Reliability and validity of the community balance and mobility scale in individuals with multiple sclerosis

Aims: This study aims to evaluate the reliability and validity of the Community Balance and Mobility Scale (CB&M) in people with multiple sclerosis (PwMS).

Methods: A total of 65 PwMS (Expanded Disability Status Scale (EDSS) ≤ 5.5) were included in the study. Test-retest, internal consistency (item-total score correlation, Cronbach's alpha coefficient) intra-rater, and inter-rater reliability were investigated for the reliability of the CB&M. For intra-rater and inter-rater reliability, CB&M measurements of 34 PwMS were videotaped. The validity of the CB&M was assessed through criterion (predictive and concurrent validity) and construct validity. Construct validity was evaluated using hypothesis testing which included examining correlations with EDSS, Timed Up and Go Test (TUG), and Dynamic Gait Index (DGI).

Results: Test-retest reliability demonstrated a good to excellent correlation (ICC = 0.995, p < 0.001). Cronbach's alpha was 0.971 (p < 0.001). Intra-rater (ICC = 0.993, p < 0.001) and inter-rater reliability (ICC = 0.986, p < 0.001) of the CB&M were also good to excellent. Cohen's kappa range values ​​of the scale vary between 0.958 - 0.665, and the percentage agreement varies between 97% and 75%. For the convergent validity of CB&M, strong correlations were observed with EDSS (r=-0.831, p < 0.001), TUG (r=-0.854, p < 0.001), and DGI (r = 0.865, p < 0.001). Additionally, the CB&M demonstrated an excellent correlation with the BBS (r = 0.907, p < 0.001). The scale exhibited no floor-ceiling effect.

Conclusion: CB&M is a reliable and valid tool for assessing balance and mobility in PwMS and offers significant advantages for evaluating balance in PwMS, as it provides comprehensive information about the balance and mobility requirements essential for community living.