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The reliability of four standardized concern for falling scales among adults with a major lower extremity amputation
Kristin Nugent1, Michael W Payne2,3, Ricardo Viana2,3
1Faculty of Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada.
Introduction:
More than 52.4% of people with a lower extremity amputation (PLEA) will fall at least once each year. Previously established standardized scales that evaluate a concern for falling (CFF) were developed primarily among community-dwelling older adults. The reliability of commonly used scales to evaluate a CFF among PLEA is needed.
Objective:
To evaluate test-retest relative and absolute reliability, and agreement of the Modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE), Falls Efficacy Scale - International (FES-I), Consequences of Falling (COF) Scale, Perceived Control Over Falling (PCOF) Scale, and Perceived Ability to Manage Falls (PAMF) Scale among PLEA.
Design:
Web-based cross-sectional repeated-measures study.
Setting:
Rehabilitation hospital.
Participants:
Adults with a transtibial or transfemoral level amputation, who had completed a prosthetic rehabilitation program, and at minimum of 1 year using a prosthesis for ambulation were recruited after regularly scheduled appointments (N = 22, mean age ± SD, 63.5 ± 12.9 years).
Interventions:
Not applicable.
Main Outcome Measure(S):
Initial and re-test scores on the mSAFFE, FES-I, COF, PCOF, and PAMF.
Results:
Intraclass correlation coefficients (ICCs) demonstrated excellent relative reliability of the mSAFFE (ICC = 0.92, 95% confidence interval [CI]: 0.82-0.97), good relative reliability of the FES-I (ICC = 0.87, 95% CI: 0.70-0.94), and fair relative reliability of the COF (ICC = 0.78, 95% CI: 0.53-0.90) and PAMF (ICC = 0.73, 95% CI: 0.46-0.88) scales. The ICC value of the PCOF scale could not be validly calculated and was not further analyzed. Calculated standard error of measurement values for the mSAFFE, FES-I, COF, and PAMF scales were small in magnitude, and Bland-Altman graphs demonstrated good agreement of initial and re-test scores for all scales.
Conclusion:
This study provides initial evidence on the suitability and reliable use of the mSAFFE, FES-I, COF, and PAMF scales within this population. Further evaluation of the validity of these scales is needed.
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