C.K. Wong, PT, PhD, OCS, Program in Physical Therapy, Columbia University, 710 W 168th St, New York, NY 10032 (USA), and Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, New York.
Phys Ther. 2013 Nov;93(11):1520-9. doi: 10.2522/ptj.20130009. Epub 2013 Jun 6.
Self-report measures of balance and multidimensional mobility assessments are common for people with a leg amputation, yet clinical assessment of balance ability remains less explored. The Berg Balance Scale (BBS), typically used for other populations with impaired balance, has been used for young people with a high level of functioning after traumatic amputation but rarely for older people after vascular amputation.
The study objective was to examine the psychometric properties of the BBS with Rasch rating scale analysis to determine the validity and utility of the BBS in assessing balance ability in adults who have a leg amputation and dwell in the community.
Rating scale analysis was applied to BBS scores obtained from a single assessment.
Adult volunteers (men and women) who had a leg amputation (any level and etiology) and dwelled in the community were recruited from a hospital-based community support group and a prosthetic clinic. Rating scale analysis of the BBS was used to assess unidimensionality, internal validity, goodness of fit, structural integrity, and person and item analyses.
The study participants were 40 people (26 men and 14 women; 57.8 [SD=9.7] years old) with leg amputations (24 transtibial, 13 transfemoral, and 3 bilateral) of mixed etiology (32 vascular and 8 nonvascular). The psychometric properties of the BBS confirmed that it measures the unidimensional construct of balance ability with adequate validity and with goodness of fit and structural integrity that meet the acceptability criteria. Person measures revealed that some participants scored near the top of the BBS, suggesting a ceiling effect; item measures revealed that participants with leg amputations had the most difficulty performing the following tasks: standing with 1 leg in front, turning 360 degrees, and placing alternate foot on a stool.
Limitations included a convenience sample and a lack of rater reliability testing.
The BBS cohered with the unidimensional construct of balance ability and had strong internal validity for use in a variety of people with leg amputations.
自我报告的平衡测量和多维移动性评估在腿部截肢者中很常见，但平衡能力的临床评估仍未得到充分探索。伯格平衡量表（BBS）通常用于其他平衡受损的人群，但也用于创伤性截肢后功能水平较高的年轻人，而很少用于血管性截肢后的老年人。
本研究旨在通过 Rasch 评分量表分析来检验 BBS 的心理测量特性，以确定 BBS 在评估社区中腿部截肢成年人平衡能力方面的有效性和实用性。
评分量表分析应用于单次评估中获得的 BBS 评分。
从医院社区支持小组和假肢诊所招募了腿部截肢（任何水平和病因）并居住在社区的成年志愿者（男性和女性）。使用 BBS 的评分量表分析来评估单维性、内部有效性、拟合优度、结构完整性以及个体和项目分析。
研究参与者为 40 人（26 名男性和 14 名女性；57.8 [标准差=9.7] 岁），他们的腿部截肢（24 例胫骨截肢、13 例股骨截肢和 3 例双侧截肢）病因多样（32 例血管性和 8 例非血管性）。BBS 的心理测量特性证实，它测量平衡能力的单一维度结构，具有足够的有效性，且拟合优度和结构完整性符合可接受的标准。个体测量结果显示，一些参与者的 BBS 得分接近最高分，表明存在天花板效应；项目测量结果显示，腿部截肢患者在以下任务中最困难：单腿站立、360 度转身和交替将脚放在凳子上。
局限性包括便利样本和缺乏评估者可靠性测试。
BBS 与平衡能力的单一维度结构相符，在各种腿部截肢患者中具有较强的内部有效性。
