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5點量尺與3點量尺量表之反應性比較:在伯格式平衡量表之發現

Comparison of Responsiveness of 5-point Scale and 3-point Scale: The Findings on the Berg Balance Scale

摘要


Background and Purpose: Increasing the number of points in the scale of individual items is often used to improve the responsiveness of a scale. However, this principle has been challenged recently. The purpose of this study was to compare the responsiveness of the original 5-point Berg balance scale (BBS-5P) with a recoded 3-poing BBS (BBS-3P) in patients after a stroke. Methods: Forty-six stroke inpatients receiving rehabilitation participated in this study. The BBS was used to assess the patients’ balance at admission and 14 days after admission to the Physical Medicine and Rehabilitation Department of National Taiwan University Hospital. The three points in the center of the BBS were recoded as a single point, thus making a new three-point scale (BBS-3P). Results: Three indices of responsiveness obtained from the BBS-5P and BBS-3P are listed as follows: 1. effect size d: 0.59 for BBS-5P and 0.68 for BBS-3P; 2. standardized response mean: 1.39 for BBS-5P and 1.44 for BBS-3P; and 3. p value using the Wilcoxon’s signed ranks test: <0.001 for BBS-5P and <0.001 for BBS-3P. These results indicate that both scales exhibit high and similar responsiveness on stroke inpatients receiving rehabilitation. Furthermore, internal consistency of the BBS-3P was high. The relationship between the BBS-5P and BBS-3P scores was extreme, indicating high concurrent validity of the BBS-3P. Conclusion: The study supports arguments made by previous researchers to the effect that a number of clinical measures are overcomplicated. The BBS could be simplified without sacrificing responsiveness. Further studies are needed to investigate the psychometric characteristics of the simplified BBS. All measures based on a scale larger than three might be carefully re-evaluated in the interest of simplifying measures.

並列摘要


Background and Purpose: Increasing the number of points in the scale of individual items is often used to improve the responsiveness of a scale. However, this principle has been challenged recently. The purpose of this study was to compare the responsiveness of the original 5-point Berg balance scale (BBS-5P) with a recoded 3-poing BBS (BBS-3P) in patients after a stroke. Methods: Forty-six stroke inpatients receiving rehabilitation participated in this study. The BBS was used to assess the patients’ balance at admission and 14 days after admission to the Physical Medicine and Rehabilitation Department of National Taiwan University Hospital. The three points in the center of the BBS were recoded as a single point, thus making a new three-point scale (BBS-3P). Results: Three indices of responsiveness obtained from the BBS-5P and BBS-3P are listed as follows: 1. effect size d: 0.59 for BBS-5P and 0.68 for BBS-3P; 2. standardized response mean: 1.39 for BBS-5P and 1.44 for BBS-3P; and 3. p value using the Wilcoxon’s signed ranks test: <0.001 for BBS-5P and <0.001 for BBS-3P. These results indicate that both scales exhibit high and similar responsiveness on stroke inpatients receiving rehabilitation. Furthermore, internal consistency of the BBS-3P was high. The relationship between the BBS-5P and BBS-3P scores was extreme, indicating high concurrent validity of the BBS-3P. Conclusion: The study supports arguments made by previous researchers to the effect that a number of clinical measures are overcomplicated. The BBS could be simplified without sacrificing responsiveness. Further studies are needed to investigate the psychometric characteristics of the simplified BBS. All measures based on a scale larger than three might be carefully re-evaluated in the interest of simplifying measures.

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