Objective-To explore shortened response formats for use with the Activities-specific Balance Confidence scale and then: 1) evaluate the unidimensionality of the scale; 2) evaluate the item difficulty; 3) evaluate the scale for redundancy and content gaps; and 4) evaluate the item standard error of measurement (SEM) and internal consistency reliability among aging individuals (â„50 years) with a lower-limb amputation living in the community.Design-Secondary analysis of cross-sectional survey and chart review data.Setting-Out-patient amputee clinics, Ontario, Canada.Participants-Four hundred forty eight community living adults, at least 50 years old (mean = 68 years), who have used a prosthesis for at least 6 months for a major unilateral lower limb amputation. Three hundred twenty five (72.5%) were men.
Intervention-N/aMain Outcome Measure(s)-Activities-specific Balance Confidence Scale.Results-A 5-option response format outperformed 4-and 6-option formats. Factor analyses confirmed a unidimensional scale. The distance between response options is not the same for all items on the scale, evident by the Partial Credit Model (PCM) having a better fit to the data than the Rating Scale Model. Two items, however, did not fit the PCM within statistical reason. Revising the wording of the two items may resolve the misfit, and improve the construct validity Corresponding author: Dr. William C Miller, Department of Occupational Science and Occupational Therapy, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Tel work: 604-714-4108, Fax: 604-714-4168, bcmiller@telus.net. We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, if applicable, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in the title page of the manuscript.The manuscript submitted does not contain information about medical device(s).
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CIHR Author Manuscriptand lower the SEM. Overall, the difficulty of the scale's items is appropriate for use with aging individuals with lower-limb amputation, and is most reliable (Cronbach â = 0.94) for use with individuals with moderately low balance confidence levels.Conclusions-The ABC-scale with a simplified 5-option response format is a valid and reliable measure of balance confidence for use with individuals aging with a lower limb amputation.
KeywordsAging; amputation; self-efficacy; rehabilitation; psychometrics; postural balanceFalling and the consequences of falling are important health issues for older individuals with a lower limb amputation. In Canada, the prevalence of falling among community dwelling individuals with a lower-limb amputation is reported to be as high as 52%. 1 Further, the annual incidence of falling among older adults (â„65 years) living in the community is commonly reported to be around 30% to ...