Fear of falling in patients with stroke: a reliability study

Abstract

Objective: To examine the scaling properties and test–retest reliability of an expanded version of the Falls Efficacy Scale (FES) and to compare group differences in the scores. The expanded version focuses on more basic, primary activities of daily living (ADL), which makes the scale more suitable for subjects with moderate to low functional ability, e.g. patients with stroke. Design: A test–retest reliability study with one group convenience sample. Setting: Two day-care units: a rehabilitation unit and a geriatric rehabilitation unit. Subjects: A volunteer sample of 30 patients (mean age 65 years, SD 11 years) who had sustained stroke between 5 and 84 months prior to the investigation. Main outcome measure: A 13-activity questionnaire (the Swedish modification of the Falls Efficacy Scale (FES(S)) comprising the 10 activities of the original FES and three additional activities was used. Falls efficacy was rated on a 10-point visual analogue scale for each activity on two occasions, 5–22 (mean 10, Md 7) days apart. Results: The overall test–retest reliability of the FES(S) was high (intraclass correlation coefficient (ICC) = 0.97). The ICC for the personal ADL (items 1–6) scores was 0.93 and for the instrumental ADL (items 8–13) 0.97. ICC for the individual items ranged from 0.76 to 0.97. Conclusions: On the basis of these preliminary findings, the FES(S) appears to have acceptable test–retest reliability. The test may be a reasonable addition for assessing stroke patients with balance disturbances and risk for falls.