The Community Balance and Mobility Scale Alleviates the Ceiling Effects Observed in the Currently Used Gait and Balance Assessments for the Community-Dwelling Older Adults
The Community Balance and Mobility Scale Alleviates the Ceiling Effects Observed in the Currently Used Gait and Balance Assessments for the Community-Dwelling Older Adults
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DOI：
10.1519/jpt.0000000000000024
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发表时间：
2015-04-01
影响因子：
2.4
通讯作者：
Balasubramanian, Chitralakshmi K.
中科院分区：
文献类型：
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作者：
Balasubramanian, Chitralakshmi K.
背景和目的：目前使用的平衡评估显示天花板效应，缺乏活动的社区流动性较高的功能老年人。本研究的目的是调查社区平衡和流动性（CB&M）量表在高功能社区居住的老年人人群中的可靠性和有效性，因为CB&M量表包括对几项具有挑战性的任务的评估，并可能减轻在该队列中常用的步态和平衡评估中观察到的天花板效应。40名老年人（73.4 +/- 6.9岁）的便利样本参加了这项横断面研究。以前标准化的平衡和流动性评估测量类似的结构作为CB&M用于验证。结果包括定时起身和行走测试、贝格平衡量表（BBS）、动态步态指数（DGI）、功能性前伸测试（FRT）、短距离体能测试（SPPB）、6分钟步行测试（6 MWT）、活动特定平衡信心量表（ABC）、步态速度和个体内步态变异性。结果：CB&M量表的评分者信度（ICC > 0.95）和内部一致性（α = 0.97）较高。CB&M评分与DGI、BBS、SPPB和6 MWT表现出强相关性（rho = 0.70-0.87; P <0.01）;与福尔斯史、TUG、ABC和步态速度中度相关（rho = 0.44-0.65; P <0.01）;与FRT、摆动和站立时间变异性低相关（rho = 0.34-0.37; P <0.05）。动态步态指数、BBS、SPPB和ABC评估显示了天花板效应（7.5%-32.5%），而CB&M上没有注意到地板或天花板效应。Logistic回归模型显示CB&M评分显著预测福尔斯史（χ 2 = 6.66，OR = 0.92; P <0.01）。CB&M量表的曲线下面积为0.80（95% CI：0.65-0.95）。CB&M评分
Background and Purpose: Currently used balance assessments show a ceiling effect and lack activities essential for community mobility in higher-functioning older adults. The aim of this study was to investigate the reliability and validity of the Community Balance and Mobility (CB&M) Scale in a high-functioning community-dwelling older adult population since the CB&M Scale includes assessment of several challenging tasks and may alleviate the ceiling effects observed in commonly used gait and balance assessments for this cohort.Methods: A convenience sample of 40 older adults (73.4 +/- 6.9 years) participated in this cross-sectional study. Previously standardized balance and mobility assessments measuring similar constructs as the CB&M were used for validation. Outcomes included Timed Up and Go Test, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Functional Reach Test (FRT), Short Physical Performance Battery (SPPB), 6-Minute Walk Test (6MWT), Activities Specific Balance Confidence scale (ABC), gait speed, and intraindividual gait variability. A falls questionnaire documented the history of falls.Results: Rater reliability (ICC > 0.95) and internal consistency (alpha = .97) of the CB&M scale were high. CB&M scores demonstrated strong correlations with DGI, BBS, SPPB, and 6MWT (rho = 0.70-0.87; P < .01); moderate correlations with falls history, TUG, ABC, and gait speed (rho = 0.44-0.65; P < .01); and low correlations with FRT, swing and stance time variability (rho = 0.34-0.37; P < .05). Dynamic Gait Index, BBS, SPPB, and ABC assessments demonstrated ceiling effects (7.5%-32.5%), while no floor or ceiling effects were noted on the CB&M. Logistic regression model showed that the CB&M scores significantly predicted falls history (chi(2) = 6.66, odds ratio = 0.92; P < .01). Area under the curve for the CB&M scale was 0.80 (95% CI: 0.65-0.95). A score of CB&M