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Erfassung der Gleichgewichtsfähigkeit bei selbstständig lebenden Erwachsenen

Reliabilität und Validität der deutschsprachigen Version der Fullerton Advanced Balance Scale

Assessment of balance in community dwelling older adults

Reliability and validity of the German version of the Fullerton Advanced Balance Scale

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Zusammenfassung

Ziel dieser Studie ist die Validierung der deutschsprachigen Übersetzung der Fullerton Advanced Balance Scale (FAB-D). Die 10-Item-Testbatterie ist ein Instrument zur Erfassung der verschiedenen multisensorischen Dimensionen der Gleichgewichtsfähigkeit. Die mittels der Hin- und Rückübersetzungsmethode ins Deutsche übertragene FAB-D-Skala wurde mit 96 älteren selbstständig lebenden Erwachsenen ohne bisherige Sturzerfahrung (Alter 71,6 ± 7,5 Jahre) und 66 älteren Erwachsenen mit mindestens einem Sturz im letzten halben Jahr (Alter 75,3 ± 7,3 Jahre) durchgeführt. Die Berg-Balance-Skala (BBS), die Activities-Specific-Balance-Confidence(ABC-D)-Skala, der Fragebogen zum Gesundheitszustand SF-36, die Physical Activity Scale for the Elderly (PASE), der Trail-Making-Test (TMT) sowie motorische Testverfahren zu Gleichgewicht, Kraft und Mobilität wurden als Validierungsinstrumente eingesetzt. Explorative und konfirmatorische Faktorenanalysen zeigten für das Einfaktorenmodell die beste Passung. Die interne Konsistenz lag für die deutsche Version der FAB-D-Skala bei 0.988. Die Test-Retest-Reliabilität des Summenscores betrug r = 0.965 und schwankte für die einzelnen Aufgaben zwischen 0.86 und 0.88. Die Skalen stehen in einem inhaltlichen Zusammenhang mit konvergenten Messungen zur posturalen Kontrolle und der sturzassoziierten Selbstwirksamkeit (BBS: r = 0.685; Timed-Up-and-Go-Test: r =−0.632; ABC-D: r = 0.561). Die Kriteriumsvalidität zeigte sich anhand der statistisch bedeutsamen Korrelationen der FAB-D-Gesamtskala mit den Subdimensionen des SF-36 (physisch: 0.52, psychisch: 0.38), der PASE (0.29), dem TMT A (−0.30) und B (−0.41), dem 30-s-Aufstehtest (0.59) sowie dem 10-m-Gehen (normale Geschwindigkeit −0.49; hohe Geschwindigkeit −0.56). Unterschiede in den FAB-D-Skalenwerten fanden sich zwischen Personen mit und ohne Sturzbiographie: Bereits gestürzte Personen wiesen signifikant niedrigere FAB-D-Gesamtwerte (30,3 ± 8,6) auf als Personen ohne aktuelle Sturzbiographie (36,1 ± 4,2). Als Ergebnis lässt sich festhalten, dass die deutsche Version der FAB-D-Skala vergleichbare Gütekriterien zur englischen Originalversion besitzt und damit geeignet ist, die Dimensionen der Gleichgewichtsfähigkeit, zu erheben.

Abstract

The purpose of this study was to validate the German translation of the originally English Fullerton Advanced Balance Scale (FAB-D). The 10-item test battery is a performance-based measure that addresses the multiple dimensions of balance. The German FAB-D using a forward-backward procedure was examined by a sample of n = 96 community dwelling older adults (71,6 ± 7,5 years of age) who had reported no history of a fall in the previous 6 months (non-fallers) and 66 older adults (age 75,3 ± 7,3 years of age) who reported falling one or more times (recurrent fallers). The following internationally accepted instruments were used for validation: The Berg-Balance-Scale (BBS), the Activities-Specific Balance Confidence (ABC-D) scale, the Short Form Health Survey (SF-36), the Physical Activity Scale for the Elderly (PASE), the Trail-Making-Test (TMT), and motor tests (balance, strength, mobility). Explorative and confirmative factor analysis showed the best fit for a one dimensional solution. Cronbach’s alpha of the German version of the FAB-D was 0.988. Test-retest reliability for the total score was 0.965 and ranged from 0.86–0.88 for individual items. The scales correlate with convergent measures assessing postural control and falls-related confidence (BBS, r = 0.685; Timed-Up-and-Go-Test, r = −0.632; ABC-D, r = 0.561). Criterion validity of the FAB-D was established by statistically significant correlations between the total scale, and the subdimensions of the SF-36 (physical 0.52, mental 0.38), the PASE (0.29), the TMT A (−0.30) and B (−0.41), the Chair Rising Test (0.59) and the 10 m walk (normal velocity −0.49; fast velocity −0.56). Significant differences in the FAB-D scores were found in older adults with (30,3 ± 8,6) and without falls (36,1 ± 4,2). Older adults with a recent fall history scored lower on the FAB-D than older adults without a recent fall history. To conclude, the German version of the FAB-D has properties analogous to the original English version and is apparently useful in assessing the multiple dimensions of balance in community dwelling older adults.

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Notes

  1. 17 Untersuchungsteilnehmer verweigerten die Abgabe des Fragebogens; ein weiterer machte keine Angaben zu seinem Körpergewicht.

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  1. Institut für Sport- und Bewegungswissenschaft, Universität Stuttgart, Allmandring 28, 70569, Stuttgart, Deutschland

    N. Schott

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Tab. 7 Testinstruktionen für die deutschsprachige Version der „Fullerton Advanced Balance Scale“ (FAB-D, mod. nach [40], S. 66–68)
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Schott, N. Erfassung der Gleichgewichtsfähigkeit bei selbstständig lebenden Erwachsenen. Z Gerontol Geriat 44, 417–428 (2011). https://doi.org/10.1007/s00391-011-0236-8

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