Relevance of the Activities-Specific Balance Confidence (ABC) Scale to Urban Community-Dwelling Adults With Diagnosed Vestibular Dysfunction

Published:September 29, 2022DOI:


      • The Activities-based Balance Confidence Scale has been used to measure fall risk.
      • The relevancy of these questions has not been evaluated for an urban population.
      • Distributed a modified ABC survey assessing the relevance of individual prompts.
      • Found certain items were less relevant to those in an urban setting.


      To determine how relevant the items on the activities-specific balance confidence (ABC) scale are to patients living in an urban setting and to evaluate additional items relevant to urban populations but not included in the current version of the scale.


      Cross-sectional clinical survey.


      Urban, tertiary vestibular rehabilitation clinic.


      Vestibular rehabilitation clinic outpatients (N=103).



      Main Outcome Measures

      Relevance of 16 day-to-day tasks on the ABC scale on a scale of 0 (not performed) to 10 (performed regularly); median relevancy score (MRS) for most relevant items.


      One hundred three participants (73.7% female, mean age 61.5± years) with vestibular disorders completed the survey. The items with the highest MRS were walking around a house (MRS=10), reaching for a shelved item eye level (MRS=9), taking the stairs (MRS=7), bending over and picking up a slipper (MRS=7), and stepping onto or off an escalator while holding the railing (MRS=7). Lowest MRS items to someone living in an urban environment included walking across a parking lot to the mall (MRS=0) and walking outside the house to a car parked in the driveway (MRS=0). The most common functional activities not addressed by ABC score included navigating the subway/public transit (35.9%) and walking through crowds (32.0%).


      This study revealed insights about important activities of daily living for those in an urban setting. Results show that the ABC scale should be modified to better reflect the specific activities of urban dwellers.


      List of abbreviations:

      ABC (activities-specific balance confidence), MRS (median relevancy score)
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