Construct validity and reliability of the modified gait efficacy scale for older adults

To perform a cross-cultural adaptation of the mGES into Dutch and investigate its construct validity, internal consistency, test-retest reliability and floor and ceiling effects in a large cohort of community-dwelling older adults. We translated the British version of the mGES into Dutch, back into English, and had a native English speaker review the final version. Next, we included 223 community-dwelling older adults from the ‘Veilig in Beweging Blijven’ (VIBE) cohort (69.8 [67.6–74.3] years old, 155 (69.5%) female), who filled out both the mGES and the Falls Efficacy Scale-International (FES-I) twice, with a month in between. Construct validity was assessed by Spearman’s correlation between the scores on the mGES and the FES-I. Internal consistency was assessed with Cronbach’s alpha and test-retest reliability was assessed with the intra class correlation coefficient (ICC(2,1)). Construct validity (rho = −0.81, <i>p</i> &lt; 0.001), internal consistency (α = 0.95), and test-retest reliability (ICC(2,1)=0.90, 95%CI = [0.87–0.92]) were all excellent. Ceiling effect was observed in 44 (19.7%) participants which suggest caution when evaluating the mGES for fit and confident older adults. The Dutch mGES is a valid and reliable tool to assess confidence in walking and is suggested as a tool for evaluating self-efficacy after interventions aimed at improving gait.IMPLICATIONS FOR REHABILITATIONAssessment and rehabilitation of gait may be affected by self-efficacy of walking performance.We show that the Dutch translation of the modified gait efficacy scale is a valid and reliable tool for assessing self-efficacy of walking.A ceiling effect was observed that was associated with muscle strength and symptoms of depression.The results of the present study underline the use of the modified gait efficacy scale in the assessment and evaluation of self-efficacy of walking in rehabilitation. Assessment and rehabilitation of gait may be affected by self-efficacy of walking performance. We show that the Dutch translation of the modified gait efficacy scale is a valid and reliable tool for assessing self-efficacy of walking. A ceiling effect was observed that was associated with muscle strength and symptoms of depression. The results of the present study underline the use of the modified gait efficacy scale in the assessment and evaluation of self-efficacy of walking in rehabilitation.

本研究旨在对修订版步态效能量表（modified Gait Efficacy Scale, mGES）开展跨文化调适，将其转化为荷兰语版本，并在大型社区居住老年人群体中检验其结构效度、内部一致性、重测信度及地板、天花板效应。
本研究将英国版mGES翻译为荷兰语，随后回译为英语，并邀请母语为英语的人员对终稿进行审核。
随后纳入来自"Veilig in Beweging Blijven"（VIBE）队列的223名社区居住老年人，年龄为69.8岁（四分位间距67.6~74.3岁），其中女性155名（占比69.5%）；所有受试者均在间隔1个月的两次评估中，先后完成mGES与跌倒效能量表国际版（Falls Efficacy Scale-International, FES-I）的填写。
采用Spearman相关分析评估mGES与FES-I得分的相关性，以检验结构效度；采用克朗巴赫α系数评估内部一致性；采用组内相关系数（ICC(2,1)）评估重测信度。
研究结果显示，结构效度（rho=-0.81，*p*<0.001）、内部一致性（α=0.95）及重测信度（ICC(2,1)=0.90，95%置信区间[0.87~0.92]）均表现优异。共有44名受试者（占比19.7%）出现天花板效应，提示在评估mGES的适配性，以及对自信老年人使用该量表时需谨慎。
荷兰语版mGES是评估行走自信的有效且可靠工具，可用于评估旨在改善步态的干预措施后的自我效能感。
康复应用启示
行走表现的自我效能感可能影响步态评估与康复过程。本研究证实，荷兰语版修订版步态效能量表是评估行走自我效能感的有效可靠工具。本研究观察到的天花板效应与肌肉力量及抑郁症状相关。本研究结果进一步支持在康复领域中，使用修订版步态效能量表评估行走自我效能感的合理性。
行走表现的自我效能感可能影响步态评估与康复过程。本研究证实，荷兰语版修订版步态效能量表是评估行走自我效能感的有效可靠工具。本研究观察到的天花板效应与肌肉力量及抑郁症状相关。本研究结果进一步支持在康复领域中，使用修订版步态效能量表评估行走自我效能感的合理性。