Validity of the modified Berg Balance Scale in adults with intellectual and visual disabilities.
The modified Berg Balance Scale cannot predict falls in adults who have both intellectual disability and visual impairment.
01Research in Context
What this study did
The team tested the modified Berg Balance Scale (mBBS) in adults who have both intellectual disability and visual impairment.
They wanted to know if the scale could predict future falls and if scores matched other balance measures.
What they found
The mBBS showed weak links with other balance tools.
It gave no warning about who would fall later.
The authors conclude the test is not valid for this dual-disability group.
How this fits with other research
Chen et al. (2013) found the Pediatric Balance Scale works well in children with cerebral palsy.
Their positive result clashes with the current negative finding, but the kids had only motor issues and full vision.
Johnson et al. (2009) showed body-size tools are reliable in adults with severe ID, proving some measures do hold up when vision is missing.
Together the papers warn: balance tasks that need sight may fail when eyesight is also impaired.
Why it matters
If you serve adults with both ID and visual impairment, skip the mBBS. Pick fall-risk tools that do not rely on sight, such as timed chair stands or force-plate sway tests. Document the visual status before you choose any balance screen.
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02At a glance
03Original abstract
BACKGROUND: A modified version of the Berg Balance Scale (mBBS) was developed for individuals with intellectual and visual disabilities (IVD). However, the concurrent and predictive validity has not yet been determined. AIM: The purpose of the current study was to evaluate the concurrent and predictive validity of the mBBS for individuals with IVD. METHOD: Fifty-four individuals with IVD and Gross Motor Functioning Classification System (GMFCS) Levels I and II participated in this study. The mBBS, the Centre of Gravity (COG), the Comfortable Walking Speed (CWS), and the Barthel Index (BI) were assessed during one session in order to determine the concurrent validity. The percentage of explained variance was determined by analyzing the squared multiple correlation between the mBBS and the BI, COG, CWS, GMFCS, and age, gender, level of intellectual disability, presence of epilepsy, level of visual impairment, and presence of hearing impairment. Furthermore, an overview of the degree of dependence between the mBBS, BI, CWS, and COG was obtained by graphic modelling. Predictive validity of mBBS was determined with respect to the number of falling incidents during 26 weeks and evaluated with Zero-inflated regression models using the explanatory variables of mBBS, BI, COG, CWS, and GMFCS. RESULTS: The results demonstrated that two significant explanatory variables, the GMFCS Level and the BI, and one non-significant variable, the CWS, explained approximately 60% of the mBBS variance. Graphical modelling revealed that BI was the most important explanatory variable for mBBS moreso than COG and CWS. Zero-inflated regression on the frequency of falling incidents demonstrated that the mBBS was not predictive, however, COG and CWS were. CONCLUSIONS: The results indicated that the concurrent validity as well as the predictive validity of mBBS were low for persons with IVD.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.01.005