The Korean version of relative and absolute reliability of gait and balance assessment tools for patients with dementia in day care center and nursing home

Abstract

[Purpose] This study was aimed to determine the relative and absolute reliability of Korean version tools of the Berg Balance Scale (BBS), the Timed Up and Go (TUG), the Four-Meter Walking Test (4MWT) and the Groningen Meander Walking Test (GMWT) in patients with dementia. [Subjects and Methods] A total of 53 patients with dementia were tested on TUG, BBS, 4MWT and GMWT with a prospective cohort methodological design. Intra-class Correlation Coefficients (ICCs) to assess relative reliability and the standard error of measurement (SEM), minimal detectable change (MDC95) and its percentage (MDC%) to analyze the absolute reliability were calculated. [Results] Inter-rater reliability (ICC(2,3)) of TUG, BBS and GMWT was 0.99 and that of 4MWT was 0.82. Inter-rater reliability was high for TUG, BBS and GMWT, with low SEM, MDC95, and MDC%. Inter-rater reliability was low for 4MWT, with high SEM, MDC95, and MDC%. Test-retest (ICC(2,3)) of TUG, BBS and GMWT was 0.96–0.99 and Test-retest (ICC(2,3)) of 4MWT was 0.85. The test-retest was high for TUG, BBS and GMWT, with low SEM, MDC95, and MDC%, but it was low for 4MWT, with high SEM, MDC95, and MDC%. [Conclusion] The relative reliability was high for all the assessment tools. The absolute reliability has a reasonable level of stability except the 4MWT.

Recommended motor assessments based on psychometric properties in individuals with dementia: a systematic review

“…Five studies assessed inter-rater reliability of nine assessments. ICC ranged from 0.72 to 1.00 and MDC 95 included values between 0.0 and 98.0% [14, 15, 43, 99, 118]. Accordingly, all assessments reached sufficient relative inter-rater reliability.…”

“…Most studies focused on between-day test-retest reliability, while some studies examined within-day and within-session test-retest reliability. Comparing these studies, ICC increased and MDC 95% decreased, respectively, from between-day (ICC = 0.02–0.99, MDC 95% = 6.8–225.7% [5, 14, 17, 43, 51, 53, 63, 102, 118, 120, 121]), through within-day (ICC = 0.79–0.99, MDC 95% = 21.1–30.0% [6, 26, 118]), to within-session test-retest reliability (ICC = 0.95–0.98 [114]).…”

“…Fifteen studies investigated test-retest reliability considering 24 assessments. ICC ranged between 0.02 and 0.99 and MDC 95% varied from 6.8 to 225.7% [5, 6, 14, 17, 26, 43, 51, 53, 63, 102, 110, 114, 118, 120, 121] (see Table 3).…”

“…Since information on minimal important change of considered motor assessments in IWD is rare [17], and no other firm criteria for acceptable values [42] are available, we considered a MDC 95% higher than 30% as unacceptable [43, 44]. Based on COSMIN reliability criteria for good measurement properties [41] and indications for unacceptable values [43, 44], we rated relative and absolute reliability as follows: sufficient relative/absolute reliability (+): ICC ≥ 0.70/minimal detectable change at 95% confidence interval < minimal important changeindeterminate relative/absolute reliability (? ): ICC not reported/minimal important change not definedinsufficient relative/absolute reliability (−): ICC < 0.70/minimal detectable change at 95% confidence interval > minimal important changeunacceptable absolute reliability (↓): MDC 95% > 30%…”

Relationship between knee extension strength and gait styles in patients with dementia

“…Dementia leads to deterioration in walking. [1–3] Although gait disorders are common in the elderly and are related to loss of functional independence, falls, and death, [4–6] they are more prevalent in elderly persons with dementia than in normal elderly people. [7,8] Therefore, dementia causes not only cognitive problems but also a decline in gait.…”