To examine the interrater and intrarater reliability of the Balance Computerized Adaptive Test (Balance CAT) in patients with chronic stroke having a wide range of balance functions.
Repeated assessments design (1wk apart).
Seven teaching hospitals.
A pooled sample (N=102) including 2 independent groups of outpatients (n=50 for the interrater reliability study; n=52 for the intrarater reliability study) with chronic stroke.
Main Outcome Measures
For the interrater reliability study, the values of intraclass correlation coefficient, minimal detectable change (MDC), and percentage of MDC (MDC%) for the Balance CAT were .84, 1.90, and 31.0%, respectively. For the intrarater reliability study, the values of intraclass correlation coefficient, MDC, and MDC% ranged from .89 to .91, from 1.14 to 1.26, and from 17.1% to 18.6%, respectively.
The Balance CAT showed sufficient intrarater reliability in patients with chronic stroke having balance functions ranging from sitting with support to independent walking. Although the Balance CAT may have good interrater reliability, we found substantial random measurement error between different raters. Accordingly, if the Balance CAT is used as an outcome measure in clinical or research settings, same raters are suggested over different time points to ensure reliable assessments.
List of abbreviations:ANOVA (analysis of variance), BBS (Berg Balance Scale), CAT (computerized adaptive test), ICC (intraclass correlation coefficient), LOA (limits of agreement), MDC (minimal detectable change), MDC% (percentage of minimal detectable change), PASS (Postural Assessment Scale for Stroke Patients)
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- The relationship between balance, disability, and recovery after stroke: predictive validity of the Brunel Balance Assessment.Neurorehabil Neural Repair. 2007; 21: 341-346
- Measuring balance in the elderly: preliminary development of an instrument.Physiother Can. 1989; 41: 304-311
- Validation of a standardized assessment of postural control in stroke patients the Postural Assessment Scale for Stroke Patients (PASS).Stroke. 1999; 30: 1862-1868
- Analysis and comparison of the psychometric properties of three balance measures for stroke patients.Stroke. 2002; 33: 1022-1027
- Development of a computerized adaptive test for assessing balance function in patients with stroke.Phys Ther. 2010; 90: 1336-1344
- Computerized adaptive testing: a primer.Lawrence Erlbaum Associates, Mahwan2000
- A comparison of responsiveness and predictive validity of two balance measures in patients with stroke.J Rehabil Med. 2012; 44: 176-180
- Comparison of the test-retest reliability of the Balance Computerized Adaptive Test and a computerized posturography instrument in patients with stroke.Arch Phys Med Rehabil. 2014; 95: 1477-1483
- Measurement reliability.J Am Acad Child Adolesc Psychiatry. 2001; 40: 486-488
- Rating scales for neurologists.J Neurol Neurosurg Psychiatry. 2003; 74: iv22-iv26
- Foundations of clinical research: applications to practice.3rd ed. Pearson Prentice Hall, Upper Saddle River2009
- A guideline of selecting and reporting intraclass correlation coefficients for reliability research.J Chiropr Med. 2016; 15: 155-163
- Criteria for assessing the tools of disability outcomes research.Arch Phys Med Rehabil. 2000; 81: S15-S20
- Statistical methods for assessing agreement between two methods of clinical measurement.Lancet. 1986; 1: 307-310
- Measuring agreement in method comparison studies.Stat Methods Med Res. 1999; 8: 135-160
- Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine.Sports Med. 1998; 26: 217-238
- Interpreting change scores of tests and measures used in physical therapy.Phys Ther. 2006; 86: 735-743
- The test-retest reliability of 2 mobility performance tests in patients with chronic stroke.Neurorehabil Neural Repair. 2007; 21: 347-352
- Reliability and responsiveness of the activities of daily living computerized adaptive testing system in patients with stroke.Arch Physical Med Rehabil. 2014; 95: 2055-2063
- Intrarater and interrater reliability of the Hierarchical Balance Short Forms in patients with stroke.Arch Physical Med Rehabil. 2016; 97: 2137-2145
- Evaluating patient-based outcome measures for use in clinical trials.Health Technol Assess. 1998; 2 (1-74): i-iv
- What is sufficient evidence for the reliability and validity of patient-reported outcome measures?.Value Health. 2007; 10: S94-S105
- Psychometric evaluation of self-report outcome measures for prosthetic applications.J Rehabil Res Dev. 2016; 53: 797-812
- Test-retest reliability and minimal detectable change of two simplified 3-point balance measures in patients with stroke.Eur J Phys Rehabil Med. 2017; 53: 719-724
- Test-retest reliability and responsiveness of the Barthel Index-based Supplementary Scales in patients with stroke.Eur J Phys Rehabil Med. 2017; 53: 710-718
- Individual-level responsiveness of the original and short-form postural assessment scale for stroke patients.Phys Ther. 2013; 93: 1377-1382
- Inter-rater agreement and stability of functional assessment in the community-based elderly.Arch Phys Med Rehabil. 1994; 75: 1297-1301
Published online: April 10, 2018
© 2018 by the American Congress of Rehabilitation Medicine