Psychometric properties of the Community Balance and Mobility Scale for people with stroke

BACKGROUND: Community Balance and Mobility Scale (CB&M) is a comprehensive performance-based measure developed to assess functional balance and mobility. It represents a potential balance assessment tool for higher functioning stroke survivors. AIM: The aim of this study was to investigate the psychometric property of CB&M in people with stroke. DESIGN: A methodological study evaluating the psychometric properties. SETTING: The setting of the study was a university-based rehabilitation center. POPULATION: Sixty people with stroke and thirty healthy older adults were included in this study. METHODS: Participants were recruited from community and assessed using CB&M and other well-established scales. Statistical analyses included descriptive statistics, 7-day test-retest reliability, inter-rater reliability and construct validity testing and receiver operating characteristic curve analysis. RESULTS: The CB&M demonstrated excellent internal consistency (Cronbach's α=0.943), inter-rater reliability (intraclass correlation coefficient = 0.992), and test-retest reliability (intraclass correlation coefficient = 0.983). The CB&M Score showed good to excellent correlations with the Berg Balance Scale (r=0.880, P<0.001) and 10-Metre Walk Test at maximum speed (r=-0.763, P<0.001), significant positive correlations with the Fugl-Meyer Assessment, ankle dorsiflexor strength on the affected side, and components of limits of stability test (r=0.341 - 0.631, P<0.01); and significant negative correlations with reaction time in limits of stability test, 10-Metre Walk Test at usual speed, Timed Up and Go test, and the routine activities domain of the questionnaire (r=-0.283 - -0.715, P<0.05). Receiver operating characteristic curve analysis revealed that a cutoff score of 62 could distinguish balance performance (area under the curve = 0.966) with high sensitivity (90.0%) and specificity (95.0%). CONCLUSIONS: The CB&M is a reliable, valid, sensitive, and specific clinical performance measure for evaluating balance ability in individuals with stroke aged 55 years or above. CLINICAL REHABILITATION IMPACT: Clinicians can use this tool to efficiently detect subtle balance and mobility deficits in higher-functioning stroke survivors. It can help clinicians identify those at risk for community mobility limitations and guide targeted rehabilitation to enhance community participation.