Investigation of reliability and validity of TWO balance scales in individuals with multiple sclerosis

This study was conducted to examine the reliability and validity of the Fullerton Advanced Balance Scale (FAB) and the Community Balance & Mobility Scale (CB&M) in individuals with Multiple Sclerosis (MS). A total of 65 individuals with multiple sclerosis, 55 women and 10 men, aged 18-55 (36.48±9.40), Expanded Disability Status Scale (EDSS) ranging from 1-5.5, 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 in order to examine the reliability of FAB and CB&M. While the test-retest reliability was examined, the patients were evaluated for the second time within 2-15 days after their first evaluation, and FAB and CB&M were applied. In the intra-rater and inter-rater reliability examination; FAB and CB&M applications of 34 patients whose initial evaluation was taken were video-recorded and re-watched by two physiotherapists at different times and scored. Observer reliability was calculated with the obtained scores. By examining the validity of FAB and CB&M, concurrent validity for criterion validity; The construct validity was calculated using hypothesis testing. For validity, correlations between both scales with Berg Balance Scale (BBS), EDDS, Dynamic Gait Index (DGI), Multiple Sclerosis Quality of Life Instrument-54 (MSQol-54), Timed Up and Go Test (TUG) were examined. As a result of the analyzes, it was determined that the test-retest reliability of FAB and CB&M's Intraclass Correlation Coefficient (ICC) values were excellent (ICC= 0.994 and 0.995, respectively). 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, the intra-rater reliability (ICC=0.929, p<0.001) and Inter-rater reliability (ICC=0.986, p<0.001) of CB&M were calculated excellent. Cronbach's alpha value was calculated to examine the internal consistency of FAB and CB&M, and a perfect correlation was determined (Cronbach's alpha coefficient: 0.929 and 0.971, respectively). FAB had an excellent correlation with BBS and EDSS; CB&M had an excellent correlation with BBS and EDSS (0.919 (p<0.001),-0.885 (p<0.001), 0.907 (p<0.001), -0.831 (p<0.001), respectively). For convergent validity of FAB, TUG (r=-0.833, p<0.001), DGI (r=0.916, p<0.001), MSQol-54 Physical (r=0.458, p<0.001) and MSQol-54 Cognitive (r=0.297), p<0.001) scales, it was determined that the scale had convergent validity. For convergent validity of CB&M, TUG (r=-0.854, p<0.001), DGI (r=0.865, p<0.001), MSQol-54 Physical (r=0.482, p<0.001) and MSQol-54 Cognitive (r=0.315, p<0.001), the relationship between and was examined and it was found to have convergent validity. According to the results of the study, FAB and CB&M proved to be a reliable and valid scale in individuals with Multiple Sclerosis.