Reliability and validity of five balance assessments battery in individuals with schizophrenia

Purpose: This study examines the test-retest reliability, concurrent and discriminant validity of Star excursion balance test (SEBT), One-leg stance (OLS), Functional reach test (FRT), Timed up-and-go test (TUG), and Tandem walking test (TW) in individuals with schizophrenia. Methods: Thirteen participants with schizophrenia who had a history of falls and 13 age-matched controls with schizophrenia who had no history of falls received the five balance assessments battery to establish test-retest reliability. A force platform was administered to examine concurrent validity, while balance assessment performance between fallers and non-fallers was examined for discriminant validity. Conventional receiver operating characteristic curve analysis was used to estimate the optimal cutoff scores. Results: Based on the 95% confidence interval of the intraclass correlation coefficients (ICC), the test-retest reliability was good for SEBT and TUG (ICC = .92 -.99) but poor for TW (eyes open) (ICC = .15 -.74). Concurrent validity with force platform parameters showed a larger amount of significant correlations for SEBT (with r_s = -.738∼-.392) and TUG (with r_s = .401-.771) and low for OLS (with r_s = -.494∼-.398). The discriminant validity was established for SEBT and TUG. The highest area under the curves (AUC >.8) was noted for SEBT and TUG, demonstrating better sensitivity and specificity. The cutoff score for specific assessment was also provided. Conclusion: The SEBT and TUG demonstrated better reliability and validity for examining the balance functions of individuals with schizophrenia. Furthermore, with the larger AUC, the SEBT and TUG showed superior performance in identifying fall risks.