The primary objective of this systematic review was to evaluate the psychometric properties of the ABC scale and its various versions, across multiple populations and conditions, in alignment with the COSMIN 2024 guidelines.
A systematic literature search was conducted across MEDLINE, EMBASE, Scopus, PsycINFO, Web of Science, and CINAHL, from the inception of the ABC scale until August 2024. Studies reporting at least one psychometric property of the ABC scale in adult populations were included. Data extraction focused on various psychometric properties, including internal consistency, criterion validity, construct validity, reliability, and responsiveness, as defined by the the COSMIN guideline for conducting systematic reviews of patient-reported outcome measures version 2.0. Methodological quality was appraised using the COSMIN Risk of Bias checklist and recommendation on the quality of the measure was made using GRADE .
Seventy-two studies involving 13,372 participants from 20 countries and across 17 languages were included. The review found strong evidence supporting the internal consistency (Cronbach’s α > 0.80), construct validity (correlation coefficients ≥ 0.50), and responsiveness of the ABC scale in populations with conditions such as vestibular disorders, lower-limb amputation, stroke, and Parkinson’s disease. However, some evidence indicated structural validity concerns in certain populations, such as those with complex neurological disorders. Limited evidence was found regarding measurement error and test-retest reliability across different language versions.
The ABC scale demonstrates strong psychometric properties, making it a reliable tool for assessing balance confidence in various populations. However, further research is needed to refine its structural validity and explore its performance in populations with neurological disorders. Future studies should also investigate the minimal clinically important differences and measurement error across different versions of the ABC scale.
The results provide clinicians with strong evidence to continue using the ABC scale in assessing balance confidence. It supports its integration into rehabilitation programs for improving balance-related outcomes and reducing fall risk. Additionally, the review informs the development of culturally adapted versions of the ABC scale for use in diverse clinical settings.
Psychometrics
Systematic Review
