Translation and Psychometric Analysis of Activities Specific Balance Confidence Scale (Abc-U) and Fall Efficacy Scale International (Fes-I-U) in Elderly
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Abstract
Background: With the increasing elderly population globally, understanding and managing fear of falling and balance issues have become paramount, especially in countries like Pakistan. The Activities-specific Balance Confidence (ABC) scale is a widely recognized tool for assessing these concerns in older adults. However, there was a need for a version adapted to the Urdu-speaking population.
Objective: The study aimed to translate the ABC scale into Urdu and assess its psychometric properties to provide a reliable tool for evaluating fear of falling and balance confidence in Pakistani older adults.
Methods: This analytical study involved a sample of 120 elderly individuals, selected through non-probability convenience sampling from PAF Hospital Islamabad and local communities. Inclusion criteria were individuals aged 60 years or above, capable of walking with or without aid, and proficient in Urdu. Those with known pathologies affecting balance, psychological issues, vision impairments, or a history of fractures were excluded. The English version of the ABC scale was translated into Urdu following the COSMIN guidelines. Psychometric testing included evaluating internal consistency, test-retest reliability, and concurrent validity. Data analysis was performed using SPSS version 25.
Results: The Urdu version of the ABC scale showed high internal consistency (Cronbach's alpha > 0.90). The Standard Error of Measurement (SEM) for the complete tool was 2.40, with individual components ranging from 3.55 to 11.2. The Minimal Detectable Change (MDC95) for the full scale score was 6.4. Concurrent validity, assessed through correlation with the Fall Efficacy Scale International Urdu version (FES-I-U), revealed a strong negative relationship (r = -0.80, p < 0.0001). The mean normative value of self-perceived balance confidence among participants was 70.5.
Conclusion: The study successfully translated and validated the ABC scale into Urdu, providing a reliable and valid tool for assessing fear of falling and balance confidence among Urdu-speaking older adults in Pakistan. This adaptation is crucial for culturally sensitive geriatric care and fall prevention strategies.
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References
Oliveira CC, Lee A, Granger CL, Miller KJ, Irving LB, Denehy L. Postural control and fear of falling assessment in people with chronic obstructive pulmonary disease: a systematic review of instruments, international classification of functioning, disability and health linkage, and measurement properties. Archives of physical medicine and rehabilitation. 2013;94(9):1784-99.e7.
Kendrick D, Kumar A, Carpenter H, Zijlstra GA, Skelton DA, Cook JR, et al. Exercise for reducing fear of falling in older people living in the community. The Cochrane database of systematic reviews. 2014;2014(11):Cd009848.
Fong E, Li C, Aslakson R, Agrawal Y. Systematic review of patient-reported outcome measures in clinical vestibular research. Archives of physical medicine and rehabilitation. 2015;96(2):357-65.
Halvarsson A, Franzén E, Ståhle A. Balance training with multi-task exercises improves fall-related self-efficacy, gait, balance performance and physical function in older adults with osteoporosis: a randomized controlled trial. Clinical rehabilitation. 2015;29(4):365-75.
Bloem BR, Marinus J, Almeida Q, Dibble L, Nieuwboer A, Post B, et al. Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations. Movement disorders : official journal of the Movement Disorder Society. 2016;31(9):1342-55.
Boyce MJ, Lam L, Chang F, Mahant N, Fung VSC, Bradnam L. Validation of Fear of Falling and Balance Confidence Assessment Scales in Persons With Dystonia. Journal of neurologic physical therapy : JNPT. 2017;41(4):239-44.
Figueiredo D, Neves M. Falls Efficacy Scale-International: Exploring psychometric properties with adult day care users. Archives of gerontology and geriatrics. 2018;79:145-50.
Winser SJ, Kannan P, Bello UM, Whitney SL. Measures of balance and falls risk prediction in people with Parkinson's disease: a systematic review of psychometric properties. Clinical rehabilitation. 2019;33(12):1949-62.
Ishige S, Wakui S, Miyazawa Y, Naito H. Reliability and validity of the Activities-specific Balance Confidence scale-Japanese (ABC-J) in community-dwelling stroke survivors. Physical therapy research. 2020;23(1):15-22.
Yu Z, Coresh J, Qi G, Grams M, Boerwinkle E, Snieder H, et al. A bidirectional Mendelian randomization study supports causal effects of kidney function on blood pressure. Kidney international. 2020;98(3):708-16.
Molhemi F, Monjezi S, Mehravar M, Shaterzadeh-Yazdi MJ, Salehi R, Hesam S, et al. Effects of Virtual Reality vs Conventional Balance Training on Balance and Falls in People With Multiple Sclerosis: A Randomized Controlled Trial. Archives of physical medicine and rehabilitation. 2021;102(2):290-9.
Monjezi S, Negahban H, Tajali S, Mofateh R, Molhemi F, Mostafaee N. Psychometric properties of the Persian-version of the Activities-specific Balance Confidence scale and Fall Efficacy Scale-International in Iranian patients with multiple sclerosis. Physiother Theory Pract. 2021;37(8):935-44.
Shaik AR, Ahmad F, Miraj M, Alqahtani M, Alzhrani M, Alanazi A, et al. Efficacy of the structured balance awareness program on perceived balance confidence and fear-related maladaptive behaviour in post-stroke survivors. NeuroRehabilitation. 2021;49(4):547-52.
Ishige S, Wakui S, Miyazawa Y, Naito H. Psychometric properties of a short version of the Activities-specific Balance Confidence scale-Japanese (Short ABC-J) in community-dwelling people with stroke. Physiother Theory Pract. 2022;38(11):1756-69.
Kashif M, Ahmad A, Bandpei MAM, Gilani SA, Hanif A, Iram H. Combined effects of virtual reality techniques and motor imagery on balance, motor function and activities of daily living in patients with Parkinson's disease: a randomized controlled trial. BMC geriatrics. 2022;22(1):381.
Kashif M, Ahmad A, Bandpei MAM, Gilani SA, Iram H, Farooq M. Psychometric Properties of the Urdu Translation of Berg Balance Scale in People with Parkinson's Disease. International journal of environmental research and public health. 2022;19(4).
Khan MT, Shareef F, Farooq U, Tahir A. Impact of Facility Characteristics on Patient Safety, Patient Experience, and Service Availability for Procedures in Hospitals. Pakistan Journal of Rehabilitation. 2022;11(1):136-44.
Makki ARK, Tahir M, Amin U, Tabassum MMB, Kamran M, Tahir F. Mechanism of Meniscal Injury and its Impact on Performance in Athletes: Meniscal Injury in Athletes. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2022;2(3):232-7.
Malik J, Farooq U, Tahir M, Ayyaz A, khalid Makki AR. Impact of Attending Online Classes on Mental Health Among University Students During COVID-19 Pandemic in Lahore: Impact of Online Classes in Covid-19. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2022;2(2):162-9.
Saeed A, Kemall F, Iqbal J, Sarwar R, Mustafa M, Tahir M. Effect of Resistance Exercise Training Program on Quality of Life in Women with and without Polycystic Ovary Syndrome; A Cross Sectional Survey. Pakistan Journal of Medical & Health Sciences. 2022;16(07):956-.
Soh SL, Tan CW, Xu T, Yeh TT, Bte Abdul Rahman F, Soon B, et al. The Balance Recovery Confidence (BRC) Scale. Physiother Theory Pract. 2022:1-12.
Tahir A, Fatima A, Khan MT. Association of depression in patients with fibromyalgia syndrome. Pakistan Journal of Rehabilitation. 2022;11(1):174-83.
Yağci Şentürk A, Livanelioğlu A. The cross-cultural adaptation and factor analysis of the Turkish version of Iconographical Falls Efficacy Scale Long Version. International journal of older people nursing. 2022;17(4):e12453.
Asghar M, Safdar Z, Tahir M. Quality of life and functional Outcomes among Burn Patients: A Cross Sectional Survey. Journal of Health and Rehabilitation Research. 2023;3(2):293-8.
Elyoseph Z, Geisinger D, Zaltzman R, Mintz M, Gordon CR. The vestibular symptomatology of Machado-Joseph Disease. Journal of vestibular research : equilibrium & orientation. 2023.
Espírito Santo J, Hita-Contreras F, Marques de Loureiro NE, Brandão Loureiro V, Aibar-Almazán A, Carcelén-Fraile MDC, et al. Associations between the impact of menopausal symptoms and fall-related self-efficacy. Menopause (New York, NY). 2023;30(4):421-6.
Hasan S, Chevidikunnan MF, Khan F. Reliability and validity of the Arabic version of the modified falls efficacy scale. Disability and rehabilitation. 2023:1-9.
Safdar Z, Asghar M, Tahir M. Level of Quality of Life among Post Stroke Patients; A Cross Sectional Survey. Journal of Health and Rehabilitation Research. 2023;3(2):299-304.
Suzuki K, Morishita S, Nakano J, Okayama T, Inoue J, Tanaka T, et al. Neurological Outcomes of Chemotherapy-Induced Peripheral Neuropathy in Patients With Cancer: A Systematic Review and Meta-Analysis. Integrative cancer therapies. 2023;22:15347354231185110.
Tahir M, Maqsood M, Azhar N, Safdar Z, Amin U, Waheed TS. Association of Knee Pain in Long Standing and Sitting among University Teachers: Association of Knee Pain in University Teachers. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2023;3(1):314-21.
Tahir M, Tehzeeb K, Javaid F, Khan UA, Ayyaz A, Usama M. EFFECTS OF ROUTINE PHYSICAL THERAPY WITH AND WITHOUT HIGH INTENSITY INTERVAL TRAINING ON BALANCE, QUALITY OF LIFE AND FUNCTION IN PARKINSON’S DISEASE PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology. 2023;30(19):483-90.