Inter-rater and intra-rater reliability of the Balance Computerized Adaptive Test in patients with stroke

Publication date: Available online 11 April 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Hsin-Yu Chiang, Wen-Shian Lu, Wan-Hui Yu, I-Ping Hsueh, Ching-Lin Hsieh
ObjectiveTo examine the inter-rater and intra-rater reliability of the Balance Computerized Adaptive Test (Balance CAT) in patients with chronic stroke having a wide range of balance functions.DesignA repeated-assessments design (1 week apart) was used to examine the inter-rater and intra-rater reliability of the Balance CAT. The Balance CAT was administered by 3 raters in the inter-rater reliability study and by 2 raters in the intra-rater reliability study.SettingSeven teaching hospitalsParticipantsTwo independent groups of outpatients (n=50 for the inter-rater reliability study; n=52 for the intra-rater reliability study) with chronic stroke were recruited.InterventionsNot applicable.Main Outcome MeasureBalance CAT.ResultsFor the inter-rater reliability study, the values of ICC, minimal detectable change (MDC), and MDC% for the Balance CAT were 0.84, 1.90, and 31.0%, respectively. For the intra-rater reliability study, the values of ICC, MDC, and MDC% ranged from 0.89 to 0.91, 1.14 to 1.26, and 17.1% to 18.6%, respectively.ConclusionsThe Balance CAT showed sufficient intra-rater reliability in patients with chronic stroke having balance functions ranging from sitting with support to independent walking. While the Balance CAT may have good inter-rater reliability, we found substantial random measurement error between different raters. Accordingly, if the Balance CAT is used as an outcome measure in clinical or research settings, same raters are suggested over different time points to ensure reliable assessments.



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