Myers A M, Fletcher P C, Myers A H, Sherk W
Department of Health Studies and Gerontology, University of Waterloo, Ontario, Canada.
J Gerontol A Biol Sci Med Sci. 1998 Jul;53(4):M287-94. doi: 10.1093/gerona/53a.4.m287.
Balance confidence is an important indicator of functional mobility and independence in older adults. Preliminary psychometric evidence for the Activities-specific Balance Confidence (ABC) Scale is promising, with a series of four studies adding information on the discriminative and evaluative properties of this tool.
The original validation sample was reinterviewed one year later. In the second study, the ABC was administered to 475 older adults ranging from home care clients to highly functioning individuals in community exercise programs. The third study compared 31 residents of retirement homes given a 10-week balance control exercise program and fall education with 32 residents who received only fall education. The fourth study examined balance confidence preoperatively and postoperatively for 27 patients undergoing hip or knee replacement.
ABC scores remained stable over 12 months in higher functioning elders, but deteriorated in retirement home residents over 26 weeks. Ten weeks of balance training significantly improved balance confidence, as did hip or knee replacement with standard physical therapy. ABC scores lower than 50 indicated a low level of physical functioning characteristic of home care clients. ABC scores above 50 and lower than 80 indicated a moderate level of functioning characteristic of elders in retirement homes and persons with chronic health conditions. ABC scores above 80 are indicative of highly functioning, usually physically active older adults, and are achievable through exercise and rehabilitative therapies. CONCLUSIONS. Balance confidence is amenable to change and able to distinguish between elders at various levels of functional mobility. These results provide comparative benchmarks for researchers and clinicians working with different groups of older adults.
平衡信心是老年人功能活动能力和独立性的重要指标。特定活动平衡信心（ABC）量表的初步心理测量证据很有前景，有一系列四项研究补充了关于该工具区分性和评估性属性的信息。
一年后对原始验证样本进行重新访谈。在第二项研究中，对475名老年人施测ABC量表，这些老年人涵盖了从家庭护理对象到社区锻炼项目中功能良好的个体。第三项研究比较了31名接受为期10周平衡控制锻炼项目和跌倒教育的养老院居民与32名仅接受跌倒教育的居民。第四项研究检查了27名接受髋关节或膝关节置换手术患者术前和术后的平衡信心。
在功能较高的老年人中，ABC得分在12个月内保持稳定，但在养老院居民中，26周内得分下降。十周的平衡训练显著提高了平衡信心，髋关节或膝关节置换手术结合标准物理治疗也有同样效果。低于50分的ABC得分表明是家庭护理对象特有的低身体功能水平。50分以上且低于80分的ABC得分表明是养老院老年人和慢性健康状况患者特有的中等功能水平。高于80分的ABC得分表明功能良好，通常是身体活跃的老年人，并且可以通过锻炼和康复治疗实现。结论：平衡信心是可以改变的，并且能够区分不同功能活动水平的老年人。这些结果为研究不同老年人群体的研究人员和临床医生提供了比较基准。
