the Berg Balance Scale (BBS), the Balance subscale of the Fugl-Meyer test (FM-B), and the Postural Assessment Scale for Stroke Patients (PASS), in stroke patients with a broad range of neurological and functional impairment from the acute stage up to 180 days after onset.

Methods— One hundred twenty-three stroke patients were followed up prospectively with the 3 balance measures 14, 30, 90, and 180 days after stroke onset (DAS). Reliability (interrater reliability and internal consistency) and validity (concurrent validity, convergent validity, and predictive validity) of each measure were examined. A comparison of the responsiveness of each of the 3 measures was made on the basis of the entire group of patients and 3 separate groups classified by degree of neurological severity.

Results— The FM-B and BBS showed a significant floor or ceiling effect at some DAS points, whereas the PASS did not show these effects. The BBS, FM-B, and PASS all had good reliability and validity for patients at different recovery stages after stroke. The results of effect size demonstrated fair to good responsiveness of all 3 measures within the first 90 DAS but, as expected, only a low level of responsiveness at 90 to 180 DAS. The PASS was more responsive to changes in severe stroke patients at the earliest period after stroke onset, 14 to 30 DAS.

Conclusions— All 3 measures tested showed very acceptable levels of reliability, validity, and responsiveness for both clinicians and researchers. The PASS showed slightly better psychometric characteristics than the other 2 measures.

Key Words: cerebrovascular disorders • reproducibility of results

This article has been cited by other articles:

				M. Beninato, L. G. Portney, and P. E. Sullivan Using the International Classification of Functioning, Disability and Health as a Framework to Examine the Association Between Falls and Clinical Assessment Tools in People With Stroke Physical Therapy, August 1, 2009; 89(8): 816 - 825. [Abstract] [Full Text] [PDF]

				L. Wevers, I. van de Port, M. Vermue, G. Mead, and G. Kwakkel Effects of Task-Oriented Circuit Class Training on Walking Competency After Stroke: A Systematic Review Stroke, July 1, 2009; 40(7): 2450 - 2459. [Abstract] [Full Text] [PDF]

				T. Steffen and M. Seney Test-Retest Reliability and Minimal Detectable Change on Balance and Ambulation Tests, the 36-Item Short-Form Health Survey, and the Unified Parkinson Disease Rating Scale in People With Parkinsonism Physical Therapy, June 1, 2008; 88(6): 733 - 746. [Abstract] [Full Text] [PDF]

				L. Blum and N. Korner-Bitensky Usefulness of the Berg Balance Scale in Stroke Rehabilitation: A Systematic Review Physical Therapy, May 1, 2008; 88(5): 559 - 566. [Abstract] [Full Text] [PDF]

				C. M. Boyd, C. O. Weiss, J. Halter, K. C. Han, W. B. Ershler, and L. P. Fried Framework for Evaluating Disease Severity Measures in Older Adults With Comorbidity J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2007; 62(3): 286 - 295. [Abstract] [Full Text] [PDF]

				C.-W. Chien, J.-H. Lin, C.-H. Wang, I-P. Hsueh, C.-F. Sheu, and C.-L. Hsieh Developing a Short Form of the Postural Assessment Scale for People With Stroke Neurorehabil Neural Repair, January 1, 2007; 21(1): 81 - 90. [Abstract] [PDF]

				J Barra, V Chauvineau, T Ohlmann, M Gresty, and D Perennou Perception of longitudinal body axis in patients with stroke: a pilot study J. Neurol. Neurosurg. Psychiatry, January 1, 2007; 78(1): 43 - 48. [Abstract] [Full Text] [PDF]

				I-P. Hsueh, W.-C. Wang, C.-H. Wang, C.-F. Sheu, S.-K. Lo, J.-H. Lin, and C.-L. Hsieh A Simplified Stroke Rehabilitation Assessment of Movement Instrument Physical Therapy, July 1, 2006; 86(7): 936 - 943. [Abstract] [Full Text] [PDF]

				C.-Y. Chou, C.-W. Chien, I-P. Hsueh, C.-F. Sheu, C.-H. Wang, and C.-L. Hsieh Developing a Short Form of the Berg Balance Scale for People With Stroke Physical Therapy, February 1, 2006; 86(2): 195 - 204. [Abstract] [Full Text] [PDF]

				C.-H. Wang, I-P. Hsueh, C.-F. Sheu, and C.-L. Hsieh Discriminative, Predictive, and Evaluative Properties of a Trunk Control Measure in Patients With Stroke Physical Therapy, September 1, 2005; 85(9): 887 - 894. [Abstract] [Full Text] [PDF]

				S F. Mackintosh, K Hill, K J Dodd, P Goldie, and E Culham Falls and injury prevention should be part of every stroke rehabilitation plan Clinical Rehabilitation, April 1, 2005; 19(4): 441 - 451. [Abstract] [PDF]

				C.-H. Wang, I-P. Hsueh, C.-F. Sheu, G. Yao, and C.-L. Hsieh Psychometric Properties of 2 Simplified 3-Level Balance Scales Used for Patients With Stroke Physical Therapy, May 1, 2004; 84(5): 430 - 438. [Abstract] [Full Text] [PDF]

				P. S. Pohl, S. Perera, P. W. Duncan, R. Maletsky, R. Whitman, and S. Studenski Gains in Distance Walking in a 3-Month Follow-Up Poststroke: What Changes? Neurorehabil Neural Repair, March 1, 2004; 18(1): 30 - 36. [Abstract] [PDF]

				I-P. Hsueh, W.-C. Wang, C.-F. Sheu, and C.-L. Hsieh Rasch Analysis of Combining Two Indices to Assess Comprehensive ADL Function in Stroke Patients Stroke, March 1, 2004; 35(3): 721 - 726. [Abstract] [Full Text] [PDF]

				I-P. Hsueh, C.-H. Wang, C.-F. Sheu, and C.-L. Hsieh Comparison of Psychometric Properties of Three Mobility Measures for Patients With Stroke Stroke, July 1, 2003; 34(7): 1741 - 1745. [Abstract] [Full Text] [PDF]

				C.-L. Hsieh, C.-F. Sheu, I-P. Hsueh, and C.-H. Wang Trunk Control as an Early Predictor of Comprehensive Activities of Daily Living Function in Stroke Patients Stroke, November 1, 2002; 33(11): 2626 - 2630. [Abstract] [Full Text] [PDF]