German version of the Community Balance and Mobility Scale

Translation and evaluation of measurement properties

Deutschsprachige Version der Community Balance and Mobility Scale

Übersetzung und Evaluation der Gütekriterien

Abstract

Background

Tools to detect subtle balance deficits in high-functioning community-dwelling older adults are lacking. The Community Balance and Mobility Scale (CBM) is a valuable tool to measure balance deficits in this group; however, it is not yet available in the German language.

Objective

The aim was 1) to translate and cross-culturally adapt the CBM into the German language and 2) to investigate the measurement properties of the German CBM (G-CBM).

Material and methods

The original CBM was translated into the German language according to established guidelines. A total of 51 older adults (mean age 69.9 ± 7.1 years) were recruited to measure construct validity by comparing the G‑CBM against standardized balance and/or mobility assessments including the Fullerton Advanced Balance Scale (FAB), Berg Balance Scale (BBS), 3 m Tandem Walk (3MTW), 8 Level Balance Scale (8LBS), 30 s Chair Stand Test (30CST), Timed Up and Go (TUG) test, gait speed, and the Falls Efficacy Scale International (FES-I). Intrarater and interrater reliability and internal consistency reliability were estimated using intraclass correlations (ICC) and Cronbach’s alpha, respectively. Ceiling effects were calculated as the percentage of the sample scoring the maximum score.

Results

The G‑CBM correlated excellently with FAB and BBS (ρ = 0.78–0.85; P < 0.001), good with 3MTW, TUG, and FES-I (ρ = −0.55 to −0.61; P < 0.001), and moderately with 8LBS, 30CST, and habitual gait speed (ρ = 0.32–0.46; P < 0.001). Intrarater (ICC3,k = 0.998; P < 0.001) and interrater (ICC2,k = 0.996; P < 0.001) reliability, and internal consistency reliability (α = 0.998) were also high. The G‑CBM did not show ceiling effects.

Conclusion

The G‑CBM is a valid and reliable tool for measuring subtle balance deficits in older high-functioning adults. The absence of ceiling effects emphasizes the use of this scale in this cohort. The G‑CBM can now be utilized in clinical practice.

Zusammenfassung

Hintergrund

Instrumente zur Identifikation leichter Balanceeinschränkungen bei selbstständig zuhause lebenden, älteren Erwachsenen in einer guten körperlichen Verfassung sind bislang für den deutschsprachigen Gebrauch kaum wissenschaftlich evaluiert. Die Community Balance and Mobility Scale (CBM) ist ein geeignetes Instrument zur Erfassung von Balanceeinschränkungen in dieser Personengruppe. Allerdings existiert für die CBM bislang keine deutschsprachige Version.

Ziel

Ziel dieser Studie war 1. die standardisierte Übersetzung der CBM ins Deutsche (G-CBM) und deren interkulturelle Adaptation und 2. die Überprüfung der Gütekriterien der G‑CBM.

Material und Methoden

Die englischsprachige Original-CBM wurde gemäß internationalen Leitlinien übersetzt. In die Studie wurden 51 ältere Erwachsene (69,9 ± 7,1 Jahre) eingeschlossen. Die Konstruktvalidität wurde anhand von Korrelationen mit etablierten Instrumenten zur Balance- und/oder Mobilitätsprüfung, wie der Fullerton Advanced Balance Scale (FAB), Berg Balance Scale (BBS), 3 m Tandemgang (3MTW), 8 Level Balance Scale (8LBS), 30 s-Aufstehtest (30CST), Timed up and Go (TUG) Test, Ganggeschwindigkeit und Falls Efficacy Scale International (FES-I), bestimmt. Zudem wurden Intrarater- und Interrater-Reliabilität (Intraklassenkorrelationskoeffizient, [ICC]) und interne Konsistenz (Cronbachs α) untersucht. Deckeneffekte wurden als Prozentsatz der Probanden, die die maximale Punktzahl erreichten, berechnet.

Ergebnisse

Die G‑CBM korrelierte hoch mit FAB und BBS (ρ = 0,78 bis 0,85; P < 0,001), gut mit 3MTW, TUG, und FES-I (ρ = −0,55 bis −0,61; P < 0,001) sowie moderat mit 8LBS, 30CST und der Ganggeschwindigkeit (ρ = 0,32 bis 0,46; P < 0,001). Die Intrarater- (ICC3,k = 0,998; P < 0,001) und Interrater-Reliabilität (ICC2,k = 0,996; P < 0,001) sowie interne Konsistenz (α = 0,998) waren hoch. Die G‑CBM zeigte keine Deckeneffekte.

Diskussion

Die G‑CBM ist ein valides und reliables Instrument zur Messung leichter Balanceeinschränkungen bei älteren Erwachsenen in guter körperlicher Verfassung. Das Nichtvorhandensein von Deckeneffekten unterstreicht den Nutzen der Skala in dieser Gruppe. Die G‑CBM ist nun für den Einsatz im deutschsprachigen Raum verfügbar.

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Acknowledgements

The study was supported by PreventIT receiving funding from the European Union’s Horizon 2020 research and innovative programme (No. 689238), and from the Klaus Tschira Foundation. We thank Aileen Currie (AC), Carl-Philipp Jansen (CJ), and Lena Schaaf for supporting the translation process and the video-rating.

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Correspondence to Michael Schwenk.

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K. Gordt, S. Mikolaizak, C. Nerz, C. Barz, T. Gerhardy, M. Weber, C. Becker and M. Schwenk declare that they have no competing interests.

Ethical approval was obtained from the local institutional review board of each research centre and is in agreement with the Declaration of Helsinki. All study participants provided written informed consent prior to participation.

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Gordt, K., Mikolaizak, A.S., Nerz, C. et al. German version of the Community Balance and Mobility Scale. Z Gerontol Geriat 52, 28–36 (2019). https://doi.org/10.1007/s00391-018-1374-z

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Keywords

  • Postural balance
  • Assessment
  • Translation
  • Outcome measures
  • Elderly

Schlüsselwörter

  • Gleichgewichtsfähigkeit
  • Assessment
  • Übersetzung
  • Ergebnismessungen
  • Ältere Menschen