Cross-Cultural Adaptation and Reliability of the Berg Balance Scale in Hindi

Abstract

Context: Use of outcome measurement is an important part of modern professional practice. The Berg Balance Scale (BBS) appears to be used in many Indian rehabilitation centres, but no official version has been previously available in Hindi. The BBS was translated into Hindi by the current authors according to accepted guidelines and tested for reliability. Aims: To translate the Berg Balance Scale into Hindi and investigate the inter-rater reliability when applied to geriatric patients. Setting/Design: Translation of BBS in Hindi according to guidelines for cross-cultural validation of an outcome measurement was conducted at a renowned institute for orthopedic and rehabilitation in India. Methods and Materials: The study was approved by the University Research Ethics Committee. The study involved an initial cross-cultural translation following four stages: 1) Forward Translation 2) Synthesis of translation 3) Backward Translation 4) Expert Committee. Expert committee was formed by purposive sampling comprising of experienced health professionals and language experts. For reliability testing, thirty patient participants were recruited from an Indian Orthopaedic hospital. Reliability testing was done by two experienced physiotherapists. Statistical Analysis Used: Weighted Kappa (Kw) was used to assess inter-rater reliability for the total scores and each individual item of BBS. Intraclass correlation coefficient was calculated to make comparisons of the inter-rater reliability with results of other studies. Results: The Intra-class correlation coefficient (ICC) for the total score of the BBS was 0.977(95% Confidence Interval= 0.951-0.989). The Kw for total score of BBS was 0.819 (95% Confidence Interval = 0.734-0.905). Conclusion: Hindi version of BBS appears to have excellent inter-rater reliability when used by experienced physiotherapists for rehabilitation of geriatric patients.