Original article
Development and Validation of the Balance Outcome Measure for Elder Rehabilitation

https://doi.org/10.1016/j.apmr.2007.09.012Get rights and content

Abstract

Haines T, Kuys SS, Morrison G, Clarke J, Bew P, McPhail S. Development and validation of the Balance Outcome Measure for Elder Rehabilitation.

Objective

To develop and investigate the internal consistency, criterion-related validation, and minimum clinically significant difference of a new standing balance outcome measure for Elder Rehabilitation.

Design

Three phases: (1) cross-sectional survey with expert panel, (2) multicenter prospective cohort randomly divided into development and validation datasets, and (3) prospective cohort (single site).

Setting

Geriatric and rehabilitation units across 2 states in Australia.

Participants

A total of 1769 admissions across 17 geriatric assessment and rehabilitation units.

Interventions

Not applicable.

Main Outcome Measures

The Balance Outcome Measure for Elder Rehabilitation (BOOMER) consisted of the step test, Timed Up & Go test, Functional Reach Test, and static standing with feet together and eyes closed test. Criterion-related validity was established through comparison to the Modified Elderly Mobility Scale (MEMS) and the FIM motor score.

Results

Items of the BOOMER were already used at a majority of rehabilitation facilities surveyed. The BOOMER showed high levels of internal consistency (Cronbach α>.87) and had good correlation with the FIM motor and the MEMS (ρ>.72). The minimum clinically significant change in the BOOMER was 3 points over a 17-point scale range.

Conclusions

The BOOMER is a clinically applicable measure of standing balance among older rehabilitation patients with evidence of content and construct validity.

Section snippets

Methods

This study was conducted in 3 phases.

Phase 1

Responses to the phase 1 survey were received from 16 of the 22 QRPN member sites contacted. Eight tests (step test, TUG test, FRT, static standing with eyes closed and feet together, static tandem stance, single-leg stance, standing with feet together and eyes open, ten-meter walk test) were currently used by at least 11 of the 16 sites. One site responded that they would not be willing to use 2 of the tests (static tandem stance, single-leg stance) as a part of their standard practice. From

Discussion

The BOOMER is a new measure of standing balance impairment designed specifically for practical implementation in elder rehabilitation health care settings. We contend that the BOOMER balances the competing needs of a tool to adequately sample and scale a range of items to ensure the construct validity of the instrument while also being practically applicable for both clinical and research settings.

Establishing the validity of a measurement tool can be viewed as an ongoing process requiring many

Conclusions

Future research is required to investigate other clinometric properties of the BOOMER. Comparison to other balance scales that provide a global measure of balance, such as the Berg Balance Scale, is necessary to further understand the construct validity of the BOOMER. The resource requirements and patient burden for completing these alternative measures should also be considered in these comparisons. The sensitivity to change of the BOOMER should be investigated in comparison to other scales,

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  • Cited by (0)

    Supported by the University of Queensland New Staff Research Fund.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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