Intrarater and Interrater Reliability of the Hierarchical Balance Short Forms in Patients With Stroke
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Updated: Mar 17, 2026
Quantitative Static and Dynamic Assessment of Balance Control in Stroke Patients
Published on: May 17, 2020
Wan-Hui Yu1, Kuan-Lin Chen2, Sheau-Ling Huang3
1School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Objective:
To examine the intrarater and interrater reliability of a quick balance measure, the Hierarchical Balance Short Forms (HBSF), in outpatients with stroke receiving rehabilitation.
Design:
A repeated-assessments design (1wk apart) was used to examine the intrarater and interrater reliability of the HBSF. The HBSF was administered by a single rater in the intrarater reliability study and by 2 raters in the interrater reliability study. The raters had sufficient working experience in stroke rehabilitation.
Setting:
Seven teaching hospitals.
Participants:
Two independent groups of outpatients (N=106; each group, n=53) with stroke in chronic stages and in stable medical condition were recruited.
Interventions:
Not applicable.
Main Outcome Measure:
HBSF.
Results:
For the intrarater reliability study, the values of the intraclass correlation coefficient (ICC), minimal detectable change (MDC), and percentage of minimal detectable change (MDC%) were .95, 1.02, and 16.3%, respectively, for the HBSF. The 95% limits of agreement (LOA) of the HBSF ranged from -.69 to 1.19. For the interrater reliability study, the values of the ICC, MDC, and MDC% were .91, 1.22, and 18.3%, respectively, for the HBSF. The 95% LOA of the HBSF ranged from -1.01 to 1.35.
Conclusions:
Our results suggest that the HBSF has satisfactory intrarater and interrater reliability for assessing balance function in outpatients with stroke. The MDC values of the HBSF are useful for both researchers and clinicians to determine whether the change in balance function of an individual patient is real when administered by an individual rater or by different raters.
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