The Minimal Detectable Change for Balance and Balance Confidence After Chronic Spinal Cord Injury.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Balance and balance confidence are frequently impaired in individuals with incomplete spinal cord injury (iSCI), increasing fall risk.
• The Berg Balance Scale (BBS) and Activities-specific Balance Confidence (ABC) Scale are used to assess these impairments, but clinically significant changes are not well-defined.
• Determining the minimal detectable change (MDC) is crucial for understanding meaningful improvements in iSCI patients.

Purpose of the Study:

• To determine the minimal detectable change (MDC) for the BBS and ABC Scale in individuals with iSCI.
• To assess the test-retest reliability of the BBS and ABC Scale in this population.
• To stratify MDC by primary means of community mobility.

Main Methods:

• Fifty individuals with C1-T10 iSCI and walking speeds <1.0 m/s were recruited.
• The BBS and ABC Scale were administered twice using a population-specific standardization protocol by varied assessors.
• Test-retest reliability was assessed using the intraclass correlation coefficient, and MDC95 was calculated.

Main Results:

• Both the BBS and ABC Scale demonstrated excellent test-retest reliability in the iSCI population.
• The overall MDC95 for the BBS was 8.0 points, with lower values for community ambulators (5.4 points) than community wheelchair users (10.3 points).
• The MDC95 for the ABC Scale was 16.6%, showing similar values for ambulators (15.6%) and wheelchair users (17.5%).

Conclusions:

• The BBS and ABC Scale exhibit excellent test-retest reliability in individuals with iSCI when using a standardized protocol.
• The MDC for the BBS in iSCI is slightly higher than in other neurological conditions.
• The MDC for the ABC Scale in iSCI is comparable to other neurological populations, providing valuable benchmarks for clinical practice.