Reliability and validity of the balance recovery confidence scale in persons with stroke

Balance recovery confidence represents a salient psychological factor influencing fall risk and functional mobility. The perceived ability to regain balance following a destabilising event may vary substantially among individuals. The Balance Recovery Confidence (BRC) Scale was developed to quantify perceived ability to regain balance across a range of destabilising situations. However, its psychometric properties have not yet been established in persons with stroke.

To translate the BRC Scale into Thai and evaluate its reliability, validity, and ability to discriminate fall history in persons with stroke.

This cross-sectional study translated the BRC into Thai following established guidelines and recruited 180 individuals with subacute or chronic stroke from tertiary rehabilitation centers. Psychometric evaluations included test-retest reliability (ICC), internal consistency (Cronbach's alpha), construct validity (Spearman's correlations with BESTest items 14-18 and the ABC-Thai), and discriminative validity using ROC analysis with fall history as the reference.

The BRC-Thai demonstrated excellent test-retest reliability (ICC = 0.991) and strong correlations with BESTest items 14-18 (r = 0.766) and the ABC-Thai (r = 0.838). Internal consistency was excellent (Cronbach's α = 0.985), with item-total correlations ranging from 0.825 to 0.910. Participants with a history of falls had significantly lower BRC-Thai scores than those without (p < 0.01). ROC analysis (AUC = 0.784) indicated good discriminative ability, with an optimal cutoff score of 95/190 (70.3% sensitivity; 78.3% specificity).

The BRC-Thai is a reliable and valid measure of perceived reactive balance recovery in individuals with stroke.