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. 2014 Mar;94(3):371-8. doi: 10.2522/ptj.20130182. Epub 2013 Oct 3.
People with lower limb amputations frequently have impaired balance ability. The Berg Balance Scale (BBS) has excellent psychometric properties for people with neurologic disorders and elderly people dwelling in the community. A Rasch analysis demonstrated the validity of the BBS for people with lower limb amputations of all ability strata, but rater reliability has not been tested.
The study objective was to determine the interrater reliability and intrarater reliability of BBS scores and the differences in scores assigned by testers with various levels of experience when assessing people with lower limb amputations.
This reliability study of video-recorded single-session BBS assessments had a cross-sectional design.
From a larger study of people with lower limb amputations, 5 consecutively recruited participants using prostheses were video recorded during an in-person BBS assessment. Sixteen testers independently rated the video-recorded assessments. Testers were 3 physical therapists, 1 occupational therapist, 3 third-year and 4 second-year doctor of physical therapy (DPT) students, and 5 first-year DPT students without clinical training. Rater reliability was calculated using intraclass correlation coefficients (ICC [2,k]). Differences in scores assigned by testers with various levels of experience were determined by use of an analysis of variance with Tukey post hoc tests.
The average age of the participants was 53.0 years (SD=15.7). Amputations had occurred at the ankle disarticulation, transtibial, and transfemoral levels because of vascular, trauma, and medical etiologies an average of 8.2 years earlier (SD=7.9). Berg Balance Scale scores spanned all ability strata. Interrater reliability (ICC [2,k]=.99) and intrarater reliability of scores determined in person and through video-recorded assessments by the same testers (ICC [2,k]=.99) were excellent. For participants with the lowest levels of ability, licensed professionals assigned lower scores than did DPT students without clinical training.
Intrarater reliability calculations were based on 2 testers.
Berg Balance Scale scores assigned to people using prostheses by testers with various levels of clinical experience had excellent interrater reliability and intrarater reliability.
下肢截肢者通常平衡能力受损。Berg 平衡量表（BBS）对患有神经疾病和居住在社区的老年人具有出色的心理测量学特性。Rasch 分析表明，BBS 对所有能力层次的下肢截肢者均有效，但评分者信度尚未得到检验。
本研究旨在确定 BBS 评分的评分者间信度和评分者内信度，以及不同经验水平的评估者评估下肢截肢者时评分的差异。
这是一项关于录像单次 BBS 评估的可靠性研究，采用了横断面设计。
从一项更大的下肢截肢者研究中，连续招募了 5 名使用假肢的参与者，在他们进行 BBS 评估时进行录像。16 名评估者独立对录像评估进行评分。评估者为 3 名物理治疗师、1 名职业治疗师、3 名三年级和 4 名二年级物理治疗博士（DPT）学生以及 5 名无临床培训的一年级 DPT 学生。使用组内相关系数（ICC[2，k]）计算评分者信度。使用方差分析和 Tukey 事后检验确定不同经验水平的评估者评分差异。
参与者的平均年龄为 53.0 岁（SD=15.7）。截肢发生在踝关节离断、胫骨和股骨水平，由于血管、创伤和医疗原因，平均发生在 8.2 年前（SD=7.9）。Berg 平衡量表评分涵盖了所有能力层次。评分者间信度（ICC[2，k]=.99）和同一评估者通过现场和录像评估的评分者内信度（ICC[2，k]=.99）均非常出色。对于能力最低的参与者，持照专业人员的评分低于无临床培训的 DPT 学生。
评分者内信度计算基于 2 名评估者。
具有不同临床经验水平的评估者对使用假肢的人进行的 Berg 平衡量表评分具有出色的评分者间信度和评分者内信度。
