The reliability and agreement of scores in a novel balance measure for older adults: Specific Training According to BaLance Evaluation (STABLE)

Falls are the leading cause of injury and premature death among community dwelling elderly but can be prevented through comprehensive balance rehabilitation which ideally targets the patient’s specific needs. In this study, we evaluate the reliability and agreement of six novel clinical measures of different balance domains which applied in a patient-specific balance profile guides exercise prescription in balance rehabilitation. The intra-rater reliability and agreement of the six measures were evaluated on the same day in six different cohorts of elderly with balance disability (<i>n</i> = 65–100). Further, the inter-day intra-rater and inter-rater and test–retest reliability and agreement of the measures and the balance profile were evaluated (<i>n</i> = 100). The intra-day intra-rater reliability and agreement was moderate to excellent (ICC_2.1 = 0.525–0.968, with SDC% = 6.5–284.9%) but poor to good for the inter-day conditions (ICC_2.1 = 0.123–0.832, with SDC% = 6.6–229.2%). The reliability of classifying the lower domain in the balance profile was fair, with kappa = 0.56 (95%CI 0.36–0.76). Five of the six measures may reliably be applied to measure balance disability and to guide rehabilitation. Implications for rehabilitationBalance disability is the primary reason for accidental falls among elderly but can be prevented through comprehensive individualized balance rehabilitation.Specific Training According to BaLance Evaluation (STABLE) is a novel approach for designing effective balance exercises based on clinical measurements.Five of the six measures are reliable when applied in a patient-specific balance profile to guide rehabilitation following the STABLE approach. Balance disability is the primary reason for accidental falls among elderly but can be prevented through comprehensive individualized balance rehabilitation. Specific Training According to BaLance Evaluation (STABLE) is a novel approach for designing effective balance exercises based on clinical measurements. Five of the six measures are reliable when applied in a patient-specific balance profile to guide rehabilitation following the STABLE approach.

跌倒为社区居住老年人群受伤与过早死亡的首要诱因，但可通过以患者个体化需求为核心的全面平衡康复进行预防。本研究针对六项覆盖不同平衡维度的新型临床测评手段的信度与一致性进行评估——该类手段可依托个体化平衡特征图谱，指导平衡康复中的运动处方制定。
本研究于同日针对6组平衡障碍老年队列（样本量为n=65~100），评估了六项测评手段的评定者内信度与一致性；此外，在样本量为n=100的队列中，针对测评手段及平衡特征图谱的跨日评定者内信度、评定者间信度与重测信度及一致性进行了评估。
六项测评手段的评定者日内信度与一致性表现为中等至优秀（组内相关系数ICC₂.₁=0.525~0.968，最小可检测变化百分比SDC%=6.5%~284.9%），而跨日条件下的信度与一致性则为差至良好（ICC₂.₁=0.123~0.832，SDC%=6.6%~229.2%）。平衡特征图谱中下肢维度分类的信度尚可，Kappa系数为0.56（95%置信区间（95%CI）=0.36~0.76）。
六项测评手段中有五项可可靠地用于评估平衡障碍并指导康复实践。
康复启示：平衡障碍是老年人群意外跌倒的首要诱因，可通过全面的个体化平衡康复进行预防。基于平衡评估的专项训练（Specific Training According to BaLance Evaluation, STABLE）是一种依托临床测评手段设计高效平衡训练方案的新型方法。六项测评手段中有五项可依托个体化平衡特征图谱，在遵循STABLE方案的前提下用于指导康复实践。平衡障碍是老年人群意外跌倒的首要诱因，可通过全面的个体化平衡康复进行预防。基于平衡评估的专项训练（Specific Training According to BaLance Evaluation, STABLE）是一种依托临床测评手段设计高效平衡训练方案的新型方法。六项测评手段中有五项可依托个体化平衡特征图谱，在遵循STABLE方案的前提下用于指导康复实践。