Discriminative and predictive validity of the short-form activities-specific balance confidence scale for predicting fall of stroke survivors.
SeungHeon An, Yunbok Lee, DongGeon Lee and 3 others
PMID 28533616WHAT IT FOUND
The short-form ABC scale predicted falls in stroke survivors with high accuracy.
A score of 45.42 or lower indicated a higher risk of multiple falls. This shorter tool performed better than the full 16-item scale and takes less time to administer.
Key findings
01A short-form ABC scale score of 45.42 or lower significantly predicted the likelihood of experiencing multiple falls.
02The short-form scale had higher sensitivity (86%) and negative predictive value (91%) for identifying fall risk compared to the full ABC scale.
03The short-form scale correlates strongly with the full ABC scale and functional measures like the Berg Balance Scale.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was retrospective and cross-sectional, meaning fall history was collected by interview rather than observed prospectively, which introduces recall bias. The sample size was small (43 participants), and the faller group was particularly small (14 participants), which may limit the generalizability of the cutoff scores. The study only included stroke survivors who could walk at least 10 cm without aids, so the results do not apply to more severely impaired patients. The short-form scale showed a lower negative predictive value for the full scale, but the full scale's sensitivity was also lower, suggesting both tools have room for improvement in complex populations.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Kyungnam University Institutional Review Board.
The easy way to misread this
Do not assume the 45.42 cutoff is a universal diagnostic standard. This value was derived from a small, specific group of chronic stroke survivors who could already ambulate short distances. It may not apply to acute stroke patients, those with severe mobility limitations, or populations with different fall histories.