Article

People with lower limb amputations frequently have impaired balance
ability. The Berg Balance Scale (BBS) has excellent psychometric properties for
people with neurologic disorders and elderly people dwelling in the community. A
Rasch analysis demonstrated the validity of the BBS for people with lower limb
amputations of all ability strata, but rater reliability has not been tested.
The study objective was to determine the interrater reliability and
intrarater reliability of BBS scores and the differences in scores assigned by
testers with various levels of experience when assessing people with lower limb
amputations. DESIGN: This reliability study of video-recorded single-session BBS
assessments had a cross-sectional design. METHODS: From a larger study of people
with lower limb amputations, 5 consecutively recruited participants using
prostheses were video recorded during an in-person BBS assessment. Sixteen
testers independently rated the video-recorded assessments. Testers were 3
physical therapists, 1 occupational therapist, 3 third-year and 4 second-year
doctor of physical therapy (DPT) students, and 5 first-year DPT students without
clinical training. Rater reliability was calculated using intraclass correlation
coefficients (ICC [2,k]). Differences in scores assigned by testers with various
levels of experience were determined by use of an analysis of variance with Tukey
post hoc tests. RESULTS: The average age of the participants was 53.0 years
(SD=15.7). Amputations had occurred at the ankle disarticulation, transtibial,
and transfemoral levels because of vascular, trauma, and medical etiologies an
average of 8.2 years earlier (SD=7.9). Berg Balance Scale scores spanned all
ability strata. Interrater reliability (ICC [2,k]=.99) and intrarater reliability
of scores determined in person and through video-recorded assessments by the same
testers (ICC [2,k]=.99) were excellent. For participants with the lowest levels
of ability, licensed professionals assigned lower scores than did DPT students
without clinical training. LIMITATIONS: Intrarater reliability calculations were
based on 2 testers. CONCLUSIONS: Berg Balance Scale scores assigned to people
using prostheses by testers with various levels of clinical experience had
excellent interrater reliability and intrarater reliability.

Langue : ANGLAIS