Usefulness of the Kansas University Standing Balance Scale in inpatient rehabilitation: a retrospective validation study

Abstract

Adequate balance assessment is essential for designing rehabilitation programs and preventing falls. This study aimed to report the cross-cultural adaptation of the Korean version of the Kansas University Standing Balance Scale (KUSBS), investigate its concurrent and predictive validities, and examine aging-related differences. The adaptation was performed using a standard protocol. In this retrospective study, 1179 patients were included and classified into adult, young-old, old-old, and oldest-old groups. Furthermore, we compared the concurrent, discriminant, and predictive validities of the KUSBS and Berg Balance Scale (BBS). Nonparametric analysis was also conducted. The Spearman rho test revealed strong correlation coefficients between the KUSBS and BBS (rs > 0.7; P < 0.001). At admission, the relationship was strong in the adult, young-old, and old-old groups (rs = 0.931, 0.913, and 0.914, respectively; P < 0.001) but not the oldest-old group (rs = 0.790; P < 0.001). At discharge, the correlation coefficients were above 0.9 in all groups. Additionally, the relationship between the changes in both scales was moderate-to-strong (rs > 0.68; P < 0.001). The predictive validity for independent walking of the KUSBS was strong (rs = 0.791; P < 0.001) and significantly lower than that of the BBS (rs = 0.833; P < 0.001; Z = −3.001; P = 0.003). Furthermore, the cutoff value of the KUSBS at admission to predict independent ambulatory walkers at discharge was 3.5 in ordinal ranking in all age groups. The KUSBS is a reliable and effective tool for measuring balance in patients in inpatient rehabilitation.