Fullerton Gelişmiş Denge Ölçeği'nin Kronik İnmeli Hastalarda Geçerlik ve Güvenirliğinin İncelenmesi

Abstract

KIZILKAYA, E.,Validity And Reliability Study Of Fullerton Advanced Balance Scale In Chronic Stroke Patients, Hacettepe University Graduate School of Health Sciences, Neurology Physiotherapy Program, Master Thesis, Ankara 2021.The purpose of this study was to investigate the validity and reliability of the Fullerton Advanced Balance (FAB) Scale in chronic stroke patients. Fifty-one stroke patients, 13 females and 38 males, aged between 32-79 years, were included in this study. The reliability of the FAB Scale was examined with rater reliability and internal consistency analyzes. For the rater reliability analysis, evaluations of 16 individuals out of 51 were watched on video records 10 days after the first assessment and re-evaluated by 3 raters. In addition, the construct validity of the scale was examined through factor analysis and convergent validity; the criterion validity was investigated by examining the concurrent validity and its predictive validity on the risk of falling. The relationship of Stroke Rehabilitation Assessment of Movement (STREAM), The Short Form-36 Health Survey (SF-36), Barthel Index for Activities of Daily Living (BI) and Brunnstrom Recovery Stages (BRS) with FAB Scale was examined for convergent validity. For criterion validity, Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS) were accepted as the gold standard and concurrent validity of the FAB Scale was analyzed by examining the relationship between FAB Scale and two other scales. Analyzes showed that FAB Scale had an excellent internal consistency (Cronbach’s alpha=0,930), intra-rater (ICC=0,998, p<0,001) and inter-rater reliability (ICC=0,984, ICC=0,984, ICC=0,990, p<0,001). In the construct validity, the scale was determined as a single factored structure meeting the total variance at a rate of 63.7%. Within the convergent validity FAB Scale showed good correlation with STREAM total scores (r=0,677, p<0,001), moderate correlation with physical function subcomponent of SF-36 (r=0,436, p<0,05), good correlation with BI (r=0,628, p<0,001) and moderate correlation with both BRS upper and lower extremity scores (r=0,504, r=0,579, p<0,001). FAB Scale had criterion validity in terms of concurrence showed by excellent correlations with Mini-BESTest and BBS (r=0,928, r=,942, p<0,001). Also, the predictive validity of the scale showing no floor and ceiling effects was examined by identifying a cut-off point for fall risk, which was found as 21,5 points (%84 sensitivity, %61 specificity). The present study results that the FAB Scale is a valid and reliable tool in the assessment of balance in stroke patients.

Keywords: Fullerton Advanced Balance Scale, Stroke, Reliability, Validity