Skip to main content
  • Other Publications
  • Subscribe
  • Contact Us
Advertisement
JCORE Reference
this is the JCORE Reference site slogan
  • Home
  • Most Read
  • About Us
    • About Us
    • Editorial Board
  • More
    • Advertising
    • Alerts
    • Feedback
    • Folders
    • Help
  • Patients
  • Reference Site Links
    • View Regions
  • Archive

Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke

Kimberly J. Miller, Courtney L. Pollock, Brenda Brouwer, S. Jayne Garland
DOI: 10.2522/ptj.20150423 Published 1 October 2016
Kimberly J. Miller
K.J. Miller, PT, PhD, Department of Physical Therapy, The University of British Columbia, 212 Friedman Bldg, 2177 Wesbrook Mall, Vancouver, British Columbia, Canada DV6T 1Z3.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Courtney L. Pollock
C.L. Pollock, PT, PhD, Department of Rehabilitation Sciences, The University of British Columbia.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Brenda Brouwer
B. Brouwer, PhD, School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
S. Jayne Garland
S.J. Garland, PT, PhD, Department of Physical Therapy, The University of British Columbia.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Abstract

Background The Community Balance and Mobility Scale (CB&M) is increasingly used to evaluate walking balance following stroke.

Objective This study applied Rasch analysis to evaluate and refine the CB&M for use in ambulatory community-dwelling adults following stroke.

Methods The CB&M content was linked to task demands and motor skill classifications. Rasch analysis was used to evaluate internal construct validity (structural validity) and refine the CB&M for use with ambulatory community-dwelling adults following stroke. The CB&M data were collected at 3 time points: at discharge from inpatient rehabilitation and at 6 and 12 months postdischarge (N=238). Rasch analysis evaluated scale dimensionality, item and person fit, item response bias, scoring hierarchy, and targeting. Disordered scoring hierarchy was resolved by collapsing scoring categories. Highly correlated and “misfitting” items were removed. Sensitivity to change was evaluated with standardized response means (SRMs) and one-way repeated-measures analysis of variance.

Results The CB&M was primarily linked to closed body transport task demands. Significant item-trait interaction, disordered scoring hierarchies, and multidimensionality were found. Scoring categories were collapsed in 15/19 items, and 5 misfitting items were removed. The resulting stroke-specific 14-item unidimensional CB&M (CB&MStroke) fit Rasch model expectations, with no item response bias, acceptable targeting (13% floor effects and 0% ceiling effects), and moderate-to-strong sensitivity to change at 6 months postdischarge (SRM=0.63; 95% confidence interval=−1.523, −0.142) and 12 months postdischarge (SRM=0.73; 95% confidence interval=−2.318, −0.760).

Limitations Findings are limited to a modest-sized sample of individuals with mild-to-moderate balance impairment following stroke.

Conclusions The CB&MStroke shows promise as a clinical scale for measuring change in walking balance in ambulatory community-dwelling adults poststroke. Future studies are recommended in a larger sample to validate and further refine the scale for use in this clinical population.

Footnotes

  • Dr Miller planned and executed the analyses. All authors contributed to interpreting the results, writing, and approval of the final manuscript. The authors acknowledge the support of Dr J. Pallant in providing Rasch analysis methodology materials and advice.

  • The preliminary findings from this research were presented at the Canadian Stroke Congress; October 4–7, 2014; Vancouver, British Columbia, Canada.

  • The data used for this secondary analysis were obtained from studies supported by a Heart and Stroke Foundation of BC and Yukon grant awarded to Dr Garland (grant number 000227) and a Heart and Stroke Foundation of Ontario grant awarded to Dr Brouwer and Dr Garland (SRA 5974). Dr Miller was supported by a Heart and Stroke Foundation Junior Personnel Research Fellowship, and Dr Pollock was supported by a Canadian Institutes of Health Doctoral Fellowship. Dr Garland and Dr Brouwer are the principal investigators for grant funding of the respective clinical trials providing the data used in this secondary analysis.

  • This study was a secondary analysis of data from 2 clinical trials. Ethics approval for ClinicalTrials.gov NCT00400712 was obtained from the human research ethics boards at Western University and Queen's University. The Human Research Ethics Board at the University of British Columbia approved both ClinicalTrials.gov NCT00400712 and ClinicalTrials.gov NCT01573585.

  • Received July 30, 2015.
  • Accepted March 28, 2016.
  • © 2016 American Physical Therapy Association
View Full Text
PreviousNext
Back to top
Vol 96 Issue 10 Table of Contents
Physical Therapy: 96 (10)

Issue highlights

  • Our Future Selves: Unprecedented Opportunities
  • Toward a Transformed Understanding: From Pain and Movement to Pain With Movement
  • Virtual Reality for Stroke Rehabilitation
  • Consensus on Exercise Reporting Template (CERT): Modified Delphi Study
  • Agreement of Mechanical Diagnosis and Therapy Classification in People With Extremity Conditions
  • High-Intensity Interval Training and Moderate-Intensity Continuous Training in Ambulatory Chronic Stroke: Feasibility Study
  • Therapeutic Ultrasound and Treadmill Training Suppress Peripheral Nerve Injury–Induced Pain in Rats
  • A Further Step to Develop Patient-Friendly Implementation Strategies for Virtual Reality–Based Rehabilitation in Patients With Acute Stroke
  • Transitions in the Embodied Experience After Stroke: Grounded Theory Study
  • Neck Posture Clusters and Their Association With Biopsychosocial Factors and Neck Pain in Australian Adolescents
  • Physical Therapists' Role in Health Promotion as Perceived by the Patient: Descriptive Survey
  • Finding the “Right-Size” Physical Therapy Workforce: International Perspective Across 4 Countries
  • Does the Brief-BESTest Meet Classical Test Theory and Rasch Analysis Requirements for Balance Assessment in People With Neurological Disorders?
  • Roland-Morris Disability Questionnaire and Oswestry Disability Index: Which Has Better Measurement Properties for Measuring Physical Functioning in Nonspecific Low Back Pain? Systematic Review and Meta-Analysis
  • Responsiveness of the Balance Evaluation Systems Test (BESTest) in People With Subacute Stroke
  • Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke
  • de Morton Mobility Index Is Feasible, Reliable, and Valid in Patients With Critical Illness
Email

Thank you for your interest in spreading the word on JCORE Reference.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke
(Your Name) has sent you a message from JCORE Reference
(Your Name) thought you would like to see the JCORE Reference web site.
Print
Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke
Kimberly J. Miller, Courtney L. Pollock, Brenda Brouwer, S. Jayne Garland
Physical Therapy Oct 2016, 96 (10) 1648-1657; DOI: 10.2522/ptj.20150423

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Download Powerpoint
Save to my folders

Share
Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke
Kimberly J. Miller, Courtney L. Pollock, Brenda Brouwer, S. Jayne Garland
Physical Therapy Oct 2016, 96 (10) 1648-1657; DOI: 10.2522/ptj.20150423
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Article
    • Abstract
    • Method
    • Results
    • Discussion
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease
  • Predictors of Reduced Frequency of Physical Activity 3 Months After Injury: Findings From the Prospective Outcomes of Injury Study
  • Effects of Locomotor Exercise Intensity on Gait Performance in Individuals With Incomplete Spinal Cord Injury
Show more Measurement

Subjects

  • Examination/Evaluation
    • Tests and Measurements
  • Geriatrics
    • Stroke (Geriatrics)
  • Neurology/Neuromuscular System
    • Stroke (Neurology)
    • Balance

Footer Menu 1

  • menu 1 item 1
  • menu 1 item 2
  • menu 1 item 3
  • menu 1 item 4

Footer Menu 2

  • menu 2 item 1
  • menu 2 item 2
  • menu 2 item 3
  • menu 2 item 4

Footer Menu 3

  • menu 3 item 1
  • menu 3 item 2
  • menu 3 item 3
  • menu 3 item 4

Footer Menu 4

  • menu 4 item 1
  • menu 4 item 2
  • menu 4 item 3
  • menu 4 item 4
footer second
footer first
Copyright © 2013 The HighWire JCore Reference Site | Print ISSN: 0123-4567 | Online ISSN: 1123-4567
advertisement bottom
Advertisement Top