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Activities-Specific Balance Confidence Scale

Original Editor - Rucha Gadgil

Top Contributors - Rucha Gadgil, Lauren Lopez, Janine van Dyk, Kim Jackson, Lucinda hampton, Ewa Jaraczewska and Carina Therese Magtibay  

Objective

Activities-specific balance confidence (ABC) scale is a structured questionnaire that measures an individual’s confidence during ambulatory activities without falling or experiencing a sense of unsteadiness. It was developed in 1995 by Powell and Myers, and consists of 16 questions gauging the individual's confidence while doing activities[1].

Intended Population

The ABC scale is reported to be an accurate measure to identify individuals with a fall risk in populations of stroke, multiple sclerosis, Parkinson's, vestibular disorders, in elderly, and in other neurological conditions that can affect balance. Recent studies showed it can assess patients with COPD as well.[2]

Method of Use

  • Its a 16-item questionnaire where patients' rate their confidence while doing activities.
  • Scoring from 0-100 (0 is no confidence and 100 is full confidence)
  • Paper survey, 5-10 mins for administration.
  • No Training required.
  • Permission needs to be obtained before use from the authors.

Questionnaire

The ABC Scale has 16 questions that require the patient to rate his/her confidence that he/she will not lose balance or become unsteady while performing the following activities:

  1. Walking around the house
  2. Walking up or down stairs
  3. Bending over to pick up a slipper from the front of a closet floor
  4. Reaching for a small can off a shelf at eye level
  5. Standing on tiptoes and reaching for something above his/her head
  6. Standing on a chair to reach for something
  7. Sweeping the floor
  8. Walking outside the house to a car parked in the driveway
  9. Getting into or out of a car
  10. Walking across a parking lot to the mall
  11. Walking up or down a ramp
  12. Walking in a crowded mall where people rapidly walk past
  13. Being bumped into people as they walk through the mall
  14. Stepping on to or off an escalator while holding onto a railing
  15. Stepping onto or off an escalator while holding onto parcels (so that they are not able to hold the railing)
  16. Walking outside on icy sidewalks


Myers et al. (1998) use the following cut-off scores to define level of functioning among active older adults[3]:

  1. Lower than 50 %: low level of physical functioning
  2. 50-80 %: moderate level of physical functioning
  3. Above 80 %: high level of physical functioning

[4]

Versions

Apart from the 16-item questionnaire, there is ABC-6 which is a short version consisting of 6 questions.

The scale has also be translated to multiple languages like chines, german etc.

Psychometric Properties

Reliability

  • Internal Consistency: high Internal consistency (a = 0.96) in geriatric population[5], the scale also has a strong test-retest reliability for the total score with a intraclass correlation coefficient of =0.85 and 0.82.
  • Test-Retest reliability: excellent overall test-retest reliability (r=0.92, p<0.001) in elderly, excellent test-retest reliability of the overall score (ICC = 0.85; 95% CI 0.68-0.93), and moderate to strong item level test-retest reliability (ICC ranged from 0.53 – 0.93) in stroke[6]

Validity

  • Criterion validity and construct validity: adequate in stroke patients[7].

Resources

Information about the ABC questionnaire.

References

  1. ↑ Moiz JA, Bansal V, Noohu MM, Gaur SN, Hussain ME, Anwer S, Alghadir A. Activities-specific balance confidence scale for predicting future falls in Indian older adults. Clin Interv Aging. 2017 Apr 10;12:645-651.
  2. ↑ Alsubheen SA, Beauchamp MK, Ellerton C, Goldstein R, Alison JA, Dechman G, et al. Validity of the Activities-specific Balance Confidence Scale in individuals with chronic obstructive pulmonary disease. Expert Review of Respiratory Medicine. 2022 Jun 3;16(6):689–96.
  3. ↑ Myers AM, Fletcher PC, Myers AH, Sherk W. Discriminative and Evaluative Properties of the Activities-specific Balance Confidence (ABC) Scale. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 1998 Jul 1;53A(4):M287–94.
  4. ↑ North 49 Physical Therapy :Activity Specific Balance Confidence Scale Scoring. Available from:www.youtube.com/watch?v=MJkAqA3btr0
  5. ↑ Botner EM, Miller WC, Eng JJ. Measurement properties of the Activities-specific Balance Confidence Scale among individuals with stroke. Disability and rehabilitation [Internet]. 2005;27(4):156–63.
  6. ↑ Seamon BA, Kautz SA, Velozo CA. Rasch Analysis of the Activities-Specific Balance Confidence Scale in Individuals Poststroke. Archives of Rehabilitation Research and Clinical Translation. 2019 Dec;1(3-4):100028.
  7. ↑ Filiatrault J, Gauvin L, Fournier M, Parisien M, Robitaille Y, Laforest S, et al. Evidence of the Psychometric Qualities of a Simplified Version of the Activities-specific Balance Confidence Scale for Community-Dwelling Seniors. Archives of Physical Medicine and Rehabilitation [Internet]. 2007 May 1 [cited 2021 Feb 19];88(5):664–72.
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