Reliability and validity of functional balance tests post stroke.

OBJECTIVE

To contribute to the reliability and validity of a series of functional balance tests for use post stroke.

DESIGN

Within-session, test-retest and intertester reliability was tested using the kappa coefficient and intraclass correlations. The tests were performed three times and the first and third attempts compared to test the within-session reliability. The tests were repeated a few days later to assess test-retest reliability and were scored simultaneously by two physiotherapists to assess the intertester reliability. To test criterion-related validity the tests were compared with the sitting section of the Motor Assessment Scale, Berg Balance Scale and Rivermead Mobility Index using Spearman's rho.

SETTING

Stroke physiotherapy services of six National Health Service hospitals.

PARTICIPANTS

People with a post stroke hemiplegia attending physiotherapy who had no other pathology affecting their balance took part. Thirty-five people participated in the reliability testing and 48 people took part in the validity testing.

MAIN OUTCOME MEASURES: The following functional balance tests were used: supported sitting balance, sitting arm raise, sitting forward reach, supported standing balance, standing arm raise, standing forward reach, static tandem standing, weight shift, timed 5-m walk with and without an aid, tap and step-up tests.

RESULTS

The ordinal level tests (supported sitting and standing balance and static tandem standing tests) showed 100% agreement in all aspects of reliability. Intraclass correlations for the other tests ranged from 0.93 to 0.99. All the tests showed significant correlations with the appropriate comparator tests (r = 0.32-0.74 p < 0.05), except the weight shift test and step-up tests which did not form significant relationship with Berg Balance Scale (r = 0.26 and 0.19 respectively).

CONCLUSION

These functional balance tests are reliable and valid measures of balance disability post stroke.