Activities-specific balance confidence in people with multiple sclerosis

Area of Science:

• Neurology
• Rehabilitation Science
• Clinical Assessment

Background:

• Multiple sclerosis (MS) frequently causes gait and balance impairments.
• Assessing balance confidence is crucial for managing daily activities and participation in people with MS (PwMS).
• The Activities-specific Balance Confidence scale (ABC) is a widely used measure, but its validity in PwMS requires further evaluation.

Purpose of the Study:

• To evaluate the validity and reliability of the ABC scale in PwMS.
• To determine if the ABC scale can differentiate between fallers and non-fallers, and users and non-users of walking aids.

Main Methods:

• A multicentre, cross-sectional study involving 84 PwMS with mild-to-moderate disability (EDSS 1-6).
• Validation involved comparing ABC scores with objective measures like the Timed Up and Go test, 25-foot Timed Walk Test, and MS Walking Scale.
• Internal consistency and inter-item correlations were assessed using Cronbach's alpha.

Main Results:

• The ABC scale demonstrated moderate to good concurrent convergent validity with other measures, particularly the 12-item MS Walking Scale.
• The ABC scale effectively discriminated between individuals who reported multiple falls and those who did not.
• Ecological validity was supported by the scale's ability to differentiate between users and non-users of assistive walking devices.

Conclusions:

• The ABC scale is a valid and reliable instrument for assessing balance confidence in people with mild-to-moderate MS.
• Findings suggest that PwMS often experience reduced balance confidence, potentially limiting their societal participation.
• The ABC scale can inform clinical practice and rehabilitation strategies for this population.