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The Fab Balance Enquiry Scale exhibits excellent person and item separation reliability and discriminates between participants with differing balance abilities. More exploration may be warranted regarding Rasch-generated expected item scoring patterns as potential benchmarks of concurrent validity.
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Fab Balance exhibits strong construct validity with high person and item separation reliability. Nine of its 10 test items fit a unidimensional model of balance ability; Item 10 (reactive postural control) did not, thus necessitating separate interpretation. Interrater reliability for the scale measured 0.91 while intrarater reliability reached 0.99, showing that it provides an expected pattern of scoring balance ability scoring within normative populations; additionally a Bland-Altman limit of agreement was also established.
Construct validity refers to the degree to which an assessment tool measures what it claims it does, such as balance. This can be determined by testing results correlating with certain constructs of interest such as balance.
Fab Balance was developed to assess balance in higher functioning community-dwelling adults. For this, a multi-item assessment tool with high person and item separation reliability as well as discriminating between individuals of differing balance abilities was necessary.
For their multi-item battery, the research team conducted a literature search to locate existing clinical tests which challenge multiple components of postural control across various testing paradigms. Once selected, this list was narrowed down further by comparing test purposes and established clinometric properties to determine which should remain included within it.
A multi-item battery of tests was developed, comprising of Balance Error Scoring System, Tandem Gait Test and Clinical Reaction Time Test performed under single and dual task (concurrent cognitive task) testing conditions. These assessments are easily accessible to geriatric clinical specialists and can be administered without extensive equipment in clinical settings.
Fab Balance is an evidence-based multi-item balance assessment tool for higher-functioning older adults. When administered by clinical specialists in Geriatric Rehabilitation settings, its reliability and validity was proven. Unfortunately, no studies have yet examined its reliability when administered to non-clinical exercise specialists who work directly with older adults outside rehabilitation settings.
This study sought to determine the test-retest, intrarater, and inter rater reliability as well as internal consistency (item-total correlations, Cronbach’s alpha) of the FAB scale as well as concurrent validity by assessing FAB scores against EDSS, Dynamic Gait Index, and Timed Up and Go Test scores.
Six exercise specialists observed videotapes of participants’ performances on each of the four FAB tasks over two separate occasions one week apart and scored them, finding excellent intra and inter rater reliability for this scale as well as good concurrent validity with both EDSS and DGI instruments.
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Rasch modeling showed that nine out of the 10 FAB scale items fit comfortably within one dimension, and had person and item separation reliability. Furthermore, no ceiling effects occurred with this scale.
These results suggest that the FAB scale may be useful in assessing balance abilities of higher-functioning community-dwelling older adults, although further research needs to be conducted in order to fully ascertain its diagnostic and prescriptive utility in clinical settings. It would also be worthwhile exploring its sensitivity to change over time and ability to discriminate between those of differing balance abilities; when using multi-item tools it’s also essential to take account of dimensionality and hierarchy when using them.