Establishing the reliability and validity of the Falls Efficacy Scale-International among people with motor incomplete spinal cord injury: A secondary analysis.

CONTEXT: The Falls-Efficacy Scale-International (FES-I) was developed to assess concern for falling in older adults. This measure has since been used with people with motor incomplete spinal cord injuries (iSCI) in research and clinical practice, but the psychometric properties have not yet been determined in this population.

OBJECTIVE

The objectives of this research study were to determine (1) the test-retest reliability of the FES-I in people with chronic iSCI, and (2) the validity (i.e. convergent and known-groups) of the FES-I in people with chronic and subacute iSCI.

METHODS

Secondary data from three studies were used; two studies included participants with chronic iSCI (n = 20; n = 25), and one study included participants with subacute iSCI (n = 40). Data from one study that included participants with chronic iSCI were used to determine the test-retest reliability of the measure. Data from all studies were used to determine the convergent validity of FES-I scores with the Activities-specific Balance Confidence (ABC) Scale and known-group validity for both chronic and subacute populations.

RESULTS

FES-I scores were found to be reliable in people with chronic iSCI (ICC = 0.91) and showed moderately strong correlations with ABC scale scores in both chronic (r = -0.71, P < 0.001) and subacute (r = -0.88, P < 0.001) participants. Known-group validity was only found for FES-I scores and people with a self-reported fear of falling in the subacute population.

CONCLUSIONS

The FES-I is a reliable and valid measure for use in iSCI research and clinical practice; further research is needed to determine predictive and descriptive validity.