The reliability and validity of the Turkish version of Fullerton Advanced Balance (FAB-T) scale

Comparison of Proprioceptive Neuromuscular Facilitation and Pilates exercises in patients with chronic low back pain: A randomized study

BACKGROUND

Pilates and PNF exercises reduce pain, and improve function in chronic low back pain (CLBP) patients.

AIM

To compare the effects of PNF and Pilates exercises on pain, body image, fear-avoidance beliefs, core stability, and balance functions in patients with CLBP.

MATERIALS AND METHODS

Sixty CLBP patients were randomly assigned to PNF (n = 30) or Pilates (n = 30). Patients received PNF or Pilates exercise for 20 sessions over the course of 4 weeks. The outcome measures were the Numerical Pain Rating Scale, Body Cathexis Scale, Fear Avoidance Beliefs Questionnaire, Trunk Stabilization Test, and Fullerton Advanced Balance Scale. Evaluations were performed at baseline (0 weeks) and the end of treatment (4 weeks).

RESULTS

The Pilates group showed more significant improvements in core stability (F = 8.647, p = 0.005, η2 = 0.134) than the PNF group. In both groups, the pain was reduced, and fear-avoidance behaviors were decreased. Improvements in balance were observed in each group. Only the Pilates group improved in terms of body image (p = 0.050, r = 0.35) and core stability (p = 0.002, r = 0.57).

CONCLUSION

Patients with CLBP who participated in either Pilates or PNF exercises showed similar improvements in pain, body image, fear-avoidance beliefs, and balance, while Pilates exercises were more effective in improving core stability. CLBP patients in both groups showed improvements in pain severity, fear-avoidance beliefs, and balance. Only the Pilates group improved in body image and core stability. Pilates, a mind-body technique that encourages movement control and self-awareness, may offer additional advantages over PNF.

Smartphone addiction among elderly individuals: its relationship with physical activity, activities of daily living, and balance levels

BACKGROUND

The growing use of smartphones among elderly individuals, driven by social and informational needs, may lead to smartphone addiction, potentially impacting their daily lives. This study aimed to determine whether there is a difference in physical activity, activities of daily living, and balance levels between elderly individuals with and without smartphone addiction.

METHODS

This descriptive and cross-sectional study included 94 elderly individuals. Data were obtained using the Smartphone Addiction Scale-Short Version (SAS-SV), the Physical Activity Scale for the Elderly (PASE), the Lawton Instrumental Activities of Daily Living Scale (Lawton IADL), the Fullerton Advanced Balance Scale (FAB-T), and the Timed Up and Go Test (TUG). The participants were divided into two groups according to their SAS-SV scores: those with (n = 45) and those without (n = 49) smartphone addiction.

RESULTS

When the groups with and without smartphone addiction were compared, there was a significant difference between the groups in terms of Lawton IADL (t = 4.223, p < 0.001), total PASE (t = 7.791, p < 0.001), PASE work-related activity (t = 2.541, p = 0.013), household activity (t = 3.598, p = 0.001), and leisure activity (t = 7.063, p < 0.001). Structural equation modeling showed that Lawton IADL (β = -0.320, p < 0.001), PASE total (β = -0.518, p < 0.001), and PASE work-related activity (β = -0.211, p = 0.033), household activity (β = -0.300, p = 0.002), and leisure time activity (β = -0.483, p < 0.001) subscales had a direct negative predictive effect on SAS-SV. FAB-T had a direct positive predictive effect on total PASE (β = 0.186, p = 0.030) and work-related activity subscales (β = 0.197, p = 0.046). FAB-T had a direct positive predictive effect on Lawton IADL (β = 0.247, p = 0.009), but a direct negative effect on TUG (β = -0.541, p < 0.001).

CONCLUSIONS

The study determined that smartphone addiction was directly related to the maintenance of physical activity and daily living activities in elderly individuals but did not lead to a change in balance status. Future studies should consider including potential confounders, such as baseline physical fitness, socioeconomic status, and cognitive impairment, in structural equation modeling to provide more comprehensive insights.

Three-dimensional exergaming conjunction with vestibular rehabilitation in individuals with Benign Paroxysmal Positional Vertigo: A feasibility randomized controlled study

BACKGROUND

To examine the effectiveness of 3D (dimensional)-vestibular rehabilitation therapy (VRT) on gait, balance problems, processing time speed and subjective complaints in patients with Benign Paroxysmal Positional Vertigo (BPPV) compared to a control group (CG). This study aimed to test the feasibility of virtual reality-based 3D exergaming conjunction with vestibular rehabilitation.

METHODS

Twenty-two patients with BPPV (negative DixHallpike/Roll test results, existing dizziness/balance complaints) were randomly allocated to the study group (SG, n:11 3D-VRT) or Control group (CG n:11, no exercise-rehabilitation) for 8 week. The SG performed 3D-VRT for 45 to 50 min/d, 3 times/wk, and the CG did receive only Canalith Repositioning Maneuver (CRM). CRM was applied in both groups before the study. Outcome measures included 10-Meter-Walk-Test (10-MWT) (with/without head turns), Dynamic Gait Index (DGI), Choice-Stepping-Reaction-Time-ped (CSRT-MAT), Fullerton Advanced Balance Scale (FAB), and Visual Analog Scale (VAS).

RESULTS

The SG showed significantly improvement in 10-MWT without (p5 = 0.00,η2 = 0.49), with horizontal (p5 = 0.00,η2 = 0.57),vertical (p5 = 0.01,η2 = 0.48) head turns, DGI (p5 = 0.00,η2 = 0.74), CSRT-MAT, FAB (p5 = 0.00,η2 = 0.78) and VAS-dizziness (p5 = 0.00,η2 = 0.65), VAS-balance problem (p5 = 0.00,η2 = 0.43), VAS-fear of falling (p5 = 0.00,η2 = 0.42) compared to the CG.

CONCLUSION

The 3D-VRT were effective in improving gait, balance, processing speed and resolving the subjective complaints in BPPV. The 3D-VRT method is feasible for patients who suffer from residual dizziness or balance complaints after CRM. Furthermore, the 3D-VRT is more accessible and less expensive than other virtual reality applications, which may facilitate further research or clinical use.

Psychometric properties of Fullerton Advanced Balance Scale in patients with stroke

BACKGROUND

Patients experience falls frequently after stroke. Preserved or acquired balance skills decrease fall risk and improve independence. Feasibility of Fullerton Advanced Balance Scale (FAB) has been shown in balance assessment in some neurological diseases except stroke.

OBJECTIVES

The purpose of this study was to investigate the reliability and validity of Turkish version of FAB (FAB-T) in patients with stroke (PwS).

METHODS

This cross-sectional study included 51 PwS (60.64 ± 7.66 years). Reliability analyses were conducted with Cronbach's alpha, intraclass correlation coefficient (ICC), and Spearman correlation analysis. Intra-rater and inter-rater reliability were assessed with three raters. FAB-T, Stroke Rehabilitation Assessment of Movement (STREAM), Brunnstrom Recovery Stages (BRS), Barthel Index (BI), and 36-Item Short Form Health Survey (SF-36) were used for convergent validity. Correlations of FAB-T with Berg Balance Scale (BBS) and Mini-Balance Evaluation Systems Test (Mini-BESTest) were measured for concurrent validity. Spearman correlation analysis was used for convergent and concurrent validity. For predictive validity patients' self-reports of falling were analyzed with ROC.

RESULTS

Intra-rater (ICC = 0.998) and inter-rater reliability (ICCs = 0.984; 0.984; 0.990), and internal consistency (Cronbach's alpha = 0.930) were excellent. FAB-T had good correlations with STREAM (ρ = 0.677) and BI (ρ = 0.628), moderate correlations with BRS (ρ = 0.504 and ρ = 0.579) and physical function of SF-36 (ρ = 0.436). FAB-T excellently correlated with Mini-BESTest and BBS (ρ = 0.928 and ρ = 0.942). The cutoff score of FAB-T was determined to be 21.5 points, with sensitivity of 84% and specificity of 61% (AUC = 0.749).

CONCLUSIONS

FAB-T is a reliable and valid balance assessment tool with an acceptable accuracy of fall prediction in PwS.

Reliability and Validity of The Fullerton Advanced Balance Scale in People with Multiple Sclerosis

PURPOSE

This study was conducted to evaluate the reliability and validity of the Fullerton Advanced Balance Scale (FAB) in people with Multiple Sclerosis (PwMS).

METHODS

A total of 65 people with multiple sclerosis, Expanded Disability Status Scale (EDSS) ranging from 1 to 5.5, were included in the study. Test-retest reliability, intra-rater, inter-rater reliability, and internal consistency (item-total score correlation, Cronbach's alpha coefficient) were investigated to examine the reliability of FAB. In the intra-rater and inter-rater reliability analysis, the FAB application of 34 patients, whose initial evaluation was gathered, was video-recorded and re-watched by two physiotherapists at different times and scored. For the Validity of FAB, concurrent validity with criterion validity; construct validity with hypothesis testing were calculated. Convergent validity was assessed for correlations with EDDS, Dynamic Gait Index (DGI), and Timed Up and Go Test (TUG).

RESULTS

Test-retest reliability of FAB Intraclass Correlation Coefficient (ICC) values was excellent (ICC= 0.994, p < 0.001). While the intra-rater reliability (ICC=0.986, p < 0.001) and inter-rater reliability (ICC=0.985, p < 0.001) of the FAB were calculated at an excellent level. Cronbach's alpha value was determined to perfect correlation. (Cronbach's alpha coefficient: 0.929). FAB had an excellent correlation with BBS (0.919 (p < 0.001). For convergent validity of FAB, EDSS (r=-0.885, p < 0.001), TUG (r=-0.833, p < 0.001), and DGI (r = 0.916, p < 0.001), it was determined that the scale had convergent validity.

CONCLUSION

The FAB proved to be a reliable and valid in PwMS. The study showed that the FAB could be applied regardless of the physiotherapists' clinical experiences. It has been determined that the scale can be used in PwMS with a wide EDSS score. Considering the inter-rater and intra-rater reliability results, it is thought that the FAB is also suitable for use in the online environment.

Measures of attributes of locomotor capacity in older people: a systematic literature review following the COSMIN methodology

BACKGROUND

Locomotor capacity (LC) is an important domain of intrinsic capacity and key determinant of functional ability and well-being in older age. The United Nations Decade of Healthy Ageing (2021-2030) calls for strengthening data and research on healthy ageing, including the measurement of older persons' LC. To advance the measurement and monitoring of LC, there is pressing need to identify valid and reliable measures.

OBJECTIVE

To identify all the available tools that were validated for measurement of LC or of its specific attributes in older people and to assess the methodological quality of the studies and measurement properties of the tools.

DESIGN

Systematic review.

SETTING

Anywhere (Community-dwelling; long-term care facility; etc.).

SUBJECTS

Older people.

METHODS

We used highly sensitive search strategies to search the following databases: Medline, Embase, Scopus, CINAHL and PsycINFO. The study was conducted following the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology for systematic review of outcome measurement instruments.

RESULTS

A total of 125 studies were included, which assessed tools for balance (n = 84), muscle power (n = 12), muscle strength (n = 32, including four studies about tools for balance and muscle power) and endurance (n = 1). No studies on tools for muscle function, joint function, or locomotor capacity overall, were retrieved. We identified 69 clinician-report or objective assessment tools for balance, 30 for muscle strength, 12 for muscle power and 1 endurance assessment tool. The GRADE assessment of quality of evidence showed that only a few tools have high quality evidence for both sufficient validity and reliability: The Balance Evaluation Systems Test (BESTest), the Mini-Balance Evaluation Systems Test (Mini-BESTest), the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test.

CONCLUSIONS

A few tools with high quality evidence for sufficient validity and reliability are currently available for balance assessment in older people that may be recommended for use in clinical and research settings. Further validation studies are required for muscle strength, muscle power and endurance assessment tools.

Reliability and validity of the Turkish version of Fullerton Advanced Balance Scale in cerebral palsy

BACKGROUND

The Fullerton Advanced Balance Scale (FAB) is a multi-item balance assessment test designed to measure balance in relatively higher functioning individuals. The aim of this study was to examine the reliability and validity of the Turkish version of the FAB (FAB-T) in children with cerebral palsy (CP).

RESEARCH QUESTION

Is the Turkish version of the Fullerton Advance Balance Scale valid and reliable in determining balance problems in children with cerebral palsy and determining the underlying cause of this condition?

METHODS

Forty-six children with CP participated in this study. Rasch analysis was used to investigate item adherence. Internal consistency of the FAB-T was established using Cronbach's alpha coefficient. Test-retest reliability was also evaluated. In addition, to assess concurrent validity, FAB-T scores were compared with the Pediatric Balance Scale (PBS) using the Spearman correlation coefficient.

RESULTS

The FAB-T showed satisfactory internal consistency (Cronbach's alpha value=0.94) and excellent test-retest reliability (ICC=0.99). The FAB and the PBS exhibited concurrent positive validity (r = 0.913; p < 0.001). All items of the FAB-T were found to fit the Rasch Model (Chi-square 16.01(df=20), p = 0.716).

SIGNIFICANCE

The FAB-T is a reliable and valid tool that can be used to measure balance skills and to identify the source of the problem in children with CP.

Multitask Versus Multicomponent Training on Cognitive and Motor Functions in Persons With Mild Cognitive Impairment: A Randomized Trial

This study aims to compare the effects of multitask (MTT; multiple tasks performed simultaneously) and multicomponent training (MCT; various types of exercise performed sequentially) on processing speed, cognitive functions, gait speed, and balance functions in persons with mild cognitive impairment. Forty-two persons with mild cognitive impairment were randomly allocated to MTT (n = 21) or MCT (n = 21). Outcome measures included processing speed, cognitive functions (attention and executive functions), single-task gait speed, dual-task gait speed (DTGS-Arithmetic and DTGS-Verbal), and balance functions. Processing speed (except inhibition), cognitive functions, gait speed, and balance functions improved in the MTT and MCT groups following training, with no significant differences between the groups in processing speed or cognitive functions. The MCT group improved more on single-task gait speed (F = 15.097; p = .000; r = .270) and DTGS (DTGS-Arithmetic; F = 10.594; p = .002; r = .214), while the MTT group improved more on balance functions (F = 4.366; p = .043; r = .101). MTT and MCT strategies can be used to improve cognitive and physical outcomes in persons with mild cognitive impairment.

Boxing training in patients with stroke causes improvement of upper extremity, balance, and cognitive functions but should it be applied as virtual or real?

Background: Upper extremity hemiparesis is one of the most common post-stroke disabilities requiring rehabilitation. Objective: To compare the effects of virtual and real boxing training in addition to neurodevelopmental treatment on the upper extremity, balance, and cognitive functions in hemiparetic stroke patients. Methods: Forty hemiparetic stroke patients were assigned to either real boxing group-RBG (n=20) or virtual boxing group-VBG (n=20), for a total of 24 sessions (3 sessions/week for 8 weeks). The primary outcome was upper extremity motor ability (Wolf Motor Function Test-WMFT). The secondary outcomes were arm-hand dexterity (Manual Dexterity Test-MMDT), goal-oriented performance (Video Boxing Analysis-VBA), balance functions (Fullerton Advanced Balance Scale-FAB-T), and cognitive functions (Addenbrooke's Cognitive Examination-Revised-ACE-R). Results: There was small treatment effect on ACE-R, small-medium effect for WFMT and MMDT and large effect on bilateral punching time [VBA (Cohen's d- VBG=0.83; RBG=0.95)] and balance [FAB-T (Cohen's d - VBG=0.89; RBG=0.82)] after treatment in both groups. No significant differences were found for training effects between the groups for upper extremity functions [WMFT (p=0.799; Cohen's d=-0.07), MMDT-PT (p=0.327; Cohen's d=-0.10), MMDT-THTPT (p=0.779; Cohen's d=-0.17) and VBA bilateral punch number (p=0.068; Cohen's d=0.15)], balance functions [FAB-T (p=0.602; Cohen's d=-0.19)] and cognitive functions [ACE-R total (p=0.947, Cohen's d=0.09)]. Conclusion: The study showed that virtual and real boxing training methods, in addition to neurodevelopmental treatment, are effective in improving upper extremity, balance, and cognitive functions in patients with hemiparetic stroke. The training effects were higher on bilateral punching time and balance functions for both groups. There was no superiority of either approach.