The Activities-specific Balance Confidence (ABC) Scale.

BACKGROUND This study provides a replication of the Falls Efficacy Scale (FES) and a head-to-head comparison with the Activities-specific Balance Confidence (ABC) Scale designed to include a wider continuum of activity difficulty and more detailed item descriptors. METHODS Items for the newly developed 16-item ABC Scale were generated by 15 clinicians and 12 elderly outpatients. Psychometric testing involved 60 community seniors (aged 65-95) self-classified as either high or low in mobility confidence according to their perceived need for a walking aid and personal assistance to ambulate outdoors. RESULTS Both the FES and ABC scales were found to be internally consistent and demonstrated good test-retest reliability, convergent and criterion validity. Scalogram analyses indicated a stronger cumulative scale in the case of the ABC and skewness in the distribution of FES scores. While both scales were able to discriminate between the two mobility groups, the ABC scale was a more efficient discriminator and yielded a wider range of responses. CONCLUSIONS The present study provided additional psychometric support for the FES. However, the greater item responsiveness of the ABC scale makes it more suitable to detect loss of balancing confidence in more highly functioning seniors. Greater situation-specificity of items may also assist clinicians in targeting appropriate interventions.