Have a personal or library account? Click to login
Diagnostic tests to assess balance in patients with spinal cord injury: a systematic review of their validity and reliability Cover

Diagnostic tests to assess balance in patients with spinal cord injury: a systematic review of their validity and reliability

Open Access
|Jun 2021

Figures & Tables

Figure 1

PRISMA flow diagram for record triage through the different phases of systematic review.
PRISMA flow diagram for record triage through the different phases of systematic review.

Summary of studies that assessed the validity or reliability of 10 clinical instruments

ArticleMethodological qualityPatient characteristicsBalance measureValidityReliability
Adegoke et al. [21]Inadequate20 adult nonambulatory patients with SCIFRT Test–retest reliability was assessed. ICC ranged from 0.98 to 0.99 in individuals with different levels of injuries
Boswell-Ruys et al. [22]Doubtful30 adult patients with SCIFRT and T-Shirt TestConstruct validity was assessed using ASIA scores, level of injury, and duration of injury. The tests had good construct validity in that they distinguished between subjects with higher (C6–T7) and lower (T8–L2) levels of injuries and between patients with acute and chronic SCI. The tests correlated with ASIA motor and sensory scoresTest–retest reliability was assessed. ICC for the reach test ranged from 0.80 to 0.89 in different directions while ICC for T-Shirt Test ranged from 0.85 to 0.91 with different tasks of the test
Field-Fote and Ray [23]Adequate32 adult patients with motor incomplete SCIFRTConcurrent validity was tested with center of pressure excursion. The correlation of forward, backward, right and left reach with center of pressure excursion were 0.71, 0.72, 0.95, and 0.61, respectivelyTest–retest reliability was assessed. ICCs ranged from 0.78 to 0.95 in different directions
Lynch et al. [24]Inadequate30 adult patients with motor complete SCIFRT Test–retest reliability was assessed. ICC ranged from 0.85 to 0.94 in patients with different levels of injuries
Sprigle et al. [25]Doubtful20 adult patients with SCI and injury duration less than 6 monthsFRTConvergent validity was assessed. The correlation of FRT with activities of daily living score was 0.46Test–retest reliability was assessed. ICC was 0.85
Sprigle et al. [26]Inadequate22 adult patients with chronic SCIFRT Test–retest reliability was assessed. ICC was 0.87
Srisim et al. [27]Inadequate25 adult ambulatory patients with SCIBBS, FRT and Five Times Sit-to-Stand Test Inter-rater reliability was assessed. ICC for BBS, FRT, and Five Times Sit-to-Stand Test were 0.99, 1.00, and 0.99, respectively
Wirz et al. [28]Doubtful42 adult patients with SCIBBSConcurrent validity was assessed. The correlation of BBS with SCIM mobility score, Walking Index for SCI, Falls Efficacy Scale, motor scores, and number of falls was 0.89, 0.82, 0.93, 0.81, 0.62, and 0.17, respectivelyInter-rater reliability was assessed. ICC was 0.953
Tamburella et al. [29]Doubtful23 adult patients with incomplete SCIBBS, Tinetti (total), Tinetti (equilibrium), Tinetti (locomotion) Intra-rater reliability was assessed. ICC for BBS, Tinetti (total), Tinetti (equilibrium), and Tinetti (locomotion) were 0.97, 0.22, 0.87, and 0.78, respectively
Jørgensen et al. [30]Adequate46 adult patients with chronic SCIBBS and Mini-BESTestConstruct validity was assessed. Strong correlations between both scales (r = 0.90) and between both scales and Timed Up and Go (r > 0.70), SCIM mobility scores (r > 0.80), and 10-Meter Walk Test (r > 0.80) support high construct validityInternal consistency was assessed. Cronbach α for BBS was 0.94 while α for Mini-BESTest was 0.95
Lemay and Nadeau [31]Inadequate32 adult patients with motor incomplete SCIBBSConcurrent validity was assessed. The correlation of BBS with 2-minute walk test, Walking Index for SCI, 10-Meter Walk Test, and Timed Up and Go were 0.78, 0.81, 0.79, and –0.81, respectively, while its correlation with Functional Ambulation Inventory (SCI-FAI) ranged 0.71–0.74
Chan et al. [32]Adequate21 adult patients with chronic motor incomplete SCIMini-BESTestConcurrent and convergent validity was tested with measures of center of pressure velocity during eye open and eye closed standing and lower extremity muscle strength, respectively. The correlation of Mini-BESTest scores with center of pressure velocity during standing with eye open ranged from –0.48 to –0.76 and during standing with eye closed ranged from –0.04 to 0.07. The correlation of Mini-BESTest scores with lower extremity muscle strength was 0.73Test–retest reliability was assessed. ICC for the total score of Mini-BESTest was 0.98
Roy et al. [33]Very good23 adult patients with SCIMini-BESTest Test–retest and inter-rater reliability was assessed.
ICC for test–retest and inter-rater reliability were 0.94 and 0.96, respectively
Abou et al. [34]Adequate26 adult nonambulatory patients with chronic SCIFunction in Sitting TestConcurrent validity was tested with modified FRT (forward and lateral) and posturography assessment (virtual time to contact). The correlation of function in sitting test with lateral reach was 0.64 while its correlation with forward reach and virtual time to contact was 0.16 and 0.23, respectively.Test–retest reliability and internal consistency was assessed.
ICC was 0.95 Cronbach α was 0.81
Jørgensen et al. [35]Adequate48 adult patients with SCIMotor Assessment Scale item 3 and Sitting Balance ScoreCriterion validity was assessed. The correlation between the scales were in relation to neurological injury level (r = 0.19–0.51), extent of injury (r = 0.57–0.68), functional independence measure (r = 0.13–0.68), and 5 additional mobility and locomotor items (r = 0.10–0.49)Inter-rater reliability was assessed. For Motor Assessment Scale item 3 k with linear weights (kw) ranged from 0.83 to 0.91 with different raters while for Sitting Balance Score k with linear weights (kw) ranged from 0.69 to 0.96 with different raters
Wadhwa and Aikat [36]Doubtful30 adult patients with SCISitting Balance MeasureContent validity of Sitting Balance Measure was established through qualitative review by experts and by calculating content validity ratio.Internal consistency was assessed. Cronbach α was 0.96
DOI: https://doi.org/10.2478/abm-2021-0014 | Journal eISSN: 1875-855X | Journal ISSN: 1905-7415
Language: English
Page range: 111 - 118
Published on: Jun 30, 2021
Published by: Chulalongkorn University
In partnership with: Paradigm Publishing Services
Publication frequency: 6 issues per year

© 2021 Aatik Arsh, Haider Darain, Irfan Ullah, Syed Shakil-ur-Rehman, published by Chulalongkorn University
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.